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Filing # 23180920 E-Filed 01/30/2015 11:49:31 AM
IN THE COUNTY COURT
OF THE SEVENTEENTH JUDICIAL CIRCUIT
IN AND FOR BROWARD COUNTY, FLORIDA
CIVIL DIVISION
CASE NUMBER: 14-010686 CONO (71)
FIRST CHOICE MEDICAL REHAB
CENTER, P.A., (a/a/o Jose L. Pena Correa),
Plaintiff,
YS.
PROGRESSIVE AMERICAN INSURANCE
COMPANY,
Defendant.
/
NOTICE OF SERVING UNVERIFIED ANSWERS TO INTERROGATORIES
COMES NOW, the Defendant, PROGRESSIVE AMERICAN INSURANCE
COMPANY, by and through the undersigned counsel, and files this Notice of Serving
Unverified Answers to Interrogatories propounded by Plaintiff.
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that on this] day of January, 2015, I electronically filed the
foregoing with the Clerk of Courts by using the ECF system which will send a notice of
electronic filing to: paul@paulschrierpa.com; david@paulschrierpa.com, Paul K. Schrier,
Esquire, Paul K. Schrier, P.A., 11098 Biscayne Bivd., Suite 208, Miami, FL 33161.
ADAMS & DIACO, P.A.
ERIC M. toe FSOURE
Courthouse Tower
44 W. Flagler Street, Ste. 1675
Miami, FL 33130
(305) 374-7900
FBN 862401
Attorney for Defendant
Designated service e-mail: rlemer@adamsdiaco.com
*** FILED: BROWARD COUNTY, FL HOWARD FORMAN, CLERK 1/30/2015 11:49:31 AM.****IN THE COUNTY COURT
OF THE SEVENTEENTH JUDICIAL CIRCUIT
IN AND FOR BROWARD COUNTY, FLORIDA
CIVIL DIVISION
CASE NUMBER: 14-010686 CONO (71)
FIRST CHOICE MEDICAL REHAB
CENTER, P.A.
(a/a/o Jose L. Pena Correa),
Plaintiff,
VS.
PROGRESSIVE AMERICAN
INSURANCE COMPANY,
Defendant.
/
DEFENDANT’S RESPONSES TO PLAINTIFF’S INTERROGATORIES
COMES NOW the Defendant, PROGRESSIVE AMERICAN INSURANCE
COMPANY, by and through undersigned counsel, and hereby files its Responses to Plaintiff's
Interrogatories and states as follows:
1. Jean Labossiere
PIP Litigation Rep Sr.
3250 West Commercial Boulevard,
Suite 200
Fort Lauderdale, FL 33309
Handled litigation aspect of PIP claim.
2. Progressive American Insurance Company is licensed to do business in the State of
Florida and the name on Plaintiffs Complaint is correct.
Objection; vague and overbroad. Without waiving said objection in accordance with Fla.
R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents
contained in the PIP claims file which will be produced under separate cover to Plaintiff's
counsel. Specifically, refer to the declarations page and subject insurance policy for that
w
information.
4. Yes. The policy was in full force and effect on the date of the alleged accident.
5. In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the
non-privileged documents contained in the PIP claims file which will be produced under
separate cover to Plaintiff's counsel. Specifically, refer to the explanations of benefits for
that information.Jean Labossiere
PIP Litigation Rep Sr.
3250 West Commercial Boulevard,
Suite 200
Fort Lauderdale, FL 33309
Handled litigation aspect of PIP claim
Jennifer L. Sanabria
Medical Claims Representative
3302 South Falkenburg Road
Building D
Riverview FL 33578
Handled and adjusted PIP claim prior to filing of lawsuit.
Paul Willoughby
Medical Claims Representative
3250 West Commercial Boulevard,
Suite 200
Fort Lauderdale, FL 33309
Responded to Demand letter.
