Allstate Fire & Cas. Ins. Co. v. Hallandale Open Mri, LLC
| Decision Date | 19 April 2017 |
| Docket Number | No. 3D16-38,3D16-38 |
| Parties | Allstate Fire and Casualty Insurance Company, Petitioner, v. Hallandale Open MRI, LLC, a/a/o Alexia Blake, Respondent. |
| Court | Florida District Court of Appeals |
THIS OPINION IS NOT FINAL UNTIL DISPOSITION OF ANY MOTION FOR REHEARING AND/OR REHEARING EN BANC. ANY PREVIOUSLY-FILED MOTION FOR REHEARING EN BANC IS DEEMED MOOT.
A Writ of Certiorari to the Circuit Court for Miami-Dade County, Appellate Division, Jacqueline Hogan Scola, Jorge Cueto, and Ariana Fajardo Orshan, Judges.
Shutts & Bowen, and Suzanne Youmans Labrit and Douglas G. Brehm (Tampa); Cozen O'Connor, and Peter J. Valeta (Chicago, IL), for petitioner.
Marlene S. Reiss, for respondent.
Before SALTER, LOGUE and SCALES, JJ.
On consideration of the petitioner's motion for rehearing, the response, and the decision of the Supreme Court of Florida in Allstate Insurance Co. v. Orthopedic Specialists, No. SC15-2298, 2017 WL 372092 (Fla. Jan. 26, 2017) ("Orthopedic Specialists II"), we withdraw our opinion in this case issued September 28, 2016,1 and replace it with the opinion which follows.
In the September 2016 opinion, we dismissed a petition for second-tier certiorari filed by Allstate Fire and Casualty Insurance Company ("Allstate"). Allstate's petition asked the Court to quash a 2015 circuit court appellate division opinion affirming a county court judgment for a medical provider in a personal injury protection (PIP) auto insurance case. The appellate division decided an interpretive question regarding the sufficiency of PIP policy language following the Legislature's amendments to section 627.736, Florida Statutes, in 2008.
In Orthopedic Specialists II, the Supreme Court of Florida has now determined that interpretive question. The Court held that a PIP policy term providing that reimbursements "shall be subject to" the Medicare fee schedules insection 627.736(5)(a)2., Florida Statutes (2009), is unambiguous, resolving a conflict in decisions previously issued by the First and Fourth District Courts of Appeal: Allstate Fire & Cas. Ins. Co. v. Stand-Up MRI of Tallahassee, P.A., 188 So. 3d 1 (Fla. 1st DCA 2015) (), and Orthopedic Specialists v. Allstate Ins. Co., 177 So. 3d 19 (Fla. 4th DCA 2015) ("Orthopedic Specialists I") (). At the time the circuit court appellate division ruled in the present case, this Court had not addressed the underlying issue.2 The circuit court appellate division concluded that the PIP policy language was ambiguous, following the reasoning and opinion of the Fourth District in Orthopedic Specialists I.
Under the standard for second-tier certiorari review established in Custer Medical Center v. United Automobile Insurance Co., 62 So. 3d 1086 (Fla. 2010), and Allstate Insurance Co. v. Kaklamanos, 843 So. 2d 885 (Fla. 2003), we initially concluded that we did not have jurisdiction in this case. With the conflict issue pending before the Supreme Court of Florida, we discerned no violation of a"clearly established principle of law resulting in a miscarriage of justice." Custer Med. Ctr., 62 So. 3d at 1092. The original dissenting opinion in this case, however, argued against dismissal based on this Court's decision in Florida Wellness, which by then had concluded that the "shall be subject to" term in the PIP policy was unambiguous:
It is clearly a miscarriage of justice to prevent further review in a manner that causes the identical cases of similarly situated persons in the same court to be decided differently based on conflicting legal interpretations. And this clear miscarriage of justice resulting from the failure to allow review reflects a departure from the most essential legal requirement—equality before the law. No other legal remedy exists to stop this miscarriage of justice here except a writ of certiorari.
Allstate Fire and Cas. Ins. Co. v. Hallandale Open MRI, LLC, 41 Fla. L. Weekly D2208, D2210 (Fla. 3d DCA Sept. 28, 2016) (Logue, J., dissenting). The majority concluded that the Supreme Court of Florida would itself ultimately resolve the conflict in decisions, such that we could not yet hold in this case that the circuit court appellate division had violated a clearly established principle of law resulting in a miscarriage of justice. The pendency of the conflict issue in the Supreme Court distinguished the present case, in the view of the majority, from our own precedent relied upon by Allstate. United Auto Ins. Co. v. Garrido, 22 So. 3d 120 (Fla. 3d DCA 2009) ().
