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  • CENTRAL THERAPY CENTER, INC. VS PROGRESSIVE SELECT INSURANCE COMPANY Personal Injury Protection ($8,001 - $15,000) document preview
  • CENTRAL THERAPY CENTER, INC. VS PROGRESSIVE SELECT INSURANCE COMPANY Personal Injury Protection ($8,001 - $15,000) document preview
  • CENTRAL THERAPY CENTER, INC. VS PROGRESSIVE SELECT INSURANCE COMPANY Personal Injury Protection ($8,001 - $15,000) document preview
  • CENTRAL THERAPY CENTER, INC. VS PROGRESSIVE SELECT INSURANCE COMPANY Personal Injury Protection ($8,001 - $15,000) document preview
  • CENTRAL THERAPY CENTER, INC. VS PROGRESSIVE SELECT INSURANCE COMPANY Personal Injury Protection ($8,001 - $15,000) document preview
  • CENTRAL THERAPY CENTER, INC. VS PROGRESSIVE SELECT INSURANCE COMPANY Personal Injury Protection ($8,001 - $15,000) document preview
  • CENTRAL THERAPY CENTER, INC. VS PROGRESSIVE SELECT INSURANCE COMPANY Personal Injury Protection ($8,001 - $15,000) document preview
  • CENTRAL THERAPY CENTER, INC. VS PROGRESSIVE SELECT INSURANCE COMPANY Personal Injury Protection ($8,001 - $15,000) document preview
						
                                

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Filing # 15298687 Electronically Filed 06/26/2014 04:42:31 PM 14-4824 CENTRAL THERAPY CENTER, INC., a/a/o ERICHE GARCIA, Plaintiff, vs. PROGRESSIVE SELECT INSURANCE COMPANY, Defendant. IN THE COUNTY COURT IN AND FOR MIAMI-DADE COUNTY, FLORIDA CIVIL DIVISION CASE NUMBER: 14-02253 CC 26 (04) FLORIDA BAR NO.: 76619 PLAINTIFF'S MOTION TO STRIKE AND/OR PLAINTIFF’S MOTION FOR MORE DEFINITE STATEMENTS TO THE DEFENDANT’S ANSWER AND AFFIRMATIVE DEFENSES COMES NOW, Plaintiff, CENTRAL THERAPY CENTER, INC., a/a/o ERICHE GARCIA, by and through the undersigned counsel, and pursuant to Fla. R. Civ. P. 1.140(b), Fla. R. Civ. P. 1.140(e), and Fla. R. Civ. P. 1.140(f), files this, its Motion to Strike and/or Plaintiff's Motion For More Definite Statements to the Defendant’s Answer and Affirmative Defenses, and as grounds thereof would state as follows: STATEMENT OF FACTS 1. The present action involves Plaintiff's claim for Personal Injury Protection (PIP) benefits from Defendant in connection with the medical services provided to Defendant's insured. Nu On or about October 25, 2013, ERICHE GARCIA, sustained personal injuries related to the operation, maintenance, or use of a motor vehicle in Miami-Dade, Florida.3. On or about November 5, 2013, ERICHE GARCIA verbally assigned benefits and/or executed an Assignment of Benefits to Plaintiff, transferring her rights and interests under this policy of insurance with the Defendant to Plaintiff, who in exchange for said Assignment provided ERICHE GARCIA with medical services. 4. Plaintiff then timely submitted bills within 30 days as required by Fla. Stat. 627.736(4)(b). On or about April 30, 2014 Plaintiff filed suit to compel Defendant to render the payment wn on the overdue bills. 6. On or about June 9, 2014, Defendant filed its Answer, Affirmative Defenses. However, Defendant's affirmative defenses are unacceptably vague or otherwise improperly plead and, as such, Plaintiff is unable to sufficiently respond to them. 7. Therefore, Plaintiff requests that this Honorable Court enter an Order striking Defendant's Affirmative Defenses, or in the alternative, enter an Order requiring the Defendant to provide a more definite statement for its affirmative defenses. AFFIRMATIVE DEFENSES 8. In its Affirmative defense ({ 2 of its Answer and Affirmative Defenses); the Defendant alleges that *...Plaintiff is subject to the terms, conditions, limitations, endorsements, exclusions and effective dates of any applicable insurance agreement.” 9. In its Affirmative defense (4 3 of its Answer and Affirmative Defenses), the Defendant alleges that “...Plaintiff is subject to the terms, conditions and limitations of the Florida Motor Vehicle No-Fault Law.” 10. This is not an affirmative defense.11. It has long been an axiom Florida Law that “[a]n affirmative defense is a defense which admits the cause of action, but avoids liability, in whole or in part, by alleging an excuse, justification, or other matter negating or limiting liability.” St. Paul Mercury Ins. Co. v. Coucher, 837 So. 2d 483, 487 (Fla. Dist. Ct. App. 5th Dist. 2002), (citing Fla. E. Coast Ry. Co. v. Peters, 72 Fla. 311, 73 So. 151 (Fla. 1916)). 12. In this case the Defendant’s “affirmative defense” does not admit the action, does not avoid any degree of liability, in whole or in part, and fails to state an excuse, justification or other matter negating or limiting liability. 13. Therefore this defense should be stricken. 14. In its Affirmative defense (4 5 of its Answer and Affirmative Defenses), the Defendant alleges that “...the assignment attached to the Complaint is legally defective and Plaintiff lacks standing to proceed with the instant action.” 15. This defense should be stricken as it is too vague to permit Plaintiff to intelligibly respond. 