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[U] Glick v. Progressive Northern Insurance Co.

Superior Court of Pennsylvania

January 24, 2014

DR. RICHARD S. GLICK, D.O., INDIVIDUALLY AND ON BEHALF OF ALL OTHERS SIMILARLY SITUATED
v.
PROGRESSIVE NORTHERN INSURANCE COMPANY AND MOUNTAIN LAUREL INSURANCE COMPANY, D/B/A/ PROGRESSIVE INSURANCE COMPANY APPEAL OF: DR. RICHARD S. GLICK, D.O., AND NORTH PHILADELPHIA REHABILITATION CENTER, INC.DR. RICHARD S. GLICK, D.O., INDIVIDUALLY AND ON BEHALF OF ALL OTHERS SIMILARLY SITUATED
v.
PROGRESSIVE NORTHERN INSURANCE COMPANY AND MOUNTAIN LAUREL INSURANCE COMPANY, D/B/A/ PROGRESSIVE INSURANCE COMPANY APPEAL OF: PROGRESSIVE NORTHERN INSURANCE COMPANY AND MOUNTAIN LAUREL INSURANCE COMPANY

NON-PRECEDENTIAL DECISION

Appeal from the Order Entered July 2, 20121 In the Court of Common Pleas of Philadelphia County Civil Division at No. March Term, 2002, No. 001179

Appeal from the Order Entered July 2, 2012 In the Court of Common Pleas of Philadelphia County Civil Division at No. March Term, 2002, No. 001179

BEFORE: BENDER, J., PANELLA, J., and FITZGERALD [*] , J.

MEMORANDUM

BENDER, J.

In this class action, Progressive Northern Insurance Company and Mountain Laurel Insurance Company, doing business as Progressive Insurance Company (Progressive), appeal from the trial court's July 2, 2012 order entered pursuant to Pa.R.A.P. 341 (b)(3) and (c). Richard S. Glick, D.O., as representative of a class of medical provider plaintiffs (the Providers) cross-appeals. At issue are five interlocutory orders dated October 1, 2003 (granting class certification); April 14, 2009 (granting the Providers partial summary judgment on the issue of liability); June 4, 2009 (denying Progressive's motion for reconsideration); February 11, 2011 (denying Progressive's motion for partial summary judgment on the issue of liability); and April 30, 2012 (denying the Providers' motion for partial summary judgment on the issue of damages and concurrently granting Progressive's cross-motion on the same issue).[1] After review, we reverse the order granting class certification, vacate the remaining orders, and remand with instructions.

Progressive sells auto insurance policies pursuant to the Pennsylvania Motor Vehicle Financial Responsibility Law, 75 Pa.C.S.A. § 1701, et seq. (the MVFRL). Glick offers treatment to persons injured in auto accidents. When Glick provides medical services to an injured person, he sends a standardized invoice, known as the HCFA-1500 Form, to Progressive. According to Glick's amended complaint, submission of the HCFA-1500 Form constitutes reasonable proof of the amount of benefits due an injured person covered under a Progressive policy. Nevertheless, according to Glick, Progressive allows the bills to become overdue, eventually remits payment of the principal, but fails to include payment of 12% interest as required by the MVFRL.

Glick sought class certification to recover unpaid interest on all overdue HCFA-1500 bills. The trial court granted certification of the following class:

[t]he class shall consist of any person, institution, corporation, entity or provider of medical benefits … who has provided and therefore received or is entitled to receive payments for any medical benefits or first party benefits … as those terms are defined in § 1702, § 1711 and § 1712(1), (5) & (6) of the Pennsylvania Motor Vehicle Financial Responsibility Law, 75 Pa.C.S. § 1701 et seq. … arising out of injuries suffered by [Progressive's] insured in motor vehicle accidents, where [Progressive's] payment of such medical benefits are or were "overdue" (as defined in section 1716 of the MVFRL) and [Progressive] have not paid the medical benefits in full because the payments by Progressive did not include 12% per annum interest on such overdue Medical Benefits and/or no payment of Medical Benefits has yet been made or are overdue.

Trial Court Order, 10/1/2003.

Thereafter, the court granted the Providers partial summary judgment on the issue of liability, concluding that submission of standardized billing forms stating the amounts of charges and a description of services constituted "reasonable proof of the amount of benefits" under the controlling provisions of the MVFRL. Accordingly, the court required that Progressive pay interest at 12% per annum on all amounts not tendered within 30 days of billing, pursuant to MVFRL section 1716, further holding that interest should be calculated beginning from the day on which a bill becomes overdue.

Progressive filed a motion for reconsideration, which was denied. Progressive also filed a motion seeking partial summary judgment on a related issue: whether a standardized invoice filed on behalf of institutional providers such as hospitals, the so-called UB-92 Form, similarly provided sufficient notice of medical benefits. The court denied Progressive's motion. Following the parties' stipulation that an immediate appeal would facilitate resolution of the entire case, the court certified this matter pursuant to Pa.R.A.P. 341(b)(3) and (c). The parties timely appealed and complied with Pa.R.A.P. 1925.

At every stage of this litigation, the parties have essentially agreed that proper resolution of this case hinges on a single issue of statutory construction. Issues of statutory construction are pure questions of law subject to de novo review. White Deer Twp. V. Napp, 985 A.2d 745, 754 (Pa. 2009). The scope of our review is plenary. Id. Regarding the trial court's order granting class certification, we review for an abuse of discretion, defined as "a clearly erroneous finding of fact, an errant conclusion of law, or an improper application of law to fact." Sa ...


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