.

Defense Digest

Recent Florida PIP Appellate Decisions Put Focus Back on Swift and Automatic Medical Benefits Payments

Defense Digest, Vol. 28, No. 1, April 2022

April 1, 2022

by Sean P. Greenwalt

Key Points:

  • Florida’s Fourth District Court of Appeal has recently taken up two separate cases relating to the PIP litigation ancillary issues of interest and penalty and postage. 
  • In South Florida Pain & Rehabilitation of West Dade v. Infinity Auto Ins. Co., the court examined the question of whether a provider is entitled to attorney’s fees under § 627.736(8), Florida Statutes (2018), after having recovered a judgment solely on the statutory penalty and postage costs authorized by § 627.736(10). 
  • In Precision Diagnostic, Inc. v. Progressive Am. Ins. Co., the court answered whether the interest rate owed on a PIP claim should fluctuate quarterly or be paid based on the fixed quarter date the amount became overdue, and whether the doctrine of de minimis non curat lex is applicable to interest within the no-fault context.

It is promulgated that the purpose of Florida’s no-fault personal injury protection (PIP) statute is to ensure the “swift and virtually automatic payment” to the insured. Nunez v. Geico Gen. Ins. Co., 117 So.3d 388, 391 (Fla. 2013). However, PIP litigation has evolved over the years, and ancillary issues, such as the payment of penalty and postage reimbursement and various theories of interest calculation, began to develop, even in circumstances without no-fault benefits at issue. The result of a judgment for interest, penalty or postage alone in these instances would commonly result in an award of attorney’s fees and costs for plaintiffs. 

These ancillary issues involving interest, penalty and postage often evaded higher-level review until the January 1, 2021, statutory change to Florida’s appellate court jurisdiction, when most small claims and county court cases could be appealed directly to Florida’s District Courts of Appeal. Palmetto Physical Therapy Inc. v. Progressive Select Ins. Co., 320 So.3d 213 (Fla. 3d DCA 2021). As a result of the appellate jurisdiction change, within the last year, Florida’s Fourth District Court of Appeal has taken up two separate cases on the issues of interest and penalty and postage. Both decisions have focused on the purpose of Florida’s no-fault statute, which is to reimburse a claimant’s insurance benefits as a result of a motor vehicle accident. 

Penalty and postage reimbursements are essentially financial incentives for an insurer to pay PIP benefits correctly to avoid the pre-suit litigation phase entirely. Section 627.736(10)(d) reads: “[i]f, within 30 days after receipt of notice by the insurer, the overdue claim specified in the notice is paid by the insurer together with applicable interest and a penalty of 10 percent of the overdue amount paid by the insurer, subject to a maximum penalty of $250, no action may be brought against the insurer.” See also United Auto Ins. Co. v. 5-Star Rehabilitation Center, Inc., 2020 WL 6304285 (Fla. 11th Jud. Cir. App. 2020). The requirement for postal cost reimbursements is actually found separately in Section 627.736(10)(c).

In April 2021, the Fourth District Court of Appeal, in South Florida Pain & Rehabilitation of West Dade v. Infinity Auto Ins. Co., 318 So.3d 6 (Fla. 4th DCA 2021), took up the question of “whether [a] provider is entitled to attorney’s fees under section 627.736(8), Florida Statutes (2018), after it recovered a judgment solely on the statutory penalty and postage costs authorized by section 627.736(10)[.]” 

The court answered the question in the negative, citing to a plain language interpretation of the PIP statute. The court noted that an exception to section 627.736(8)’s entitlement to attorney’s fees occurs under “section 627.736(10)(d) [where] an insurer is not obligated to pay any attorney fees if it pays the insured’s PIP claim within thirty days after receipt of the pre-suit demand letter.” The Fourth District held that the absence of penalty and postage within the statute’s language controlled, finding: “[i]f the Legislature had intended for attorney’s fees to be otherwise recoverable under the statute, it would have said so.” 

Upon review of the totality of the opinion, it is evident that the importance of no-fault insurance is not ancillary issues or technicalities but the recovery of medical benefits to the actual plaintiffs. The court went on to clarify “[t]he Legislature’s intent when enacting the no-fault statute was to ensure the swift payment of ‘medical, surgical, funeral, and disability insurance benefits.’” 