16. Florida Courts soundly hold that the principles of pleading which apply to plaintiff's complaint apply equally to all affirmative defenses raised in an answer. See Walker vy. Walker, 254 So. 2d 832 (Fla. Ist DCA 1971); Zito v. Washington Fed. Sav. and Loan Ass'n of Miami Beach, 318 So. 2d 175 (Fla. 3d DCA 1975). A plaintiff is as much entitled to the certainty required in the pleading of a defense as is a defendant to be apprised of the nature of the plaintiff's claim. Zito, 318 So.2d at 176; Walker, 254 So. 2d at 834-835. The degree of certainty required in an Answer is that the defendant must set forth the facts in a manner as to reasonably inform the plaintiff of what is proposed to be proved in order to provide the plaintiff with a fair opportunity to meet the defense and19, prepare his evidence accordingly. See Zito, 318 So. 2d at 176; Citizens Nat'l Bank of Orlando y. Youngblood, 296 So, 2d 92 (Fla. 4th DCA 1974). . The Plaintiff would concede that the pleading of ideas and conclusions are permissible when they are pleaded in conjunction with ultimate facts. While conclusions do not necessarily make a pleading bad, they serve no useful purpose unless supported by facts which tend to support the conclusion. Ellison v. City of Ft. Lauderdale, 175 So.2d 198 (Fla. 1965). In fact, when supported by ultimate facts, conclusions serve a very important function in pointing out the inference which the pleader intends to rely upon. /d. at 200. However, pleading conclusions of law unsupported by allegations of ultimate fact is legally insufficient. Bliss v. Carmona, 418 So.2d 1017 (Fla. 3d DCA 1982); see also Cady v. Chevy Chase Sav. and Loan, Inc., 528 So.2d 136 (Fla. 4th DCA 1988) (holding affirmative defenses that are nothing more than conclusory are not good defenses to the complaint). . Defendant’s affirmative defense is an exceedingly vague allegation. Though Defendant, alleges that the assignment attached to the Complaint is legally defective; Defendant fails to provide the basis for its allegations (i.e., the evidence on which it relies to allege). Defendant fails to state in what way, if any, such assignment is legally deficient. Defendant fails to provide the basis as to its allegation that such assignment is at all deficient. As demonstrated supra, Plaintiff is entitled to a degree of certainty in the pleading of a defense that is sufficient to apprise Plaintiff of the nature of the defense, which standard requires that Defendant set forth facts in a manner that reasonably informs Plaintiff of20. 22. 23. 24. 26. 27. what it is that Defendant intends to prove, so as to provide Plaintiff a fair opportunity to meet the defense and prepare its evidence accordingly. As also demonstrated supra, while the pleading of conclusions of law is permissible, it is only so when the pled conclusions of law are pled in conjunction with facts which ultimately support the conclusion of law. . Defendant’s bare allegation is not an objectively known “fact” but rather, is a mere conclusion of law. Defendant fails to provide the specific basis of its otherwise wholly unsupported conclusion of law. Via its vague styling of its affirmative defense, Defendant has failed to provide Plaintiff any opportunity whatsoever to meet the defense and prepare its evidence accordingly. In this case the Defendant's “affirmative defense” does not admit the action, does not avoid any degree of liability, in whole or in part, and fails to state an excuse, justification or other matter negating or limiting liability. Therefore this defense should be stricken. . In its Affirmative defense (| 10 of its Answer and Affirmative Defenses), the Defendant alleges that *... Plaintiff failed to serve a valid pre-suit demand letter pursuant to Fla. Stat. 627.736(10). Plaintiff is precluded from asserting this action for the underlying benefits.” This defense should be stricken as it is too vague to permit Plaintiff to intelligibly respond. Defendant’s affirmative defense is an exceedingly vague allegation. Though Defendant alleges that Plaintiff failed to serve a valid pre-suit demand letter, Defendant fails to28. 29. 30. wo provide the basis for its allegations (i.e., the evidence on which it relies to allege). Defendant fails to state in what way, if any, the demand letter received by Defendant was not valid. Defendant fails to state what basis it relies on in alleging that such demand letter is not valid. As demonstrated supra, Plaintiff is entitled to a degree of certainty in the pleading of a defense that is sufficient to apprise Plaintiff of the nature of the defense, which standard requires that Defendant set forth facts in a manner that reasonably informs Plaintiff of what it is that Defendant intends to prove, so as to provide Plaintiff a fair opportunity to meet the defense and prepare its evidence accordingly. As also demonstrated supra, while the pleading of conclusions of law is permissible, it is only so when the pled conclusions of law are pled in conjunction with facts which ultimately support the conclusion of law. Defendant's bare allegation is not an objectively known “fact” but rather, is a mere conclusion of law. Plaintiff certainly maintains that the treatment provided was lawful and not in excess of the patient’s medical needs. . Defendant fails to provide the specific basis of its otherwise wholly unsupported conclusion of law. Via its vague styling of its affirmative defense, Defendant has failed to provide Plaintiff any opportunity whatsoever to meet the defense and prepare its evidence accordingly. . Therefore this defense should be stricken. . In its Affirmative defense ({ 14 of its Answer and Affirmative Defenses), the Defendant alleges that *...Plaintiff failed to provide the required documentation to support its claim that the services allegedly rendered were reasonable, necessary and related to the alleged34, 35. 