Progressive Am. Ins. Co. v. Eduardo J. Garrido D.C. P.A.

• Decision Date: 15 February 2017
• Docket Number: No. 3D15–1067,3D15–1067
• Citation: 211 So.3d 1086
• Parties: PROGRESSIVE AMERICAN INSURANCE COMPANY, Appellant, v. EDUARDO J. GARRIDO D.C. P.A., etc., Appellee.
• Court: Florida District Court of Appeals

211 So.3d 1086

PROGRESSIVE AMERICAN INSURANCE COMPANY, Appellant,

v.EDUARDO J. GARRIDO D.C. P.A., etc., Appellee.

No. 3D15–1067

District Court of Appeal of Florida, Third District.

Opinion filed February 15, 2017.

Kubicki Draper, P.A., and Betsy E. Gallagher and Michael C. Clarke (Tampa), for appellant.

Christian Carrazana, P.A., and Christian Carrazana, for appellee.

Before SUAREZ, C.J., and LAGOA and SCALES, JJ.

SCALES, J.

Appellant, defendant below, Progressive American Insurance Company ("Progressive"), appeals a final summary judgment of the Miami–Dade County Court that both (i) declared a portion of Florida's PIP statute unconstitutional as applied to chiropractors; and (ii) determined that, in the absence of an "emergency medical condition" diagnosis, Florida's PIP statute allows an insured to recover up to $10,000 in PIP benefits. The county court certified the constitutional issue to us as a question of great public importance. We accepted jurisdiction,¹ and we reverse the county court's final summary judgment.

I. Facts

In February of 2013, Progressive's insured, Alejandro Godoy, was involved in a car accident in Miami. Godoy suffered personal injuries and began treatment with chiropractor Eduardo Garrido, the Appellee and plaintiff below. Godoy assigned to Garrido his PIP benefits under Godoy's Progressive policy, and Garrido submitted to Progressive invoices totaling $6,075.12 for his treatment of Godoy.

Progressive paid Garrido $2,500 in PIP benefits, but declined to pay Garrido any further PIP benefits because there had been no determination made by an authorized physician under section 627.736(1)(a)3. of the Florida Statutes that Godoy suffered an emergency medical condition ("EMC").² Progressive based its refusal to pay in excess of $2,500 in benefits on section 627.736(1)(a)4., which limits PIP benefits to $2,500 "if a provider ... determines that the injured person did not have an emergency medical condition." Progressive reasoned that, because no authorized physician had diagnosed Godoy with an EMC, its PIP liability was limited to $2,500.

In response to Progressive's refusal to pay Garrido more than $2,500, Garrido filed the instant declaratory judgment action in Miami–Dade County Court. Garrido's complaint contained three counts. In Count I, Garrido sought a declaration that the full $10,000 PIP benefit applied to the claim at issue, despite the absence of a determination by an authorized medical provider that Godoy suffered an EMC.

In Counts II and III of his complaint, Garrido alleged that the exclusion of chiropractors from the list of professionals, scheduled in section 627.736(1)(a)3., that are authorized to diagnose a patient with an EMC is unconstitutional as applied to chiropractors on both equal protection and due process grounds. After the inception of his lawsuit, Garrido filed an affidavit in support of his motion for summary judgment in which he purported to have diagnosed Godoy with an EMC, despite not being authorized to provide such diagnosis under section 627.736(1)(a)3.

The trial court entered final summary judgment for Garrido, concluding that the statute was unconstitutional as applied to chiropractors on both equal protection and due process grounds. The trial court also determined that Garrido's diagnosis of Godoy with an EMC was "legally sufficient" to trigger the availability of Progressive's PIP policy limit of $10,000, and certified to us the following question of great public importance:

IS THE OMISSION OF CHIROPRACTORS FROM THE LIST OF HEALTH CARE PROFESSIONALS AUTHORIZED TO DIAGNOSE AN EMERGENCY MEDICAL CONDITION UNDER § 627.736(1)(a)(3), FLA. STAT. (2013) [stet] UNCONSTITUTIONAL AS APPLIED TO CHIROPRACTORS ON THE GROUNDS OF EQUAL PROTECTION AND DUE PROCESS UNDER THE FLORIDA CONSTITUTION?

A separate panel of this Court accepted jurisdiction. We answer the question in the negative and reverse the trial court's summary final judgment for Garrido.

II. Analysis³

A. Relevant Statutory Backdrop

For decades, in addition to providing death benefits under section 627.736(1)(c), all PIP insurance policies written in Florida have been required to provide up to $10,000 in benefits for an insured's covered medical expenses under section 627.736(1)(a) and for an insured's loss of income and earning capacity under section 627.736(1)(b).