While this particular opinion was limited to scenarios only involving penalty and postage, it appeared from the court’s judicial history concerning the recovery of attorney fees and costs that the same line of reasoning could potentially apply to the recovery of interest payments alone when no actual PIP benefits were at issue. To date, this has not occurred, but further opinions on interest have recently shaped the issue’s jurisprudence in the no-fault context. 

Later in the year, on October 20, 2021, the Fourth District Court of Appeal also issued two front opinions concerning interest. Interest as a legal issue in PIP has been well on its way to developing multiple legal theories, bolstering it as a matter almost as prevalent as recovering actual PIP benefits. Certain theories of recovery against interest stem from whether it was subject to the pre-suit demand requirement, if it must be specifically pled in a complaint, if the interest rate should change quarterly, or whether the doctrine of de minimis non curat lex to interest alone applied to the no-fault statute. 

Fla. Stat. Section 627.736(4)(d) provides the context for no-fault interest payments: 

All overdue payments bear simple interest at the rate established under s. 55.03 or the rate established in the insurance contract, whichever is greater for the quarter in which the payment became overdue, calculated from the date the insurer was furnished with written notice of the amount of covered loss. Interest is due at the time payment of the overdue claim is made.

The Fourth District Court of Appeal in Precision Diagnostic Inc. v. Progressive American Ins. Co., 330 So.3d 32 (Fla. 4th DCA 2021) took on two of the above issues in its interest decision. First, whether the interest rate owed on a PIP claim should fluctuate quarterly or be paid based on the fixed quarter date the amount became overdue, and second, whether the doctrine of de minimis non curat lex is applicable to interest within the no-fault context. 

As for the fluctuating interest issue, the court clarified a recently brewing interest argument by opining that interest should not be adjusted quarterly or left as to the specific quarter date that interest is due. Rather, interest should adjust based on the annually set rate. The court reasoned that, even though “the Chief Financial Officer sets the interest rate quarterly, section 55.03 [where PIP interest rates are taken from] only provides for an already established interest rate to adjust annually, not quarterly.” 

While the fluctuating interest decision will have far-reaching consequences much beyond the scope of this article, there will be an equally significant effect from the court’s recognition of the de minimis non curat lex doctrine to interest amounts in the no-fault context.

Black’s Law Dictionary defines the doctrine of de minimis non curat lex as “the law does not concern itself with trifles.” The Florida Supreme Court has described the legal maxim to mean that “the law does not care for small things.” Loeffler v. Roe, 69 So.2d 331, 338 (Fla. 1953). 

De minimis non curat lex “is a hallowed, long established and long recognized principle of law, and a party is entitled to call it in aid.” Precision Diagnostic, Inc., 330 So.3d at 35 (quoting Alec Samuels, De Minimis Non Curat Lex, 1985 Statute L. Rev. 167, 167 (1985)). Without the doctrine, litigation over trifling amounts will be a “waste of the time and money, and impair[] the dignity of the court and judge.” Id. (quoting Alec Samuels, De Minimis Non Curat Lex, 1985 Statute L. Rev. 167, 168 (1985)).  

In Precision Diagnostic, the provider sued over an interest difference of $4.17 based on the fluctuating interest argument above. When the trial court ruled in favor of the insurer’s de minimis argument, that the interest alone amount was too little to recover, the plaintiff’s appeal followed. The Fourth District Court of Appeal agreed with the insurer’s argument and noted the long history of the de minimis doctrine applying to a wide range of legal fields, including criminal, workers’ compensation and attorney fee awards for de minimis recoveries. However, the Precision Diagnostic decision is the first statewide binding appellate opinion explicitly recognizing the doctrine of de minimis non curat lex in the no-fault PIP context, although it is limited to interest-alone recoveries. 

A cause for concern for the Fourth District was the appearance that the case at issue was not brought for a genuine desire to recover $4.17 in miscalculated interest, “but rather for the award of attorney’s fees.” 

Time will tell the lasting effects of the above opinions. However, one common theme seems clear, the objective of Florida’s no-fault statute centers on the speedy reimbursement of medical, surgical, funeral and disability insurance benefits, not ancillary matters outside the core of the statute.

