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Filing # 40794975 E-Filed 04/27/2016 02:54:50 PM
IN THE COUNTY COURT OF THE SIXTH JUDICIAL CIRCUIT
IN AND FOR PINELLAS COUNTY, FLORIDA
SMALL CLAIMS
TOWER IMAGING, INC.,
AS ASSIGNEE OF LAWRENCE POLLIN,
Plaintiff, CASE NO.:15-011058 SC
VS.
OWNERS INSURANCE COMPANY,
Defendant.
AMENDED COMPLAINT
COMES NOW, the Plaintiff Tower Imaging, Inc. (as assignee of Lawrence Pollin), (hereinafter
“Plaintiff’), and brings this action against Owners Insurance Company (hereinafter “Defendant’”),
seeking unpaid Medical Payments (Med Pay) and further this complaint addresses a current and valid
dispute over the Respondent’s obligation under Florida Statute Sections 627.736; 627.7401 and the
subject policy of automobile insurance, and in support alleges as follows:
ALLEGATIONS COMMON TO ALL COUNTS
1. This is an actions for unpaid and overdue Med Pay for date(s) of service 10/17/2014, which
does not claim an amount in excess of the sum of $99.00 exclusive of costs and attorney’s
fees.
2. At all times material hereto, Plaintiff and Defendant operated their businesses in the state of
Florida and maintained an office(s) in said county for that purpose.
***ELECTRONICALLY FILED 04/27/2016 02:54:50 PM: KEN BURKE, CLERK OF THE CIRCUIT COURT, PINELLAS COUNTY***The insured purchased a policy of automobile insurance (hereinafter referred to as THE
POLICY) from the Defendant, which provided Personal Injury Protection (No Fault)
benefits and/or Medical Payment Benefits.
Said policy of insurance was in accordance with Florida Statues Section §627.736. A true
and correct copy of the policy is not available to the Plaintiff, but the Defendant is in
possession of said policy, endorsements, and declarations page.
At all times material hereto, Defendant was and is a corporation duly licensed to transact
insurance business in the State of Florida and maintained agents for transaction of its
customary business in PINELLAS County, Florida.
On or about 9/24/2014, Lawrence Pollin sustained personal injuries related to the operation,
maintenance and/or use of a motor vehicle.
As a direct and proximate result of the bodily injuries, the insured, Lawrence Pollin, incurred
reasonable expenses for necessary medical, rehabilitative, nursing and remedial care and/or
supplies, and lost wages.
The Defendant issued a policy of automobile insurance that provided personal injury
protection benefits, Med Pay and/or extended medical expense coverage, and as such, said
policy was required by law to comply with Florida Statute §627.730 - §627.7405.
The above-described policy was in full force and effect on the date that the insured sustained
the bodily injuries, and thus the subject policy of automobile insurance provided PIP and/or
Med Pay coverage to the insured for the bodily injuries sustained, under claim number 49-
677886-00.10.
11.
12.
13.
14.
The Defendant was furnished with a properly executed application for No-Fault benefits
together with medical authorization and medical bills to enable the Respondent to obtain
information necessary to promptly consider payment of any claims.
Defendant failed to make payment within 30 days of receipt of Plaintiff's bills, which is
required under the Florida PIP statute and / or Med Pay policy.
The Plaintiff is the assignee of the insured’s benefits inuring to the patient under the policy
of insurance. A written and/or equitable assignment of benefits has been executed in
compliance with Florida law. Plaintiff intended to be properly paid for the bills it submitted
in accordance with the Med Pay policy.
Both the Plaintiff and the insured have performed all conditions precedent to entitle the
Plaintiff to recover benefits for said necessary medical, rehabilitative and remedial treatment
regarding the above-described policy.
Due to the Defendant’s failure to pay all Med Pay benefits and/or interest in accordance with
the contract, and/or provide documentation pursuant to contract and law, Plaintiff has been
required to retain the undersigned law firm to prosecute this action.
The Plaintiff has agreed to pay, and the attorney has agreed to accept, and Court awarded
fees and/or costs.16.
17.
18.
19.
20.
BREACH OF CONTRACT
Plaintiff repeats and re-alleges paragraphs 1-15 as if set forth in their entirety.
The Defendant did not make payment of part or all the benefits or interest due under the
policy within thirty (30) days as required by the insurance policy and Florida Statutes
§627.736(4) (b).
The Defendant failed to pay its insured’s covered losses and the Defendant had no
reasonable proof to establish that it was not responsible for the payment.
Defendant has failed to pay the Med Pay and/or interest required by statute, policy and/or
law.
Due to the failure of the Defendant to pay all benefits in accordance with the law and terms
of the insurance contract, the Plaintiff has been required to retain the undersigned law firm
for the prosecution of this suit. The Plaintiff has agreed to pay, and the attorneys of the
respective law firm have agreed to accept, any court awarded fee.JURY DEMAND
Plaintiff would further demand a trial by jury on all issues so triable by right.
WHEREFORE, the Plaintiff demands judgment for all statutory penalties and postage
together with pre-judgment interest thereon, all interest on any past benefits and penalties not timely
paid, costs and attorney’s fees pursuant to Florida Statute §627.428 and Florida Statutes
§627.736(8), legal assistant fees pursuant to Florida Statutes §57.104 and costs pursuant to Florida
Statutes §92.231 and Florida Statutes §57.041.
Dated this _27th__ day of April, 2016.
/s/ C. Spencer Petty
C. Spencer Petty, Esq.
FBN: 051396
IRVIN & PETTY, P.A.