36. 38. automobile accident set forth in the Complaint, Plaintiff is precluded from asserting this action for the underlying benefits.” This defense should be stricken as it is too vague to permit Plaintiff to intelligibly respond. Defendant's affirmative defense is an exceedingly vague allegation. Though Defendant alleges that Plaintiff failed to provide the required documentation to support its claim; Defendant fails to provide the basis for its allegations (i.e., the evidence on which it relies to allege). Defendant fails to state what documentation, if any, was not provided; Defendant fails to state under what authority it has maintained the allegation that Plaintiff failed to provide these documents and is thus precluded from this action. As demonstrated supra, Plaintiff is entitled to a degree of certainty in the pleading of a defense that is sufficient to apprise Plaintiff of the nature of the defense, which standard requires that Defendant set forth facts in a manner that reasonably informs Plaintiff of what it is that Defendant intends to prove, so as to provide Plaintiff a fair opportunity to meet the defense and prepare its evidence accordingly. . As also demonstrated supra, while the pleading of conclusions of law is permissible, it is only so when the pled conclusions of law are pled in conjunction with facts which ultimately support the conclusion of law. Defendant's bare allegation is not an objectively known “fact” but rather, is a mere conclusion of law. Plaintiff certainly maintains that the treatment provided was lawful and not in excess of the patients medical needs. . Defendant fails to provide the specific basis of its otherwise wholly unsupported conclusion of law. Via its vague styling of its affirmative defense, Defendant has failedto provide Plaintiff any opportunity whatsoever to meet the defense and prepare its evidence accordingly. 40. Therefore this defense should be stricken. 41. In its Affirmative defense (4 18 of its Answer and Affirmative Defenses), the Defendant alleges that “...[t]he policy at issue, clearly and unambiguously elected the permissive Medicare Fee Schedule methodology for calculating reimbursements, based on the language contained within A085 endorsement, which has been properly incorporated into the subject policy of insurance. .” 42. This is not an affirmative defense. 43. In this case the Defendant’s “affirmative defense” does not admit the action, does not avoid any degree of liability, in whole or in part, and fails to state an excuse, justification or other matter negating or limiting liability. 44, Therefore this defense should be stricken. 45. In the alternative, this Court should enter an order requiring Defendant to provide a more definite statement of its allegations. Fla. R. Civ. P. 1.140(e) entitled “Motion for More Definite Statement” requires that: If a pleading to which a responsive pleading is permitted is so vague or ambiguous that a party cannot reasonably be required to frame a responsive pleading, that party may move for a more definite statement before interposing a responsive pleading. The motion shall point out the defects complained of and the details desired. If the motion is granted and the order of the court is not obeyed within 10 days after notice of the order or such other time as the court may fix, the court may strike the pleading to which the motion was directed or make such order as it deems just. 46. Defendant's affirmative defense contains mere conclusions of law that are unsupported by any factual evidence and as such are “so vague [and] ambiguous that [Plaintiff] cannot reasonably be required to frame a responsive pleading.”47. Therefore, Defendant must be required to specifically identify those defenses which it alleges are viable and valid defenses against Plaintiff's claims. WHEREFORE, the Plaintiff respectfully requests that this Honorable Court grant this Motion to Strike and/or in the alternative, Motion for More Definite Statement herein, and award any and all other relief the Court deems just and proper. CERTIFICATE OF SERVICE IT HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished on this ZG _ day of Sune. 2014, to: Randall B. Bishop, Esq., Law Offices of Neil V. Singh, to SFPIPHC@Progressive.com & RBishop1@Progressive.com, by email. CORREDOR, HUSSEINI & SNEDAKER, P.A. Attorney for Plaintiff 9130 S. Dadeland Blvd. Datran Center II, Suite 1202 Miami, Florida 33156 Telephone No. 305-670-1880 Fascimile No. 305-670-1985 Email: service@corredorhusseinilaw.com