Jose L. Pena Correa; (knowledge of the facts and circumstances surrounding the motor
vehicle accident and PIP benefits at issue);
Any and all medical providers who have treated Jose L. Pena Correa;
Any and all passengers who may have been in the automobile with Jose L. Pena Correa at
the time of the alleged incident;
Any and all witnesses who may have witnessed the alleged incident;
Any and all individuals who may have been involved, and/or contributed to the alleged
incident;
Any and all individuals listed on the accident report;
Any and all individuals with any knowledge of the alleged incident, who may become
known during the discovery process;
Defendant reserves the right to amend this list at a later date if more individuals become
known through discovery.
Objection; vague and ambiguous.
Objection; irrelevant.
Objection; not relevant nor likely to lead to the discovery of admissible evidence.
Without waiving said objection the subject insurance policy was sold by Florida All Star,
Ins., 106 Buenaventura Boulevard, Kissimmee FL 34743. In accordance with Fla. R. Civ.
P. 1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents
contained in the PIP claims file which will be produced under separate cover to Plaintiff's
counsel. Specifically, refer to the declarations page for that information.10.
id.
12.
13.
15,
Defendant has made no such allegation at this time. In accordance with Fla. R. Civ. P.
1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents contained
in the PIP claims file which will be produced under separate cover to Plaintiff's counsel.
Specifically, refer to the assignments of benefits for that information.
In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the
non-privileged documents contained in the PIP claims file which will be produced under
separate cover to Plaintiff's counsel. Specifically, refer to the explanations of benefits for
that information.
Objection; vague and ambiguous. Without waiving said objection:
Daniella Crays
Medical Claims Representative
3302 South Falkenburg Road
Building D
Riverview FL 33578
Handled and adjusted PIP claim prior to filing of lawsuit.
It is Plaintiff's burden to establish that the medical services provided were medically
necessary, related to the accident, and/or the charges for said medical services were
reasonable. However, Defendant reserves the right to submit evidence to the contrary.
Defendant properly reimbursed the services at issue pursuant to statutory and policy
guidelines. Specifically, Defendant paid for the medical services at issue pursuant to
$627.736(S)(a)(2), Florida Statutes (2013), and the subject policy, which permits
reimbursement of medical services pursuant to any fee schedule specifically referenced in
Florida Statute 627.736 regarding reimbursement. Plaintiff failed to comply with all the
statutory and policy requirements by failing to bill in accordance with AMA guidelines,
by inter alia, submitting bills with improper and/or erroneous CPT codes and by failing to
produce supporting documentation. Plaintiff failed to comply with all the statutory and
policy prerequisites to bringing this action as Plaintiff failed to provide Defendant with
written notice and reasonable proof of a covered loss and the amount of same and any
and all documentation to support such loss. Specifically, Plaintiff submitted bills to
Defendant for treatment that, upon information and belief, was not rendered to Jose Pena
Correa.
In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the
non-privileged documents contained in the PIP claims file which will be produced under
separate cover to Plaintiff's counsel. Specifically, refer to the PIP Payment Log for that
information.
In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the
non-privileged documents contained in the PIP claims file which will be produced under
separate cover to Plaintiff's counsel. Specifically, refer to the Health Insurance Claim
Forms, PIP payment log, Explanation of Benefits and medical records for that
information.16. a)- c) In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to
the non-privileged documents contained in the PIP claims file which will be produced
under separate cover to Plaintiff's counsel. Specifically, refer to the Health Insurance
Claim Forms, Explanation of Benefits and medical records for that information.
d) The witnesses Defendant intends to call at trial are unknown at this time. Defendant
reserves the right to amend this answer as discovery is still ongoing.
17. None at this time, however, the Defendant reserves the right to amend this answer as
discovery is still ongoing.
18. In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the
non-privileged documents contained in the PIP claims file which will be produced under
separate cover to Plaintiff's counsel. Specifically, refer to the Explanation of Benefits for
that information.
Answering Party
STATE OF FLORIDA )
SS:
COUNTY OF )
BEFORE ME, the undersigned authority, personally appeared
who is personally known to me or has produced as identification, and being
duly sworn, on oath, deposes and says that he/she has read the foregoing Answers to PIP
Interrogatories and that the facts contained therein are true and correct to the best of his/her
knowledge and belief.
