Opinion

Government Employees Insurance Co. v. AFO Imaging, Inc.

Court
District Court, M.D. Florida
Filed
Jul 7, 2021
Cited by
0 cases
Authority
More cited than 19.8%

The opinion

UNITED STATES DISTRICT COURT

MIDDLE DISTRICT OF FLORIDA

TAMPA DIVISION

GOVERNMENT EMPLOYEES

INSURANCE CO., et al.,

Plaintiffs,

v. Case No. 8:20-cv-2419-VMC-CPT

AFO IMAGING, INC. d/b/a

ADVANCED DIAGNOSTIC GROUP,

et al.,

Defendants.

/

ORDER

This matter comes before the Court upon consideration of

Plaintiffs and Counterclaim-Defendants Government Employees

Insurance Co., Geico Indemnity Co., Geico General Insurance

Company, and GEICO Casualty Co.’s (collectively, “Geico’s”)

Motion to Dismiss Counterclaims (Doc. # 54), filed on March

29, 2021. Defendant and Counterclaimant AFO Imaging, Inc.

d/b/a Advanced Diagnostic Group responded on April 19, 2021.

(Doc. # 56). For the reasons below, the Motion is granted in

part and denied in part.

I. Background

Both the Court and the parties are familiar with the

facts of the civil conspiracy case. Thus, the Court need not

reiterate them in detail here. Advanced Diagnostic owns and

operates multiple Florida diagnostic clinics. (Doc. # 1 at ¶

10). Geico is a motor vehicle insurer that reimbursed Advanced

Diagnostic for certain personal injury protection insurance

(“PIP insurance”) covered radiology procedures. (Id. at ¶¶ 1,

9). In the underlying suit, Geico asserts that Advanced

Diagnostic entered into two related fraudulent schemes with

the other Defendants. First, Advanced Diagnostic allegedly

submitted or caused to be submitted thousands of PIP insurance

charges for medically unnecessary, falsified radiology

services. (Id. at ¶¶ 1, 7). Second, the Advanced Diagnostic

clinics allegedly operated in violation of Florida law

because their medical directors did not properly perform

their duties. (Id. at ¶¶ 120-38).

Geico filed the underlying complaint on October 16,

2020. (Doc. # 1). On January 4, 2021, Advanced Diagnostic

moved to dismiss the complaint. (Doc. # 36). The Court denied

the motion to dismiss on February 25, 2021. (Doc. # 50). On

March 11, 2021, Advanced Diagnostic filed its answer, also

asserting the following counterclaims against Geico: tortious

interference with contractual or prospective business

relationships (Count I), and defamation per se (Count II).

(Doc. # 51). Now, Geico moves to dismiss the counterclaims.

(Doc. # 54). Advanced Diagnostic has responded (Doc. # 56),

and the Motion is ripe for review.

II. Legal Standard

On a motion to dismiss pursuant to Federal Rule of Civil

Procedure 12(b)(6), this Court accepts as true all the

allegations in the counterclaim and construes them in the

light most favorable to the counterclaim-plaintiff. Jackson

v. Bellsouth Telecomms., 372 F.3d 1250, 1262 (11th Cir. 2004).

Further, the Court favors the counterclaim-plaintiff with all

reasonable inferences from the allegations in the

counterclaim. Stephens v. Dep’t of Health & Human Servs., 901

F.2d 1571, 1573 (11th Cir. 1990). But,

[w]hile a [counterclaim] attacked by a Rule

12(b)(6) motion to dismiss does not need detailed

factual allegations, a [counterclaim-plaintiff’s]

obligation to provide the grounds of his

entitlement to relief requires more than labels and

conclusions, and a formulaic recitation of the

elements of a cause of action will not do. Factual

allegations must be enough to raise a right to

relief above the speculative level.

Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007)

(quotations and citations omitted). Courts are not “bound to

accept as true a legal conclusion couched as a factual

allegation.” Papasan v. Allain, 478 U.S. 265, 286 (1986). The

Court must limit its consideration to “well-pleaded factual

allegations, documents central to or referenced in the

[counterclaim], and matters judicially noticed.” La Grasta v.

First Union Sec., Inc., 358 F.3d 840, 845 (11th Cir. 2004).

III. Analysis

Geico moves to dismiss both of Advanced Diagnostic’s

counterclaims. The Court will address each claim in turn.

A. Tortious Interference

First, Geico moves to dismiss Count I – Advanced

Diagnostic’s claim for tortious interference with contractual

or prospective business relationships – because it (1) fails

to “identify a single contract or relationship with any GEICO

Insureds that Advanced Diagnostic actually lost as a result

of GEICO’s actions,” (2) does not “explain how the

[explanation of benefits (“EOB”)] . . . caused ‘certain’

totally unspecified ‘primary care physicians’ to stop

referring patients to Advanced Diagnostic” or “caused the

unspecified ‘other patients’ to stop treating at Advanced

Diagnostic,” and (3) “[t]here can be no claim for tortious

interference with a business relationship where the action

complained of is undertaken to safeguard or promote one’s

financial or economic interest.” (Doc. # 54 at 9-10 (emphasis

and citation omitted)). Advanced Diagnostic responds that the

Motion fails to comply with Local Rule 3.01(g), its claim is

sufficiently pled, and Geico does not have a privilege to

interfere in the business relationship between Advanced

Diagnostic and the patients. (Doc. # 56 at 5-14).