111 Second Ave. NE, Suite 630
St. Petersburg, FL 33701
Phone: (727) 350-7770
Designated service e-mail:
Therese@irvinandpetty.com
Attorney for Plaintiff
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Filing # 40794975 E-Filed 04/27/2016 02:54:50 PM IN THE COUNTY COURT OF THE SIXTH JUDICIAL CIRCUIT IN AND FOR PINELLAS COUNTY, FLORIDA SMALL CLAIMS TOWER IMAGING, INC., AS ASSIGNEE OF LAWRENCE POLLIN, Plaintiff, CASE NO.:15-011058 SC VS. OWNERS INSURANCE COMPANY, Defendant. AMENDED COMPLAINT COMES NOW, the Plaintiff Tower Imaging, Inc. (as assignee of Lawrence Pollin), (hereinafter “Plaintiff’), and brings this action against Owners Insurance Company (hereinafter “Defendant’”), seeking unpaid Medical Payments (Med Pay) and further this complaint addresses a current and valid dispute over the Respondent’s obligation under Florida Statute Sections 627.736; 627.7401 and the subject policy of automobile insurance, and in support alleges as follows: ALLEGATIONS COMMON TO ALL COUNTS 1. This is an actions for unpaid and overdue Med Pay for date(s) of service 10/17/2014, which does not claim an amount in excess of the sum of $99.00 exclusive of costs and attorney’s fees. 2. At all times material hereto, Plaintiff and Defendant operated their businesses in the state of Florida and maintained an office(s) in said county for that purpose. ***ELECTRONICALLY FILED 04/27/2016 02:54:50 PM: KEN BURKE, CLERK OF THE CIRCUIT COURT, PINELLAS COUNTY***The insured purchased a policy of automobile insurance (hereinafter referred to as THE POLICY) from the Defendant, which provided Personal Injury Protection (No Fault) benefits and/or Medical Payment Benefits. Said policy of insurance was in accordance with Florida Statues Section §627.736. A true and correct copy of the policy is not available to the Plaintiff, but the Defendant is in possession of said policy, endorsements, and declarations page. At all times material hereto, Defendant was and is a corporation duly licensed to transact insurance business in the State of Florida and maintained agents for transaction of its customary business in PINELLAS County, Florida. On or about 9/24/2014, Lawrence Pollin sustained personal injuries related to the operation, maintenance and/or use of a motor vehicle. As a direct and proximate result of the bodily injuries, the insured, Lawrence Pollin, incurred reasonable expenses for necessary medical, rehabilitative, nursing and remedial care and/or supplies, and lost wages. The Defendant issued a policy of automobile insurance that provided personal injury protection benefits, Med Pay and/or extended medical expense coverage, and as such, said policy was required by law to comply with Florida Statute §627.730 - §627.7405. The above-described policy was in full force and effect on the date that the insured sustained the bodily injuries, and thus the subject policy of automobile insurance provided PIP and/or Med Pay coverage to the insured for the bodily injuries sustained, under claim number 49- 677886-00.10. 11. 12. 13. 14. The Defendant was furnished with a properly executed application for No-Fault benefits together with medical authorization and medical bills to enable the Respondent to obtain information necessary to promptly consider payment of any claims. Defendant failed to make payment within 30 days of receipt of Plaintiff's bills, which is required under the Florida PIP statute and / or Med Pay policy. The Plaintiff is the assignee of the insured’s benefits inuring to the patient under the policy of insurance. A written and/or equitable assignment of benefits has been executed in compliance with Florida law. Plaintiff intended to be properly paid for the bills it submitted in accordance with the Med Pay policy. Both the Plaintiff and the insured have performed all conditions precedent to entitle the Plaintiff to recover benefits for said necessary medical, rehabilitative and remedial treatment regarding the above-described policy. Due to the Defendant’s failure to pay all Med Pay benefits and/or interest in accordance with the contract, and/or provide documentation pursuant to contract and law, Plaintiff has been required to retain the undersigned law firm to prosecute this action. The Plaintiff has agreed to pay, and the attorney has agreed to accept, and Court awarded fees and/or costs.16. 17. 18. 19. 20. BREACH OF CONTRACT Plaintiff repeats and re-alleges paragraphs 1-15 as if set forth in their entirety. The Defendant did not make payment of part or all the benefits or interest due under the policy within thirty (30) days as required by the insurance policy and Florida Statutes §627.736(4) (b). The Defendant failed to pay its insured’s covered losses and the Defendant had no reasonable proof to establish that it was not responsible for the payment. Defendant has failed to pay the Med Pay and/or interest required by statute, policy and/or law. Due to the failure of the Defendant to pay all benefits in accordance with the law and terms of the insurance contract, the Plaintiff has been required to retain the undersigned law firm for the prosecution of this suit. The Plaintiff has agreed to pay, and the attorneys of the respective law firm have agreed to accept, any court awarded fee.JURY DEMAND Plaintiff would further demand a trial by jury on all issues so triable by right. WHEREFORE, the Plaintiff demands judgment for all statutory penalties and postage together with pre-judgment interest thereon, all interest on any past benefits and penalties not timely paid, costs and attorney’s fees pursuant to Florida Statute §627.428 and Florida Statutes §627.736(8), legal assistant fees pursuant to Florida Statutes §57.104 and costs pursuant to Florida Statutes §92.231 and Florida Statutes §57.041. Dated this _27th__ day of April, 2016. /s/ C. Spencer Petty C. Spencer Petty, Esq. FBN: 051396 IRVIN & PETTY, P.A. 111 Second Ave. NE, Suite 630 St. Petersburg, FL 33701 Phone: (727) 350-7770 Designated service e-mail: Therese@irvinandpetty.com Attorney for Plaintiff