Mercury Indem. Co. of Am. v. Cent. Fla. Med. & Chiropractic Ctr.

• Docket Number: 5D22-603
• Decision Date: 27 October 2023
• Parties: Mercury Indemnity Company of America, Appellant, v. Central Florida Medical & Chiropractic Center, Inc. d/b/a Sterling Medical Group a/a/o Sthefany Santiago, Appellee.
• Court: Florida District Court of Appeals

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Mercury Indemnity Company of America, Appellant, v. Central Florida Medical & Chiropractic Center, Inc. d/b/a Sterling Medical Group a/a/o Sthefany Santiago, Appellee.

No. 5D22-603

Florida Court of Appeals, Fifth District

October 27, 2023

Not final until disposition of any timely and authorized motion under Fla. R. App. P. 9.330 or 9.331.

On appeal from the County Court for Volusia County. LT Case No 2020-11958-CODL Robert A. Sanders, Jr., Judge.

Diane H. Tutt, of Conroy Simberg, Hollywood, for Appellant.

Douglas H. Stein, of Douglas H. Stein, P.A., Coral Gables for Appellee.

EISNAUGLE, J.

Mercury Indemnity Company of America ("Mercury") appeals a summary final judgment in favor of Central Florida Medical &Chiropractic Center, Inc. d/b/a Sterling Medical Group a/a/o Sthefany Santiago ("Sterling"), arguing that Sterling failed to comply with a condition precedent to suit because its notice of intent to initiate litigation (the "notice of intent" or "notice") did not provide the information required by section 627.736(10), Florida Statutes (2019). Specifically, Mercury argues that Sterling's notice was deficient because it stated the amount originally billed for each individual charge rather than "each exact amount claimed to be due" after adjustments and subtracting prior payments made by Mercury. We disagree with Mercury's reading of the statute and affirm.

Facts and Procedural History

The operative facts are not in dispute. Mercury issued an automobile insurance policy with Personal Injury Protection ("PIP") benefits to Sthefany Santiago (the "insured"). During the effective dates of coverage, the insured was involved in an automobile accident, received medical treatment from Sterling, and assigned her benefits under the insurance policy to Sterling.

Sterling submitted medical bills to Mercury for treatment rendered to the insured. When Mercury failed to make payment in full, Sterling sent Mercury a notice pursuant to section 627.736 alleging that Mercury failed to pay overdue PIP benefits. The notice listed, among other items, benefits due as "$1,597.91 (minus prior payments made, if any)," and included an itemized statement of each original charge. Mercury failed to make any additional payment on the overdue claim, and Sterling filed suit.

Sterling eventually moved for summary judgment, and Mercury responded by filing a cross-motion, arguing that Sterling failed to comply with a condition precedent to suit because the notice failed to allege "each exact amount claimed to be due." The trial court rejected Mercury's argument and rendered summary final judgment for Sterling. This appeal follows.

Statutory Interpretation

When interpreting a statute, we "follow the 'supremacy-of-text principle'-namely, the principle that '[t]he words of a governing text are of paramount concern, and what they convey, in their context, is what the text means.'" Richman v. Calzaretta, 338 So.3d 1081, 1082 (Fla. 5th DCA 2022) (alteration in original) (quoting Ham v. Portfolio Recovery Assocs., LLC, 308 So.3d 942, 946 (Fla. 2020)). Importantly, we must "arrive at a 'fair reading' of the text by 'determining the application of [the] text to given facts on the basis of how a reasonable reader, fully competent in the language, would have understood the text at the time it was issued.'" USAA Cas. Ins. Co. v. Mikrogiannakis, 342 So.3d 871, 873 (Fla. 5th DCA 2022) (alteration in original) (quoting Lab'y Corp. of Am. v. Davis, 339 So.3d 318, 323-24 (Fla. 2022)).

Of course, when interpreting any legal text, grammar and punctuation matter. "The legislature is presumed to know the meaning of words and the rules of grammar, and the only way the court is advised of what the legislature intends is by giving the generally accepted construction, not only to the phraseology of an act but to the manner in which it is punctuated." Fla. State Racing Commn v. Bourquardez, 42 So.2d 87, 88 (Fla. 1949); accord Antonin Scalia &Bryan A. Garner, Reading Law: The Interpretation of Legal Texts 141 (2012) ("[D]rafters . . . are presumed to be grammatical in their compositions."). That said, the "presumption of legislative literacy is a rebuttable one," and can be "overcome by other textual indications of meaning." Scalia &Garner, Reading Law at 141.