In 2012, the Florida Legislature enacted Laws of Florida 2012–197 (the "2012 PIP Act") which, among other things, amended the PIP statute's medical benefits provisionsto limit the availability of the full $10,000 in PIP medical benefits to only those injured persons diagnosed with an EMC. The Legislature accomplished this change by adding two subsections to section 627.736(1)(a) that are relevant to this case: (i) section 627.736(1)(a) 3. specifically identifies which medical professionals can make an EMC diagnosis so as to trigger the $10,000 benefit availability; and (ii) section 627.736(1)(a) 4. limits available PIP medical benefits to $2,500 if a medical provider determines that the injured person does not have an EMC. 2012 PIP Act; § 10.

Section 627.736(1)(a) 3. provides that up to $10,000 in PIP medical benefits are available if the injured person is diagnosed with an EMC by one of the following professionals: (i) a physician licensed under chapter 458 (medical doctor) or chapter 459 (osteopathic physician), (ii) a dentist licensed under chapter 466, (iii) a physician assistant licensed under chapter 458 or 459, or (iv) an advanced registered nurse licensed under chapter 464.

Section 627.736(1)(a) 4. limits PIP medical benefits to $2,500 if any medical provider (including chiropractic physicians licensed under chapter 460) eligible to receive PIP reimbursement benefits determines that an injured person does not have an EMC. The statute, however, is silent as to what PIP benefits are available in the event of no EMC diagnosis whatsoever.

B. The Trial Court's Order

Under this statutory scheme a chiropractor is authorized to make a no–EMC diagnosis, but is not authorized to make a determination that an injured person has an EMC. Determining as a matter of law that the statutory scheme treats chiropractors differently from what it characterized as similarly situated persons—i.e., licensed medical providers who are authorized to provide EMC diagnoses—the trial court concluded that this distinction violates chiropractors' equal protection rights because there exists no rational basis for the distinction. Underpinning the trial court's conclusion is its determination that the legitimate governmental interest advanced by the statute "is to provide greater coverage where the injured person had an EMC." The trial court also summarily concluded that the statutory scheme violates chiropractors' due process rights because the statute lacks a rational basis under an equal protection analysis.

As a matter of statutory construction, the trial court also determined that, because no medical provider issued either an EMC or no–EMC diagnosis to Godoy, section 627.736(1)(a) requires Progressive to make available the full $10,000 in PIP medical benefits.

C. The Constitutional Issue—The Certified Question

1. The Rational Basis Test in an Equal Protection Challenge

We note that the trial court employed the appropriate test to determine the statute's constitutionality. A court must analyze an equal protection challenge that does not involve a fundamental right or suspect classification under the rational basis test. Estate of McCall v. U.S. , 134 So.3d 894, 901 (Fla. 2014). "To satisfy the rational basis test, a statute must bear a rational and reasonable relationship to a legitimate state objective, and cannot be arbitrarily or capriciously imposed." Id. ⁴

The Legislature has the power to establish classifications, to make distinctions among persons or groups, without running afoul of equal protection law. Hechtman v. Nations Title Ins. of N.Y. , 840 So.2d 993, 996–97 (Fla. 2003) (upholding under rational basis test distinction between attorney and non-attorney title insurance agents); State Dep't of Ins. v. Keys Title & Abstract Co. , 741 So.2d 599, 601–02 (Fla. 1st DCA 1999). Courts "are obligated to accord legislative acts a presumption of constitutionality and to construe challenged legislation to effect a constitutional outcome whenever possible." Fla. Dep't of Revenue v. Howard , 916 So.2d 640, 642 (Fla. 2005). There is a strong presumption of validity if there is a rational relationship between the disparity of treatment of those persons or groups and a legitimate governmental objective. City of Fort Lauderdale v. Gonzalez , 134 So.3d 1119, 1121 (Fla. 4th DCA 2014)citing Heller v. Doe , 509 U.S. 312, 319–20, 113 S.Ct. 2637, 125 L.Ed.2d 257 (1993). Some measure of disparate treatment or inequality is constitutionally tolerable. Duncan v. Moore , 754 So.2d 708, 712 (Fla. 2000) ; Acton v. Ft. Lauderdale Hosp. , 440 So.2d 1282, 1284 (Fla. 1983). The burden on the plaintiff, therefore, is to demonstrate that there is no rational basis for the alleged disparity by showing that the statute intentionally and improperly treats him, her or it in a different manner from similarly situated persons or groups. Miller v. State , 971 So.2d 951, 952 (Fla. 5th DCA 2007).

Courts locate their rational basis test analysis "in a light deferential to Legislative action." Warren , 899 So.2d at 1096. When applying the rational basis test, courts "undertake only a limited review that is highly deferential to the legislature's choice of ends and means." Silvio Membreno & Fla. Ass'n of Vendors, Inc. v. City of Hialeah , 188 So.3d 13, 22 (Fla. 3d DCA 2016).⁵ The statute's challenger must "prove that there is no conceivable factual predicate which would rationally support the law." Id. at 25 (internal quotations and citations omitted; emphasis in original). Courts are required to give great deference to legislative policy choices, and it constitutes reversible error for a trial court to subject...