The case of Patricia Richave v. Greater Miami Caterer’s, Inc. and Retailfirst Insurance Company was concluded not to be a simple case of a claimant and employer. This case was a dispute between a health insurer and a workers’ compensation carrier that was masked as a standard workers’ compensation case.
The Claimant was involved in an accident that was initially not covered by her employer, Greater Miami Caterer’s. Later, the accident was accepted as compensable, but her hospitalization at Jackson Memorial Hospital was already covered by her health insurer, Coventry. Coventry made the payments, and sent the matter to the Rawlings Group to recoup their money from the tortfeasor’s liability carrier.
To date, the Employer/Carrier had not refunded the health insurer, though they did report sending a request for payment details from the Jackson Memorial Hospital. Though the Employer/Carrier never received correspondence, they upheld the claim that they were willing to pay the bills according to the hospital’s fee schedule.
Rawlings Group also affirmed that they were not seeking money from the claimant and had not filed any action against them.
Further, per Greynolds Park Manor v. George, 417 So2d 990 (Fla. 1St DCA 1982), it is inappropriate to direct the Employer/Carrier to reimburse a third party insurer.
This case was determined not to be a claimant’s workers’ compensation issue, and therefore not within the JCC’s jurisdiction to decide.
Pending petition DENIED and DISMISSED.
Source: The 440 Authority