The PIP Statute's Notice of Intent and Itemized Statement

When interpreting a statute, it is always wise to begin with the text itself. Section 627.736 provides, in pertinent part:

(10) Demand letter. -

(a) As a condition precedent to filing any action for benefits under this section, written notice of an intent to initiate litigation must be provided to the insurer. Such notice may not be sent until the claim is overdue, including any additional time the insurer has to pay the claim pursuant to paragraph (4)(b).

(b) The notice must state that it is a "demand letter under s. 627.736" and state with specificity:

1. The name of the insured upon which such benefits are being sought, including a copy of the assignment giving rights to the claimant if the claimant is not the insured.

2. The claim number or policy number upon which such claim was originally submitted to the insurer.

3. To the extent applicable, the name of any medical provider who rendered to an insured the treatment, services, accommodations, or supplies that form the basis of such claim; and an itemized statement specifying each exact amount, the date of treatment, service, or accommodation, and the type of benefit claimed to be due. A completed form satisfying the requirements of paragraph (5)(d) or the lost-wage statement previously submitted may be used as the itemized statement.

§ 627.736, Fla. Stat. (2019) (emphasis added).

On appeal, Mercury offers two primary reasons why the itemized statement required by section 627.736(10)(b)3. must include "each exact amount" remaining due after adjusting the claim and accounting for previous payments. First, Mercury reads the statute to require the disclosure of "each exact amount claimed to be due," arguing that the clause "claimed to be due" applies to all three antecedents, and not only the last antecedent-the "type of benefit."

Second, Mercury argues that its interpretation of "each exact amount" is necessary to accomplish the "purpose" of the statute, which in Mercury's view, is to put an insurer on notice of the actual amount for which it will be sued, relying on our sister courts' decisions in Rivera v. State Farm Mutual Automobile Insurance Co., 317 So.3d 197, 204 (Fla. 3d DCA 2021) and Chris Thompson, P.A. v. Geico Indemnity Co., 347 So.3d 1, 2 (Fla. 4th DCA 2022).^[1] As a preliminary matter, we acknowledge that interpreting section 627.736(10) is complicated by the fact that the provision does not directly address the question raised on appeal. In other words, the text of the statute could call for "each exact amount overdue" or "each exact amount originally billed for the charge." And while this difficulty is evidenced by a split among our sister courts, we conclude the statute's plain language does not require Sterling's notice of intent to calculate "each exact amount claimed to be due" by adjusting the claim and accounting for any prior payments.

First, we will explain why the doctrine of the last antecedent, a rule of grammar, refutes Mercury's argument that the phrase "claimed to be due" modifies the term "each exact amount." Second, we will demonstrate that Mercury's view of the statute's "purpose" is overly broad and not supported by the text of the statute. Third, and finally, we will analyze the statute as a whole to discern the plain and ordinary meaning of the phrase "each exact amount."

The Statute's Grammatical Construction

We first address Mercury's argument that the phrase "claimed to be due" modifies the phrase "each exact amount." Based on the doctrine of the last antecedent, we disagree.

"The doctrine of the last antecedent is a rule of grammatical construction providing that 'relative and qualifying words, phrases and clauses are to be applied to the words or phrase immediately preceding, and are not to be construed as extending to, or including, others more remote.'" Principal Life Ins. Co. v. Halstead as Tr. of Rebecca D. McIntosh Revocable Living Tr., 310 So.3d 500, 503 (Fla. 5th DCA 2020) (quoting Kasischke v. State, 991 So.2d 803, 811 (Fla. 2008)). While "the doctrine can 'be overcome by other indicia of meaning[,]' . . . use of the doctrine is 'quite sensible as a matter of grammar.'" Id. (quoting Barnhart v. Thomas, 540 U.S. 20, 26 (2003)).

Also, as we have explained, the doctrine of the last antecedent has "a well-established corollary rule based on simple punctuation." Id. Therefore, "[w]here the modifier is set off from two or more antecedents by a comma, the supplementary 'rule of punctuation' states that the comma indicates the drafter's intent that the modifier relate to more than the last antecedent." Bingham, Ltd. v. United States, 724 F.2d 921, 925 n.3 (11th Cir. 1984) (emphasis omitted).

Here, the modifying phrase "claimed to be due" is not setoff by a comma. Therefore, the corollary rule does not apply, and the doctrine itself indicates the modifier applies only to the phrase immediately preceding it-"type of benefit." Accord Bain Complete Wellness, LLC v. Garrison Prop. &Cas. Ins. Co., 356 So.3d 866, 872 (Fla. 2d DCA 2022) ("[T]he phrase 'claimed to be due' does not modify the phrase 'each exact amount,' but rather the phrase it immediately follows-'type of benefit.'").

Importantly we find no "other indicia of meaning" in the statutory language that would overcome application of the doctrine. Instead, other parts of the statute seem to support the same conclusion. For instance, if the phrase "claimed to be due"...