SWORN TO AND SUBSCRIBED before me this day » 2015.
Notary Public, State of Florida at Large
PRINT NAME OF NOTARY PUBLIC
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Filing # 23180920 E-Filed 01/30/2015 11:49:31 AM IN THE COUNTY COURT OF THE SEVENTEENTH JUDICIAL CIRCUIT IN AND FOR BROWARD COUNTY, FLORIDA CIVIL DIVISION CASE NUMBER: 14-010686 CONO (71) FIRST CHOICE MEDICAL REHAB CENTER, P.A., (a/a/o Jose L. Pena Correa), Plaintiff, YS. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant. / NOTICE OF SERVING UNVERIFIED ANSWERS TO INTERROGATORIES COMES NOW, the Defendant, PROGRESSIVE AMERICAN INSURANCE COMPANY, by and through the undersigned counsel, and files this Notice of Serving Unverified Answers to Interrogatories propounded by Plaintiff. CERTIFICATE OF SERVICE I HEREBY CERTIFY that on this] day of January, 2015, I electronically filed the foregoing with the Clerk of Courts by using the ECF system which will send a notice of electronic filing to: paul@paulschrierpa.com; david@paulschrierpa.com, Paul K. Schrier, Esquire, Paul K. Schrier, P.A., 11098 Biscayne Bivd., Suite 208, Miami, FL 33161. ADAMS & DIACO, P.A. ERIC M. toe FSOURE Courthouse Tower 44 W. Flagler Street, Ste. 1675 Miami, FL 33130 (305) 374-7900 FBN 862401 Attorney for Defendant Designated service e-mail: rlemer@adamsdiaco.com *** FILED: BROWARD COUNTY, FL HOWARD FORMAN, CLERK 1/30/2015 11:49:31 AM.****IN THE COUNTY COURT OF THE SEVENTEENTH JUDICIAL CIRCUIT IN AND FOR BROWARD COUNTY, FLORIDA CIVIL DIVISION CASE NUMBER: 14-010686 CONO (71) FIRST CHOICE MEDICAL REHAB CENTER, P.A. (a/a/o Jose L. Pena Correa), Plaintiff, VS. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant. / DEFENDANT’S RESPONSES TO PLAINTIFF’S INTERROGATORIES COMES NOW the Defendant, PROGRESSIVE AMERICAN INSURANCE COMPANY, by and through undersigned counsel, and hereby files its Responses to Plaintiff's Interrogatories and states as follows: 1. Jean Labossiere PIP Litigation Rep Sr. 3250 West Commercial Boulevard, Suite 200 Fort Lauderdale, FL 33309 Handled litigation aspect of PIP claim. 2. Progressive American Insurance Company is licensed to do business in the State of Florida and the name on Plaintiffs Complaint is correct. Objection; vague and overbroad. Without waiving said objection in accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents contained in the PIP claims file which will be produced under separate cover to Plaintiff's counsel. Specifically, refer to the declarations page and subject insurance policy for that w information. 4. Yes. The policy was in full force and effect on the date of the alleged accident. 5. In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents contained in the PIP claims file which will be produced under separate cover to Plaintiff's counsel. Specifically, refer to the explanations of benefits for that information.Jean Labossiere PIP Litigation Rep Sr. 3250 West Commercial Boulevard, Suite 200 Fort Lauderdale, FL 33309 Handled litigation aspect of PIP claim Jennifer L. Sanabria Medical Claims Representative 3302 South Falkenburg Road Building D Riverview FL 33578 Handled and adjusted PIP claim prior to filing of lawsuit. Paul Willoughby Medical Claims Representative 3250 West Commercial Boulevard, Suite 200 Fort Lauderdale, FL 33309 Responded to Demand letter. Jose L. Pena Correa; (knowledge of the facts and circumstances surrounding the motor vehicle accident and PIP benefits at issue); Any and all medical providers who have treated Jose L. Pena Correa; Any and all passengers who may have been in the automobile with Jose L. Pena Correa at the time of the alleged incident; Any and all witnesses who may have witnessed the alleged incident; Any and all individuals who may have been involved, and/or contributed to the alleged incident; Any and all individuals listed on the accident report; Any and all individuals with any knowledge of the alleged incident, who may become known during the discovery process; Defendant reserves the right to amend this list at a later date if more individuals become known through discovery. Objection; vague and ambiguous. Objection; irrelevant. Objection; not relevant nor likely to lead to the discovery of admissible evidence. Without waiving said objection the subject insurance policy was sold by Florida All Star, Ins., 106 Buenaventura Boulevard, Kissimmee FL 34743. In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents contained in the PIP claims file which will be produced under separate cover to Plaintiff's counsel. Specifically, refer to the declarations page for that information.10. id. 12. 