County Civil Court: INSURANCE
–– Summary Judgment - worker’s
compensation lien - insured’s suit was premature when PIP complaint was filed
less than 30 days after service of the demand letter – summary judgment was
improper when there was no evidence that insurer had been presented with
evidence that there had been a settlement of the worker’s compensation lien
against insured – trial court erred in considering unsworn statements made by
counsel during summary judgment hearing – Summary Final Judgment reversed. Progressive
Express Ins. Co. v. Cannino,
Appeal No. 06-0006AP-88A (
IN THE CIRCUIT COURT FOR THE SIXTH JUDICIAL CIRCUIT
PROGRESSIVE EXPRESS INSURANCE
vs. Appeal No. 06-0006AP-88A
FRANK CANNINO, Appeal No. 06-0050AP-88B
Small Claims Division
Valerie Hendricks, Esquire
Attorney for Appellant/Cross-Appellee
Roy L. Glass, Esquire
Attorney for Appellee/Cross-Appellant
Kevin B. Weiss, Esquire
Attorney for Appellee/Cross-Appellant
ORDER AND OPINION
THIS CAUSE came before the Court on two appeals, Appeal No. 06-0006AP-88A and Appeal No. 06-0050AP-88B, which were subsequently consolidated by order of this Court. In the first appeal, the Appellant, Progressive Express Insurance Company (Progressive), seeks review of Final Summary Judgment for Plaintiff, entered December 9, 2005, in favor of the Appellee, Frank Cannino (Cannino). In the second appeal, Cannino is the Appellant and seeks review of the Final Judgment of Attorney’s Fees and Costs, entered June 29, 2006, in which the trial court awarded fees and costs in favor of Cannino in the amount of $ 9,120.91, plus interest. Upon review of the briefs, the record and being otherwise fully advised, the Court reverses both rulings.
The facts underlying these appeals stem from a Complaint for Declaratory Relief, Compensatory Damages and Demand for Jury Trial filed by Cannino against Progressive seeking damages as a result of unpaid personal injury protection (PIP) benefits that Cannino sought to be applied towards a worker’s compensation lien incurred after Cannino was involved in an on-the-job automobile accident. Progressive filed its Answer, Affirmative Defenses, and Motion to Dismiss Count I of Plaintiff’s Complaint Seeking Declaratory Relief. Thereafter, Cannino filed Plaintiff’s Motion for Summary Judgment asserting that his medical treatment had been paid by his worker’s compensation carrier and that his PIP coverage had been reserved at Cannino’s direction. The Motion for Summary Judgment stated that Cannino had settled his motor vehicle liability claim. Cannino further asserted that the worker’s compensation carrier had agreed to settle its lien of $ 39,212.00 for the total sum of $ 12,940.00, and that Cannino was entitled, as a matter of law, to no less than $ 10,000.00 in PIP benefits, plus costs, interest, and attorney’s fees.
Attached to the summary judgment Motion were several letters: a letter from the worker’s compensation carrier, dated June 1, 2005, extending an “offer” to settle the worker’s compensation lien for $ 12,940.00; a demand letter, dated April 28, 2005, from Cannino’s attorney, Roy Glass, Esquire, to Michelle Pattino, Claims Specialist for Progressive, requesting that $ 10,000 be paid to offset the worker’s compensation lien of $ 36,420.00; a letter, dated June 20, 2005, from Roy Glass, Esquire, to Cindy Filko, Medical Claims Representative for Progressive, stating that Cannino was again providing Progressive with a statement of Cannino’s worker’s compensation payments for injuries and lost wages. The record reflects that Cindy Filko responded, via letter dated June 23, 2005, that Progressive could not reimburse Cannino for his bills until it received a copy of the worker’s compensation lien and a copy of all medical bills.
On October 31, 2005, Cannino’s Motion for Summary Judgment came before the trial court. Cannino’s counsel argued that summary judgment was appropriate as Progressive failed to respond to Cannino’s demand letter requesting full payment of PIP benefits, $ 10,000.00, to be applied to the worker’s compensation settlement of
$ 12,940.00. Progressive’s counsel responded that summary judgment was inappropriate as Cannino did not provide Progressive with thirty days to respond to his demand letter and that Cannino did not provide Progressive with evidence that his third-party tort claim had settled. At the conclusion of the hearing, the trial court, the Honorable Karl Grube, granted summary judgment in favor of Cannino, making several oral findings, including that: “based upon plaintiff’s counsel’s assertions,” the third party tortfeasor suit had been settled; that Progressive had been put on reasonable notice as to Cannino’s request for compensation; that Progressive had admitted all Cannino’s requests for admissions; that Progressive’s affirmative defense that Cannino failed to satisfy all conditions precedent for bringing his action was too broadly worded, and; that Progressive did not file an affidavit opposing summary judgment.