But the Supreme Court of Florida has now resolved the conflict issue in an opinion which turns on a de novo statutory and contractual interpretation, quashing Orthopedic Specialists I and approving Stand-Up MRI. Orthopedic Specialists II, 2017 WL 372092 at *1. Our colleague's earlier dissent in the present case and our own concern regarding the jurisdictional limits of second-tier certiorari as detailed by the Supreme Court of Florida in Custer Medical Center can now be reconciled. The statutory and policy language in question have been definitively analyzed and interpreted for the entire state by its highest court.
Applying the Supreme Court's opinion in Orthopedic Specialists II to the petition in the present case, we conclude that the jurisdictional requirements of Custer Medical Center are satisfied, such that the petition should be granted. From the standpoint of the circuit court appellate division panel, this may seem unwarranted, essentially quashing the panel's opinion based on a subsequently-decided appellate decision that was unavailable to the panel when called upon to rule.
When the appellate division reached its decision in 2015, this Court had not decided the issue and the appellate division followed one of the two conflicting district court opinions. But with that conflict now eliminated by our Supreme Court and a definitive interpretation available to (and binding upon) all Floridacourts, we conclude that we should exercise our jurisdiction in conformance with the Supreme Court's decision in Orthopedic Specialists II.
The concurring and dissenting opinions on rehearing which follow address the inconsistencies within the case law affecting our consideration of petitions for second-tier certiorari. On the one hand, our Supreme Court in Custer Medical Center has admonished the district courts to narrowly restrict the application of our jurisdiction regarding second-tier certiorari. But on the other hand, a decision by our Supreme Court on a substantive question of Florida law—one which, as here, finally resolves conflicting opinions on that question at the county, circuit, and district court levels throughout the state—deserves immediate application as to otherwise-final opinions that were continuously challenged at all levels by the petitioner.
The dissent's reliance on Petrysian v. Metropolitan General Insurance Co., 672 So. 2d 562 (Fla. 5th DCA 1996), and Theisen v. Old Republic Insurance Co., 468 So. 2d 434 (Fla. 5th DCA 1985), is misplaced. Those decisions addressed a different question altogether: whether a litigant may obtain post-judgment relief from a final judgment under Florida Rule of Civil Procedure 1.540 "on the ground that a subsequent appellate decision in an unrelated case changed the rule of law upon which the final judgment was based." Theisen, 468 So. 2d at 435.
In the present case, a completely different scenario is presented. The county court case became a "test case," regarding the conflict question. The amended final judgment for the medical provider/plaintiff was $407.26, the difference between the amount payable under the statutory formula of section 627.736(5)(a), Florida Statutes (2012), and the "reasonable amount" applicable if the statutory formula was inapplicable. The amended final judgment and county court record include joint stipulations of fact, and they do not reflect any attempt to collect the judgment, liquidate the amount of trial and appellate attorney's fees, or stay the final judgment, during the pendency of the appeal in the circuit court and the petition proceedings here. The further challenges to the small, county court judgment obviously were not based on the sum in controversy in that case, but rather on the thousands of PIP cases affected by the interpretive question issue each year.3
The parties thus recognized (whether or not they used the term) that this was a "pipeline"4 case that would be controlled by the ultimate outcome here or, ifapplicable, in the Supreme Court of Florida. Although they did not await the resolution of the conflict issue in a pending "appeal," it is appropriate to characterize the issue during the pendency of this certiorari case as "pending further review." The interests of medical providers and the interests of PIP insurers alike were served when clarity was provided by the Supreme Court of Florida regarding the issue.
Petition granted.
I fully concur that a writ of certiorari should issue quashing the decision of the circuit court in its appellate capacity for the reasons stated in the majority opinion. But I write to explain my belief that there is an additional ground to issue the writ of certiorari in this case. The circuit court appellate decision under review expressly and directly conflicts with prior appellate decisions of the same circuit court.5 I believe a district court of appeal has the discretion to issue a writ of certiorari on second-tier review to resolve such an express and direct conflict between circuit court appellate decisions within its district.
My position can be summarized as follows: (1) a defect in our court system currently prevents the establishment of clearly established principles of law...
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