On June 18, 2024 a
Party Discovery
was filed
involving a dispute between
Dixon, Willie,
Ethos Health Group, Llc.,
and
Government Employees Insurance Company,
for Civil
in the District Court of Hillsborough County.
Preview
Filing # 200770236 E-Filed 06/18/2024 10:18:58 AM
IN THE COUNTY COURT OF THE THIRTEENTH JUDICIAL CIRCUIT
IN AND FOR HILLSBOROUGH COUNTY, STATE OF FLORIDA
CIVIL DIVISION
ETHOS HEALTH GROUP, LLC. as
assignee of WILLIE DIXON,
Plaintiff,
vs. CASE NO.:
GOVERNMENT EMPLOYEES
INSURANCE COMPANY,
Defendant.
___________________________________/
REQUEST FOR ADMISSIONS
Plaintiff, by and through the undersigned attorney, and pursuant to Florida Rules of Civil
Procedure 1.370, requests the Defendant, to admit or deny the following request for admissions:
1. At all times material to the Complaint, Defendant was and is a foreign corporation license
to do business in the State of Florida and engages in business of automobile insurance.
2. Defendant maintains agents in Hillsborough County.
3. The insured was covered under an insurance policy issued by the Defendant at the time of
the accident that is subject of this Complaint.
4. The above referenced automobile insurance policy issued by the Defendant was in full
force and effect for the subject accident.
5. The policy provides coverage for PIP benefits for bodily injuries sustained by the insured
in the subject accident.
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 1
6. The above-styled Court, in and for Hillsborough County, Florida has jurisdiction over the
claim of the Plaintiff against the Defendant.
7. The Defendant has no medical report concerning the Plaintiff’s treatment of the insured
specifically stating the charge for treatment was “not reasonable”.
8. The Defendant has no medical report concerning the Plaintiff’s treatment of the insured
specifically stating the treatment was “not related” to the subject automobile accident.
9. The Defendant has no medical report concerning the Plaintiff’s treatment of the insured
specifically stating the treatment was “not necessary”.
10. The Defendant has not provided the Plaintiff with any reports stating that the Plaintiff’s
treatment was “not reasonable”, “not related” or “not necessary”.
11. The Defendant was furnished with written notice on covered loss and amount of same
with regard to the portions of the insured’s PIP claim, which are the subjects of the
dispute herein.
12. The Defendant never paid or hired a provider for an Independent Exam of the insured.
13. The Defendant never paid or hired a provider for a Peer Review of the Plaintiff’s
treatment of the insured.
14. Thirty days have passed since the Defendant was furnished with written notice of covered
loss and amount of the same regarding the Plaintiff’s treatment of the insured.
15. Defendant has never had “reasonable proof” to establish that Defendant was not
responsible for payment.
16. PIP benefits are due and payable as loss accrues, upon receipt of reasonable proof of such
loss and the amount of expenses and loss incurred which are covered under the policy.
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 2
17. The policy issued by Defendant is required to conform to all requirements of Florida
Statutes Sections 627.730 and 627.7405.
18. Under the policy of insurance with Defendant, all PIP benefits are overdue if not paid
within thirty (30) days after the Defendant is furnished with written notice of the fact of a
covered loss and the amount of the same unless Defendant has reasonable proof to
establish it is not reasonable for the payment.
19. Under the policy in question, all overdue PIP benefits must bear simple interest at the rate
of ten (10%) percent a year.
20. Under the policy in question, the provisions of Florida Statutes Section 627.428 apply to
any dispute between Plaintiff and Defendant concerning the coverage and the provisions
of Florida Statutes Section 627.730 and 627.7405.
21. A multiplier of Load Star for attorney’s fees would be appropriate if Plaintiff has a
contingent fee contract with the undersigned law firm.
22. All benefits previously paid by Defendant on behalf of the Plaintiff have been for
“reasonable”, “related” and “necessary” medical, rehabilitative or remedial treatment for
services.
23. All medical expenses which are the subject of this lawsuit as set out in the Complaint
which are submitted by the Plaintiff to Defendant which have not yet been paid were
“reasonable” in amount.
24. All medical expenses which are the subject of this lawsuit as set out in the Complaint
which were submitted by Plaintiff to Defendant which have not yet been paid were
“related” to the subject automobile accident.