13. 15, Defendant has made no such allegation at this time. In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents contained in the PIP claims file which will be produced under separate cover to Plaintiff's counsel. Specifically, refer to the assignments of benefits for that information. In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents contained in the PIP claims file which will be produced under separate cover to Plaintiff's counsel. Specifically, refer to the explanations of benefits for that information. Objection; vague and ambiguous. Without waiving said objection: Daniella Crays Medical Claims Representative 3302 South Falkenburg Road Building D Riverview FL 33578 Handled and adjusted PIP claim prior to filing of lawsuit. It is Plaintiff's burden to establish that the medical services provided were medically necessary, related to the accident, and/or the charges for said medical services were reasonable. However, Defendant reserves the right to submit evidence to the contrary. Defendant properly reimbursed the services at issue pursuant to statutory and policy guidelines. Specifically, Defendant paid for the medical services at issue pursuant to $627.736(S)(a)(2), Florida Statutes (2013), and the subject policy, which permits reimbursement of medical services pursuant to any fee schedule specifically referenced in Florida Statute 627.736 regarding reimbursement. Plaintiff failed to comply with all the statutory and policy requirements by failing to bill in accordance with AMA guidelines, by inter alia, submitting bills with improper and/or erroneous CPT codes and by failing to produce supporting documentation. Plaintiff failed to comply with all the statutory and policy prerequisites to bringing this action as Plaintiff failed to provide Defendant with written notice and reasonable proof of a covered loss and the amount of same and any and all documentation to support such loss. Specifically, Plaintiff submitted bills to Defendant for treatment that, upon information and belief, was not rendered to Jose Pena Correa. In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents contained in the PIP claims file which will be produced under separate cover to Plaintiff's counsel. Specifically, refer to the PIP Payment Log for that information. In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents contained in the PIP claims file which will be produced under separate cover to Plaintiff's counsel. Specifically, refer to the Health Insurance Claim Forms, PIP payment log, Explanation of Benefits and medical records for that information.16. a)- c) In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents contained in the PIP claims file which will be produced under separate cover to Plaintiff's counsel. Specifically, refer to the Health Insurance Claim Forms, Explanation of Benefits and medical records for that information. d) The witnesses Defendant intends to call at trial are unknown at this time. Defendant reserves the right to amend this answer as discovery is still ongoing. 17. None at this time, however, the Defendant reserves the right to amend this answer as discovery is still ongoing. 18. In accordance with Fla. R. Civ. P. 1.340(c), Defendant directs Plaintiff to refer to the non-privileged documents contained in the PIP claims file which will be produced under separate cover to Plaintiff's counsel. Specifically, refer to the Explanation of Benefits for that information. Answering Party STATE OF FLORIDA ) SS: COUNTY OF ) BEFORE ME, the undersigned authority, personally appeared who is personally known to me or has produced as identification, and being duly sworn, on oath, deposes and says that he/she has read the foregoing Answers to PIP Interrogatories and that the facts contained therein are true and correct to the best of his/her knowledge and belief. SWORN TO AND SUBSCRIBED before me this day » 2015. Notary Public, State of Florida at Large PRINT NAME OF NOTARY PUBLIC