Before a written order was entered, Cannino filed, on November 8, 2005, Plaintiff’s Motion for Clarification of Order to be Entered on Plaintiff’s Motion for Summary Judgment, attaching three letters sent between the parties following the summary judgment hearing. The Motion requested the trial court to clarify whether, as a matter of law, the fact that the worker’s compensation lien had not been paid precluded payment of PIP benefits by Progressive to Cannino. On December 9, 2005, the trial court entered Final Summary Judgment for Plaintiff finding that Cannino had settled the “Worker’s Compensation lien of $ 39,212.00 for the amount of $ 12,940.00, Plaintiff demanded payment of the PIP policy limits of $ 10,000.00 plus interest and penalties, none of which has been tendered or paid by Defendant Progressive.” Thereafter, on June 29, 2006, the trial court entered Final Judgment of Attorneys Fees and Costs, from which Cannino filed his Notice of Appeal.
issue before this Court is whether the trial court erred in entering summary
judgment in favor of Cannino. In
reviewing this issue, the Court reiterates that summary judgment can be granted
only when “the pleadings, depositions, answers to interrogatories, and
admissions on file together with the affidavits, if any, show that there is no
genuine issue as to any material fact and that the moving party is entitled to
judgment as a matter of law.” See
As an initial observation, while argued before the trial court but not raised as an issue on appeal, it appears that Cannino’s suit was premature. The record reflects that Cannino’s first demand letter, dated March 16, 2005, was legally insufficient. Cannino’s second demand letter, dated April 28, 2005, was not sent to the person designated by Progressive for the purpose of accepting pre-suit notices pursuant to Florida Statutes, section 627.736(11)(c). Cannino’s third demand letter was legally sufficient and was sent to the correct person, on June 3, 2005. However, Cannino filed his complaint less than thirty days later, on June 23, 2005. An insurer has thirty days to investigate a PIP claim before suit can be filed. See Fla. Stat. 627.736(4)(b); see also January v. State Farm Mutual Ins. Co., 838 So.2d 604, 607 (Fla. 5th DCA 2003).
Further, as pointed out by
Progressive during the summary judgment hearing and as is pertinent to the
issues raised on appeal, it appears the demand letter itself was premature as
there was no evidence presented to Progressive, in the form of a settlement of
the worker’s compensation lien, that there was an overdue claim. See
trial court erred in considering “assertions,” even if undisputed, that the
worker’s compensation lien had been settled.
Unsworn statements made my counsel do not establish facts, in the absence
of a stipulation, and are not evidence. See
Puya v. Superior Pools, Spas & Waterfalls, Inc., 902 So.2d 973, 975
Even if these letters had been properly attached to the complaint or an affidavit, the record reflects that there is a least a doubt as to whether the worker’s compensation claim had been settled (or at what point the worker’s compensation claim settled), whether Progressive had been put on reasonable notice as to Cannino’s request for compensation, and, if there was a settlement to which PIP benefits were due, to whom or what entity PIP benefits should be paid to avoid a duplication of benefits. See Hervey, supra. The admitted requests for admission do not support summary judgment as they merely state that Progressive received the above-cited letters by Cannino. Lastly, it is of no consequence that Progressive did not file an opposing affidavit since Cannino never met his burden of showing that there were no genuine issues of material fact. See id.
Therefore, it is,
ORDERED AND ADJUDGED that the Final Summary Judgment for Plaintiff and the Final Judgment of Attorney Fees and Costs are reversed and this cause is remanded for action consistent with this Order and Opinion.
It is further,
ORDERED AND ADJUDGED that Appellee’s Motion for Attorney’s Fees and Motion to Tax Appellate Attorney’s Fees and Costs, both filed by Cannino, are denied.
AND ORDERED in Chambers, at
R. TIMOTHY PETERS
Circuit Judge, Appellate Division
GEORGE M. JIROTKA CYNTHIA
Circuit Judge, Appellate Division Circuit Judge, Appellate Division
Copies furnished to:
Honorable Kathleen T. Hessinger
County Court Judge
Roy L. Glass, Esquire
Valerie Hendricks, Esquire
Kevin B. Weiss, Esquire
 On May 3, 2007, this Court entered its Order for Parties to Clarify Record on Appeal, as the record showed that Progressive had tendered the policy limits of $ 10,000.00 to Cannino, on or about June 7, 2005. In response, the parties clarified that the $ 10.000.00 tendered by Progressive was for underinsured motorist (UM) coverage and that the benefits sought by Cannino by filing his complaint were premised on his PIP coverage.
 This letter was attached to Plaintiff’s Notice of Intent to Claim Section 57.105, Fla. Stat., and Fla. R. Civ. P. 1.380(a)(4) Attorney’s Fees, filed October 20, 2005.
 Judge Grube has since retired and the Honorable Kathleen T. Hessinger is the successor judge who entered the subsequent Final Judgment of Attorney’s Fees and Costs.
 The Court notes that in one of the letters, dated November 2, 2005, which cannot be considered in determining whether summary judgment was appropriate, counsel for the worker’s compensation carrier states that “Mr. Glass [Cannino’s counsel] has not nor will he be sending any monies to our office in satisfaction of that lien which is now otherwise settled and waived by my client.” It is questionable as to whether Progressive owes any PIP benefits at all if the worker’s compensation carrier has “waived” its lien to which PIP benefits were to be applied.
Court, sitting in its appellate capacity, generally cannot rule on issues not
presented on appeal. See Lightsee
v. First National Bank of
 This section states, in part: “Such notice [of intent to initiate litigation] must be sent to the person and address specified by the insurer for purposes of receiving notices under this subsection.”
 Count IV of the complaint specifically alleges that Progressive failed to pay PIP benefits within thirty days of receiving written notice as required by Florida Statutes, section 627.736(4).
 See e.g. Fortune Insurance Company v. McGhee, 571 So.2d 546, 548 (Fla. 2d DCA 1990)(holding that insured was not entitled to full PIP benefits without offset for workers’ compensation benefits she received); South Carolina Insurance Company v. Arnold, 467 So.2d 324, 326 (Fla. 2d DCA 1985)(explaining that the purpose of section 627.736(4) in requiring workers’ compensation payments to be offset against PIP benefits is to preclude the duplication of recovery).