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 3
25. All medical expenses which are the subject of this lawsuit as set out in the Complaint
which were submitted by Plaintiff to Defendant which have not yet been paid were
“related” to the subject automobile accident.
26. Defendant received a properly completed PIP application and medical authorization from
the Plaintiff.
27. Defendant has not paid simple interest at the rate of ten (10%) percent per year for
payments which were not paid within thirty (30) days after the Defendant was furnished
with written notice of the face of a covered loss and the amount of the same.
28. Defendant has not conducted any survey or study of health care providers within the
Plaintiff’s community, in the last five years, to determine amounts charged by other
health care providers for services similar to those provided by the Plaintiff to the insured.
29. The Defendant has no data to support Defendant’s claim that the charges for services
rendered by the Plaintiff were unreasonable as compared to similar health care providers
within the Plaintiff’s community.
30. There has been an assignment of benefits to the Plaintiff by the insured for the benefits
claimed under the insurance policy with Defendant.
31. The Defendant has provided the insured with correspondence or other documentation
indicating the reason or reasons for the denial of benefits at issue in this lawsuit.
32. The Defendant has agreed to indemnify, defend and hold harmless the insured from a
lawsuit brought by Plaintiff against Defendant because of Defendant’s denial of payment
for services rendered by Plaintiff to Defendant’s insured.
33. The Defendant agreed to pay or indemnify the insured for all reasonable legal fees and
costs incurred by him/her, related to any derogatory credit information reported about
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 4
him to any person, arising out of Defendant’s failure to pay personal injury protection
benefits related to the disputed treatment and bill.
34. The Defendant contends that the insured was not in the subject auto accident.
35. The Defendant received bills for services rendered to the Plaintiff.
36. The Defendant received records for services provided to the Plaintiff the same day they
received the bill for services.
37. The Defendant received records for the services provided to the Plaintiff.
I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to
the Defendant, together with the Summons and Complaint.
____/s/ Alexander Licznerski________
ALEXANDER LICZNERSKI, ESQUIRE
Florida Bar No.: 123873
ANTHONY T. PRIETO, ESQUIRE
Florida Bar No.: 195529
MORGAN AND MORGAN
P.O. BOX 451
St. Petersburg, FL 33731
Tel: 727/318-6344 / Fax: 727/318-6374
Attorneys for Plaintiff
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 5
Document Filed Date
June 18, 2024
Case Filing Date
June 18, 2024
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Filing # 200770236 E-Filed 06/18/2024 10:18:58 AM IN THE COUNTY COURT OF THE THIRTEENTH JUDICIAL CIRCUIT IN AND FOR HILLSBOROUGH COUNTY, STATE OF FLORIDA CIVIL DIVISION ETHOS HEALTH GROUP, LLC. as assignee of WILLIE DIXON, Plaintiff, vs. CASE NO.: GOVERNMENT EMPLOYEES INSURANCE COMPANY, Defendant. ___________________________________/ REQUEST FOR ADMISSIONS Plaintiff, by and through the undersigned attorney, and pursuant to Florida Rules of Civil Procedure 1.370, requests the Defendant, to admit or deny the following request for admissions: 1. At all times material to the Complaint, Defendant was and is a foreign corporation license to do business in the State of Florida and engages in business of automobile insurance. 2. Defendant maintains agents in Hillsborough County. 3. The insured was covered under an insurance policy issued by the Defendant at the time of the accident that is subject of this Complaint. 4. The above referenced automobile insurance policy issued by the Defendant was in full force and effect for the subject accident. 5. The policy provides coverage for PIP benefits for bodily injuries sustained by the insured in the subject accident. 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 1 6. The above-styled Court, in and for Hillsborough County, Florida has jurisdiction over the claim of the Plaintiff against the Defendant. 7. The Defendant has no medical report concerning the Plaintiff’s treatment of the insured specifically stating the charge for treatment was “not reasonable”. 8. The Defendant has no medical report concerning the Plaintiff’s treatment of the insured specifically stating the treatment was “not related” to the subject automobile accident. 9. The Defendant has no medical report concerning the Plaintiff’s treatment of the insured specifically stating the treatment was “not necessary”. 10. The Defendant has not provided the Plaintiff with any reports stating that the Plaintiff’s treatment was “not reasonable”, “not related” or “not necessary”. 11. The Defendant was furnished with written notice on covered loss and amount of same with regard to the portions of the insured’s PIP claim, which are the subjects of the dispute herein. 