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Florida Fourth DCA rules that trial court erred in granting defendant’s motion to set off Medicare bill reductions after trial and not reducing PIP set off by premiums paid

On June 10, 2020, in Matrisciani v. Garrison Property and Casualty Insurance Company, No. 4D19-406, the Florida Fourth DCA affirmed in part and reversed in part various trial court rulings following a jury verdict in favor of the plaintiff in a motor vehicle negligence case in which the plaintiff had sued both the at-fault driver and her uninsured motorist (UM) insurer. Prior to trial, the plaintiff’s UM insurer had served her with a proposal for settlement in the amount of $1,000, which was not accepted. At trial, the jury awarded her $92,000 in total damages, $8,000 less than the other driver’s $100,000 liability insurance limits. However, the plaintiff has obtained a summary judgment before trial for $19,461.31 in medical expenses she incurred from the accident. After trial, the plaintiff and the at-fault driver reached a settlement agreement pursuant to which the trial court entered a $112,461.31 judgment against the at-fault driver that included the summary judgment amount. Further complicating matters, the trial court granted the UM’s insurer’s motion for remittitur and set-off and adjusted the total award to $62,147.73. The reduction resulted from the trial court’s finding that the jury’s $48,000 award for past medical expenses included the $19,461.31 already awarded in the summary judgment, a $10,000 set-off was necessary for past paid PIP benefits, and a $29,711.12 was necessary for Medicare and/or contractual reductions in medical bills. As a net result, the trial court granted the defendant UM insurer’s motion for attorney’s fees under its proposal for settlement.

The Fourth DCA concluded that the $1,000 proposal for settlement was made in good faith, bore a reasonable relationship to the amount of damages and a realistic assessment of its liability, and was not rendered fatally ambiguous due to a requirement that the plaintiff “satisfy all relevant liens.” However, the Fourth DCA found that the trial court erred in computing the set-off for PIP benefits by not crediting the plaintiff for the premiums she paid on the PIP coverage, citing Forest v. Sutherland, 110 So. 3d 525, 526 (Fla. 4th DCA 2013) (quoting McKenna v. Carlson, 771 So. 2d 555, 558 (Fla. 5th DCA 2000)). The Fourth DCA also concluded that the trial court erred in setting off the excess of the Medicare benefits charted at trial over the amount that Medicare actually paid. The Court acknowledged that other cases have held that it is error to permit a plaintiff to introduce into evidence (and to request from the jury) the gross amount of medical bills rather than the lesser amount actually paid as a governmental or charitable benefit in full settlement of those bills. See Boyd v. Nationwide Mut. Fire Ins. Co., 890 So. 2d 1240 (Fla. 4th DCA 2005); Cooperative Leasing, Inc. v. Johnson, 872 So. 2d 956, 960 (Fla. 2d DCA 2004); Miami–Dade Cty. v. Laureiro, 894 So. 2d 268, 269 (Fla. 3d DCA 2004). However, the Court noted that this was solely an evidentiary issue at trial the defendant had never sought for the reduced Medicare charges to be presented to the jury and that post-trial set-offs for Medicare benefits are not authorized, citing Thyssenkrupp Elevator Corp. v. Lasky, 868 So. 2d 547, 551 (Fla. 4th DCA 2003) (“cases interpreting section 768.76(1) appear not to allow a setoff for this kind of Medicare benefits”). The Fourth DCA remanded the case back to the trial court for a recalculation of the judgment, which in turn would establish the whether the proposal for settlement met the threshold amount to trigger entitlement to attorney’s fees.