GEICO GENERAL INSURANCE COMPANY vs HALLANDALE BEACH ORTHOPEDICS, INC. A/A/O FRITZNIE JARBATH

Annotate this Case

Download PDF

DISTRICT COURT OF APPEAL OF THE STATE OF FLORIDA FOURTH DISTRICT GEICO GENERAL INSURANCE COMPANY, Appellant, v. HALLANDALE BEACH ORTHOPEDICS, INC., a/a/o FRITZNIE JARBATH, Appellee. No. 4D21-206 [August 18, 2021] Appeal from the County Court for the Seventeenth Judicial Circuit, Broward County; Robert W. Lee, Judge; L.T. Case Nos. 062016SC022348AXXXCE and 062018AP025322AXCCCE. Michael A. Rosenberg, Peter D. Weinstein, and Adrianna de la CruzMuñoz of Cole, Scott & Kissane, P.A., Plantation, for appellant. David B. Pakula of David B. Pakula, P.A., Pembroke Pines, and Gary Marks of Marks & Fleischer, Fort Lauderdale, for appellee. KUNTZ, J. Geico General Insurance Company appeals the county court’s summary judgment order. We only address whether the insurance policy required Geico to pay 100% of the amount billed by the provider, Hallandale Beach Orthopedics, Inc. “The Florida PIP statute authorizes insurers to limit reimbursement to 80% of an amount set by a fee schedule, see § 627.736(5)(a)1.a.–f., by electing to do so in its policy, see § 627.736(5)(a) 5.” Geico Indem. Co. v. Muransky Chiropractic P.A., No. 4D21-457, 2021 WL 2584107, at *3 (Fla. 4th DCA June 24, 2021). In Muransky, we held that “under the PIP statute, if the billed amounts are less than 80% of the fee schedule, the insurer may pay the billed amounts in full or pay the 80% reimbursement rate of maximum charges.” Id. at *4 (citing Geico Indem. Co. v. Accident & Inj. Clinic, Inc., 290 So. 3d 980, 984 (Fla. 5th DCA 2019)). Our holding in Muransky is binding on this case. In re Rule 9.331, Determination of Causes by a Dist. Ct. of Appeal En Banc, Fla. R. App. P., 416 So. 2d 1127, 1128 (Fla. 1982). But the facts of this case require a different outcome. In Muransky, the record established that the provider billed an amount less than 80% of 200% of the applicable statutory fee schedule. 2021 WL 2584107, at *1. As a result, in that case, the answer to the legal question was dispositive. Here, the record does not establish whether the amount billed was less than 80% of 200% of the statutory fee schedule. For this reason, we reverse the court’s judgment and remand for further proceedings. If the amount billed was less than 80% of 200% of the fee schedule, the ultimate result will be the same as in Muransky. Reversed and remanded. DAMOORGIAN and ARTAU, JJ., concur. * * * Not final until disposition of timely filed motion for rehearing. 2

Some case metadata and case summaries were written with the help of AI, which can produce inaccuracies. You should read the full case before relying on it for legal research purposes.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.