AA SUNCOAST CHIROPRACTIC CLINIC, P.A., et al., on behalf of themselves and others similarly situated, Plaintiffs-Appellees,
PROGRESSIVE AMERICAN INSURANCE COMPANY, et al., Defendants-Appellants.
from the United States District Court No.
8:15-cv-02543-RAL-MAP for the Middle District of Florida
JORDAN, GRANT, and HULL, Circuit Judges.
of healthcare providers brought a class action against an
insurance company over a claims-handling process that they
argue is illegal under Florida law. The district court
certified an injunction class under Federal Rule of Civil
Procedure 23(b)(2), but it refused to certify a damages class
under Rule 23(b)(3). On interlocutory appeal, the question is
whether the injunction class should have been certified.
no occasion today to disapprove-or approve-of complaints or
classes that are not before us. In this interlocutory appeal,
we consider only whether the class as certified, proceeding
on the complaint as alleged, is viable. And because what this
"injunction" class really wants is
damages-and more precisely, because the injunctive remedy
that this class seeks would be improper- the answer to that
question is no.
Florida law, car insurance policies must provide personal
injury protection (PIP) benefits up to $10, 000. Fla. Stat.
§ 627.736(1). But under a 2012 amendment to that law,
not every injured motorist will be eligible to access all
$10, 000 in benefits. See 2012 Fla. Laws Ch.
2012-197 § 10. If a person has an "emergency
medical condition" (EMC),  he is eligible for all $10, 000
in benefits. Fla. Stat. § 627.736(1)(a)(3). If not, his
coverage is capped at $2, 500. Id. §
627.736(1)(a)(4). And we have held that in cases where no EMC
determination is made one way or the other, the default is
the $2, 500 cap. Robbins v. Garrison Prop. & Cas.
Ins. Co., 809 F.3d 583, 588 (11th Cir. 2015).
case is a dispute about who is allowed to make the negative
EMC determination. The plaintiffs-two chiropractic providers
and a medical provider that treated injured motorists insured
by Progressive who thereafter assigned their insurance
benefits to the providers (collectively,
"Suncoast")-allege that the defendants-the
Progressive Corporation and two of its insurance
underwriters, Progressive American Insurance Company and
Progressive Select Insurance Company (collectively,
"Progressive")-have denied PIP insurance benefits
in an illegal manner. Specifically, Suncoast alleges that
Progressive relied on negative EMC determinations from
non-treating healthcare providers to limit coverage to $2,
500, and that Florida law allows only treating
providers to make negative EMC determinations.
sued Progressive in Florida state court and sought
class-action status. Progressive removed the case to federal
court under the Class Action Fairness Act, which grants
federal jurisdiction over certain class actions where the
amount in controversy exceeds $5 million and there is minimal
diversity. In its second amended complaint, Suncoast asserted
two counts: one for declaratory and injunctive relief and
another for damages based on breach of contract. The
requested declaration would 1) declare unlawful
Progressive's policy provision purporting to allow
reductions in coverage based on negative EMC determinations
by non-treating physicians, 2) declare unlawful
Progressive's practice of relying on such determinations,
and 3) find that Progressive is not permitted to disregard an
affirmative EMC determination. The requested injunction would
1) restore coverage limits to $10, 000 for affected policies,
2) enjoin Progressive from including policy provisions that
the declaration found unlawful, 3) notify affected
policyholders and providers, and 4) award costs and
attorneys' fees. The breach- of-contract claim sought
damages for underpaid benefits along with interest, costs,
and attorneys' fees.
moved to certify two classes: an injunction class under
Federal Rule of Civil Procedure 23(b)(2) for count one, and a
damages subclass under Rule 23(b)(3) for count two. The
proposed injunction class was defined to include:
A. All Qualified Providers who: (i) received an assignment of
benefits from a Claimant under a Progressive PIP policy, (ii)
provided initial or follow up medical services to a Claimant
after January 1, 2013, and (iii) were given notice by
Progressive that available PIP benefits were reduced to $2,
500 because of a Negative EMC Determination that Progressive
obtained from a Non-treating Provider; and
B. All Claimants who were notified that Progressive reduced
available PIP benefits to $2, 500 because of a Negative EMC
Determination Progressive obtained from a Non-treating
damages subclass was defined to include:
All Qualified Provider Class Members: (i) who were not paid
in full for their services, (ii) who made a pre-suit demand
to Progressive for payment pursuant to § 627.736(10),
and (iii) where Progressive received documentation from a
duly licensed physician, dentist, physician's assistant
or advanced registered nurse practitioner that the Claimant
had an Emergency Medical Condition.
district court refused to certify the damages subclass-which,
under Rule 23(b)(3), would require the court to find
predominance and superiority-because doing so would
necessitate individualized assessments and case management.
But it certified the injunction class, in part because
Suncoast "assured" it that "once the legal
issue is determined, there will be no more supervision
required to determine individual damages."
sought permission for an interlocutory appeal of the
injunction class certification. See Fed. R. Civ. P.
23(f) ("A court of appeals may permit an appeal from an
order granting or denying class-action certification under
this rule . . . ."). A panel of this Court granted that
request. The only issue on interlocutory appeal is whether
the injunction class should have been certified-Suncoast has
not appealed the denial of certification of the damages
subclass, and the merits are not yet at issue.
review a class certification decision for abuse of
discretion. Brown v. Electrolux Home Prods., Inc.,
817 F.3d 1225, 1233 (11th Cir. 2016). "But abuse of
discretion is a continuum, and in the context of class
actions, review for abuse of discretion often does not differ
greatly from review for error." Id. (internal
quotation marks and citations omitted). In conducting this
analysis, we review the district court's factual
determinations for clear error and its legal determinations
de novo. Vega v. T-Mobile USA, Inc., 564 ...