*Sean is an associate in our Tampa, Florida office. He may be reached at 813.989.1814 or spgreenwalt@mdwcg.com. 

 

Defense Digest, Vol. 28, No. 1, April 2022 is prepared by Marshall Dennehey Warner Coleman & Goggin to provide information on recent legal developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. ATTORNEY ADVERTISING pursuant to New York RPC 7.1. © 2022 Marshall Dennehey Warner Coleman & Goggin. All Rights Reserved. This article may not be reprinted without the express written permission of our firm. For reprints, contact tamontemuro@mdwcg.com.

Firm Highlights

Thought Leadership

Legal Update for Special Education Law: Recent Positive Outcomes From the Group

Hearing Officer Confirms District Acted Appropriately Under IDEA and Section 504 William J. McPartland (Scranton) obtained a finding in favor of our client, a school district, on all issues following a due process hearing. The parent had filed a due process complaint alleging that the school district had breached its child find duty under the IDEA and Section 504, that the school district had discriminated against the student on the basis of disability in violation of Section 504, and that the school district had denied a free and appropriate public education to the student both by developing inadequate IEPs and via an actionable procedural violation.  Specifically, the student had received a Section 504 evaluation in October 2023, after a number of behavioral infractions culminating in a fight in September 2023, was identified as having anxiety and a sleep disorder, and received appropriate Section 504 accommodations. The student had never previously demonstrated signs of a learning disability, and the parent denied the school district permission to evaluate the student for special education needs in November 2023, and January 2024. The parent granted the district permission to evaluate the student in October 2024, after a private psychologist diagnosed the student with Attention Deficit Hyperactivity Disorder, possible Oppositional Defiance Disorder, a learning disorder, and anxiety. The school district issued a special education evaluation report in December 2024, finding that the student had an emotional disturbance and other health impairment, and an IEP providing an itinerant level of emotional support, as well as instruction in academics and social skills, was issued in January 2025, and amended in February, March, and April 2025. The student withdrew from the school district in April 2025, to attend a cyber charter school. The hearing officer determined that the school district had not violated its child find duty to the student in violation of either the IDEA or Section 504 where the district developed a Section 504 plan for the student within a month and a half of the parent’s first request for a Section 504 evaluation and where the parent repeatedly denied consent to conduct an IDEA evaluation of the student. The hearing officer noted that the student’s sporadic record of behavioral infractions prior to September 2023, did not suggest that the student had a disability prior to the parent’s initial request for an evaluation. The hearing officer further determined that no evidence had been produced to suggest that the student was discriminated against on the basis of disability in violation of Section 504. Additionally, the hearing officer determined that the IEP offered to the student was substantively adequate and that, to the extent the social and emotional programming offered by the school district was not received by the student, this resulted from the parent’s refusal to accept the same. The hearing officer finally determined that the school district did not commit an actionable procedural violation by delaying development of an IEP for the student where the parent repeatedly denied consent to evaluate the student. Court Dismisses Three of Four Claims Against School District Christopher J. Conrad and Daniel P. McGannon (Harrisburg) achieved a significant early victory on behalf of a school district client in. The team successfully obtained dismissal of three of the four claims asserted in the plaintiff’s amended complaint. The former district superintendent brought multiple claims arising out of his alleged “forced resignation,” including age discrimination under the ADEA, a Section 1983 Equal Protection claim, a Pennsylvania Whistleblower claim, and breach of contract. On behalf of the district, the defense team moved to dismiss the complaint in part, arguing: The plaintiff failed to plead sufficient facts to support a prima facie case of age discrimination. The equal protection claim was barred because the ADEA provides the exclusive federal remedy for age-based employment claims. The breach of contract claim could not stand because the underlying employment agreement had expired prior to the alleged breach. The court agreed, dismissing the ADEA, equal protection, and breach of contract claims in their entirety. As a result, only a single claim under the Pennsylvania Whistleblower Law remains pending. This outcome substantially narrows the scope of the litigation and positions the client for a more efficient defense moving forward.