12. The Defendant never paid or hired a provider for an Independent Exam of the insured. 13. The Defendant never paid or hired a provider for a Peer Review of the Plaintiff’s treatment of the insured. 14. Thirty days have passed since the Defendant was furnished with written notice of covered loss and amount of the same regarding the Plaintiff’s treatment of the insured. 15. Defendant has never had “reasonable proof” to establish that Defendant was not responsible for payment. 16. PIP benefits are due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered under the policy. 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 2 17. The policy issued by Defendant is required to conform to all requirements of Florida Statutes Sections 627.730 and 627.7405. 18. Under the policy of insurance with Defendant, all PIP benefits are overdue if not paid within thirty (30) days after the Defendant is furnished with written notice of the fact of a covered loss and the amount of the same unless Defendant has reasonable proof to establish it is not reasonable for the payment. 19. Under the policy in question, all overdue PIP benefits must bear simple interest at the rate of ten (10%) percent a year. 20. Under the policy in question, the provisions of Florida Statutes Section 627.428 apply to any dispute between Plaintiff and Defendant concerning the coverage and the provisions of Florida Statutes Section 627.730 and 627.7405. 21. A multiplier of Load Star for attorney’s fees would be appropriate if Plaintiff has a contingent fee contract with the undersigned law firm. 22. All benefits previously paid by Defendant on behalf of the Plaintiff have been for “reasonable”, “related” and “necessary” medical, rehabilitative or remedial treatment for services. 23. All medical expenses which are the subject of this lawsuit as set out in the Complaint which are submitted by the Plaintiff to Defendant which have not yet been paid were “reasonable” in amount. 24. All medical expenses which are the subject of this lawsuit as set out in the Complaint which were submitted by Plaintiff to Defendant which have not yet been paid were “related” to the subject automobile accident. 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 3 25. All medical expenses which are the subject of this lawsuit as set out in the Complaint which were submitted by Plaintiff to Defendant which have not yet been paid were “related” to the subject automobile accident. 26. Defendant received a properly completed PIP application and medical authorization from the Plaintiff. 27. Defendant has not paid simple interest at the rate of ten (10%) percent per year for payments which were not paid within thirty (30) days after the Defendant was furnished with written notice of the face of a covered loss and the amount of the same. 28. Defendant has not conducted any survey or study of health care providers within the Plaintiff’s community, in the last five years, to determine amounts charged by other health care providers for services similar to those provided by the Plaintiff to the insured. 29. The Defendant has no data to support Defendant’s claim that the charges for services rendered by the Plaintiff were unreasonable as compared to similar health care providers within the Plaintiff’s community. 30. There has been an assignment of benefits to the Plaintiff by the insured for the benefits claimed under the insurance policy with Defendant. 31. The Defendant has provided the insured with correspondence or other documentation indicating the reason or reasons for the denial of benefits at issue in this lawsuit. 32. The Defendant has agreed to indemnify, defend and hold harmless the insured from a lawsuit brought by Plaintiff against Defendant because of Defendant’s denial of payment for services rendered by Plaintiff to Defendant’s insured. 33. The Defendant agreed to pay or indemnify the insured for all reasonable legal fees and costs incurred by him/her, related to any derogatory credit information reported about 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 4 him to any person, arising out of Defendant’s failure to pay personal injury protection benefits related to the disputed treatment and bill. 34. The Defendant contends that the insured was not in the subject auto accident. 35. The Defendant received bills for services rendered to the Plaintiff. 36. The Defendant received records for services provided to the Plaintiff the same day they received the bill for services. 37. The Defendant received records for the services provided to the Plaintiff. I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the Defendant, together with the Summons and Complaint. ____/s/ Alexander Licznerski________ ALEXANDER LICZNERSKI, ESQUIRE Florida Bar No.: 123873 ANTHONY T. PRIETO, ESQUIRE Florida Bar No.: 195529 MORGAN AND MORGAN P.O. BOX 451 St. Petersburg, FL 33731 Tel: 727/318-6344 / Fax: 727/318-6374 Attorneys for Plaintiff 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 5