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State Farm Mutual Automobile Co. v. Renfroe10/31/2005
Original Jurisdiction-Petition for Writ of Certiorari.
State Farm petitions for a writ of certiorari. As grounds, State Farm argues the circuit court, in its appellate capacity, departed from the essential requirements of law by refusing to apply the definition of "medically necessary" found in section 627.732(2), Florida Statutes. We agree and grant the writ.
Facts and Procedural History
State Farm's insured was involved in an automobile accident, and sought treatment from Respondent, Dr. Renfroe. Dr. Renfroe performed a dynamic motion x-ray (DMX), which is "a videotaped x-ray motion picture showing the patient's bone and soft structures in motion." See Tran v. Hilburn, 948 P.2d 57, 57 (Colo. Ct. App. 1997). Although it paid all other claimed expenses, State Farm refused payment of the DMX, alleging it did not meet the statutory definition of medically necessary, and therefore did not qualify for payment. Dr. Renfroe responded by filing suit.
At trial, the parties stipulated the definition of "medically necessary" as contained in the Florida Statutes was applicable, and agreed to a jury instruction setting forth that definition. The statute relied upon by the parties for the definition of "medically necessary," became effective June 19, 2001. The jury returned a verdict in favor of Dr. Renfroe.
State Farm appealed to the circuit court, arguing no competent, substantial evidence supported the jury's verdict. Specifically, State Farm argued there was no testimony or evidence that the DMX evaluation was " n accordance with generally accepted standards of medical practice," which is the first element in the definition of "medically necessary." See § 627.732(2)(a), Fla. Stat. (2001).
The circuit court sua sponte found the statutory definition of "medically necessary" agreed to by the parties was inapplicable. The court reasoned: (1) In 2001, the Legislature passed a bill (the act) amending Florida's No-Fault Automobile Insurance Law; (2) Different sections of the act were given different effective dates; (3) Section 6 of the act amended paragraph (1)(a), of section 627.736, Florida Statutes (the personal injury protection or "PIP" statute), by inserting the word "medically" before "necessary." This section became effective only to insurance policies issued new or renewed on or after October 1, 2001; (4) Section 5 of the act amended paragraph (2) of section 627.732, by adding a definition of "medically necessary." This section had an effective date of June 19, 2001; (5) Since the section 6 amendment resulted in the phrase "medically necessary" appearing in the statute, the court concluded the effective date of the section 5 amendment, which defined "medically necessary," should be changed to have the same effective date as section 6 of the act.
To reach this result, the court rejected the plain language of the statute. The Legislature gave the definition of "medically necessary" an effective date of June 19, 2001, and, except in some circumstances not relevant here, a court lacks the authority to change the Legislature's choice of a statute's effective date.
PIP Never Paid for Unnecessary Medical Treatment
Both before and after the section 6 amendment, an insured's medical benefits from a PIP policy would pay only for necessary medical treatment. Subsection (1)(a) refers specifically to "medical benefits" and, before the amendment, the subsection read, in relevant part, "expenses for necessary medical . . . and necessary ambulance, hospital, and nursing services . . ." See § 627.736(1)(a), Fla. Stat. (2000) (emphasis added). The word "necessary" modified the medical benefits covered under the policy
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