Result

No-Cause Jury Verdict Secured in Wrongful Death Trial

We successfully obtained a no-cause jury verdict in a 13-day wrongful death trial. The decedent, a 59-year-old man, was admitted to the emergency room on February 15, 2019, with complaints of abdominal pain, decreased appetite, and constipation, despite the use of laxatives. The patient did not complain of any nausea, vomiting, or diarrhea. He had a significant medical history including diabetes, hypertension, prior coronary artery stenting, morbid obesity (with past gastric bypass surgery), longstanding ventral hernia, and back pain. A CT scan revealed multiple hernias and a potential closed-loop bowel obstruction, leading to a surgery consultation. Our client, an emergency general surgeon, interpreted that the patient did not have a closed loop or any significant obstruction and recommended non-surgical management. The patient was approved to have clear liquids, and had a vomiting incident shortly after, but our client was not notified. The patient was returned to NPO status, and after improving overnight, he was returned to “clears” and additional medical and renal consults were ordered. Our client did not receive any communications from the residents/nurses of any changes in the patient’s condition. On February 18, 2019, two rapid responses were called due to increased heart rate and vomiting. It is believed that the vomiting resulted in aspiration, causing sepsis, ultimately leading to the patient’s death. During the trial, the plaintiff’s sole medical expert highlighted imaging on the wrong hernia, which called into question all of his opinions in the case. We made key objections related to the expert testimony, limiting what the allegations were, and preventing new allegations from being made. After approximately two and a half hours of deliberating, the jury returned a no-cause verdict. 

Thought Leadership

Featured Conversations... Key Takeaways from A.M. Best’s Webinar on the Misuse Defense in Product Liability Claims, Featuring Michael Salvati

Michael Salvati, shareholder in our Philadelphia office, was a panelist for the April A.M. Best webinar, “The Misuse Defense: Strategic Approaches to Defending Product Liability Claims for Insurers.” During the program, Michael and his fellow panelists offered practical, jurisdiction‑specific guidance on how misuse and failure‑to‑warn theories intersect in modern product liability litigation. Michael emphasized the unique challenges these claims present—particularly in states like Pennsylvania, where evidentiary rules diverge sharply from those applied in many other jurisdictions. Failure to Warn as the “Flip Side” of Misuse Salvati explained that failure‑to‑warn allegations often arise as a direct counter to a misuse defense. As he noted, “If our misuse defense is that the plaintiff didn't use a product properly or safely, then the failure to warn claim is that we didn't tell them how to use it properly.” He emphasized that these claims can stem from either the absence of warnings or criticisms of existing warnings, such as insufficient specificity or lack of clarity about risks. Pennsylvania’s Unique Evidentiary Landscape One of Salvati’s most notable points was the stark difference in how Pennsylvania treats evidence of compliance with industry standards. He highlighted that Pennsylvania is “one of the only states…where that evidence is not admissible” in strict liability cases. Manufacturers cannot rely on compliance with ANSI, UL, ISO, or even federal safety standards to defend the product against a strict liability claim—because the focus is solely on the product itself, not the manufacturer’s conduct. Salvati acknowledged the challenge this creates for defense counsel and clients who expect such compliance to carry weight. Understanding the Three Defect Theories Salvati also walked through the three primary defect theories recognized in many jurisdictions: - Design defect – a flaw in the product’s intended design - Manufacturing defect – a deviation affecting a specific unit - Failure to warn – inadequate instructions or warnings He noted that warnings claims are increasingly significant and sometimes stand alone when design or manufacturing theories are weak. As he put it, plaintiffs often default to warnings claims because “the default position seems to be, ‘If I got hurt, there must be something wrong.’” Warranties and State‑by‑State Variations Salvati addressed how breach‑of‑warranty claims fit into the broader framework, explaining that implied warranties—such as merchantability—often overlap with strict liability in Pennsylvania. He emphasized the importance of understanding local nuances, as warranty law and admissibility rules vary widely across states. Looking Ahead: The Growing Importance of Warnings In his closing remarks, Salvati stressed that warnings should never be treated as an afterthought in product liability defense. He observed that warnings‑only claims are becoming more common and urged manufacturers and insurers to continually evaluate the clarity and completeness of their instructions and warnings. His takeaway: “We should always be talking about what are the instructions that come with our products…to bolster a misuse defense.” Listen to the complete webinar here: https://www3.ambest.com/conferences/events/eventregister.aspx?event_id=WEB1074.