1. Local Rule 3.01(g)

At the outset, the Court agrees with Advanced Diagnostic

that the Motion fails to comply with Local Rule 3.01(g), which

requires that parties confer in good faith before filing

certain motions – including motions to dismiss. Local Rule

3.01(g), M.D. Fla. A certification noting this conferral must

be included at the end of the motion. (Id.). Prior to February

2021, however, the Local Rules did not require such conferral

when moving to dismiss. See U.S. Dist. Ct. Middle Dist. of

Fla., 2020 Local Rule Revisions – Bullet Point Summary,

available at https://www.flmd.uscourts.gov/sites/flmd/files/

documents/flmd-2020-local-rule-revisions-bullet-point-

summary.pdf (last visited June 30, 2021) (noting the

expansion of Rule 3.01(g) to include motions to dismiss).

Because this Motion was filed in March 2021 – shortly

after the change in Local Rules – and because denying this

Motion for this reason would further delay the case, the Court

excuses the omission. Accordingly, the Motion is denied as to

this requested relief. See Judkins v. Bloomen Int’l, Inc.,

No. 8:09-cv-2538-EAK-TBM, 2010 WL 2510665, at *2 (M.D. Fla.

June 21, 2010) (“The Court will not use this technicality as

the basis for denying the motion but advises that Plaintiff’s

counsel henceforth adhere to Local Rule 3.01(g).”).

2. Failure to State a Claim

Turning to the substance of the counterclaims,

“[t]ortious interference with a contract and tortious

interference with a business relationship are very similar

causes of action. The primary difference is that in one there

is a contract and in the other there is only a business

relationship.” Plain Bay Sales, LLC v. Gallaher, No. 18-

80581-CIV-DIMITROULEAS, 2018 WL 4208343, at *4 (S.D. Fla.

Aug. 23, 2018). The Court will address each in turn.

a. Contractual Relationship

To state a claim for tortious interference with a

contractual relationship under Florida law, the plaintiff

must sufficiently allege the following elements: (1) “the

existence of a contract”; (2) “the defendant’s knowledge

thereof”; (3) “the defendant’s intentional and unjustified

procurement of a breach thereof”; and (4) damages. Sun Life

Assurance Co. of Can. v. Imperial Premium Fin., LLC, 904 F.3d

1197, 1215 (11th Cir. 2018) (citation omitted).

Here, Advanced Diagnostic has not alleged the existence

of a contract with any patients. Advanced Diagnostic only

cursorily states: “Geico was aware that AFO maintains

contractual or prospective business relationships with

patients who sustained personal injuries in motor vehicle

accidents and who were insured under polices [(sic)] of

insurance issued by Geico.” (Doc. # 51 at ¶ 58). This vague

allegation fails to raise the alleged right to relief above

a speculative level. See Collier HMA Physician Mgmt., LLC v.

NCH Healthcare Sys., Inc., No. 2:18-cv-408-SPC-MRM, 2019 WL

277733, at *8 (M.D. Fla. Jan. 22, 2019) (dismissing a claim

for tortious interference with a contractual relationship

where the plaintiff failed to allege the existence of an

actual contract to which it was a party).

Accordingly, Count I is dismissed without prejudice to

the extent it asserts a claim for tortious interference with

a contractual relationship. See Roberta L. Marcus, Inc. v.

New Cingular Wireless PCS, LLC, No. 12-20744-Civ-SCOLA, 2012

WL 12866788, at *6 (S.D. Fla. Oct. 25, 2012) (“[T]he Amended

Complaint fails to allege the existence of a contract that

Marcus contends the Defendants interfered with. Although

there are other pleading deficiencies regarding Count VII,

this defect is fatal.”).

b. Business Relationship

To state a claim for tortious interference with a

business relationship under Florida law, the plaintiff must

sufficiently allege the following elements: “(1) the

existence of a business relationship under which the

plaintiff has legal rights; (2) an intentional and

unjustified interference with the relationship; and (3)

damage to the plaintiff as a result of the tortious

interference with that relationship.” Coach Servs., Inc. v.

777 Lucky Accessories, Inc., 752 F. Supp. 2d 1271, 1273 (S.D.

Fla. 2010) (quoting Ad-Vantage Tel. Directory Consultants,

Inc. v. GTE Directories Corp., 849 F.2d 1336, 1348-49 (11th

Cir. 1987)). “To satisfy the first prong of a tortious

interference of a business relationship claim, the plaintiff

may allege ‘tortious interference with present or prospective

customers but no cause of action exists for tortious

interference with a business’s relationship to the community

at large.’” Id. (quoting Ethan Allen, Inc. v. Georgetown

Manor, Inc., 647 So.2d 812, 815 (Fla. 1994)). “As a general

rule, an action for tortious interference with a business

relationship requires a business relationship evidenced by an

actual and identifiable understanding or agreement which in

all probability would have been completed if the defendant

had not interfered.” Bell v. Tampa Bay Downs, Inc., No. 8:10-

cv-2835-JSM-TBM, 2011 WL 6718266, at *1 (M.D. Fla. Dec. 21,

2011) (citation omitted).

Here, the business relationship in question is between

Advanced Diagnostic and “patients who sustained personal

injuries in motor vehicle accidents and who were insured under

polices [(sic)] of insurance issued by Geico” and to whom

Advanced Diagnostic “provides health care services.” (Doc. #

51 at ¶¶ 58-59). However, Count I does not allege there is or

was an understanding between these patients and Advanced

Diagnostic such that they would seek medical care at their

clinics. See Drenberg v. Focus! . . . On Surety, LLC, No.

6:13-cv-1351-RBD-KRS, 2013 WL 6768667, at *3 (M.D. Fla. Dec.

20, 2013) (“At the pleading stage, it is not necessary to

name the specific customers at issue so long as there are

sufficient allegations concerning a business relationship

that affords the claimant ‘existing or prospective legal or

contractual rights.’” (citation omitted)). Although Advanced

Diagnostic alleges that it had a right to receive payment

from Geico, that evidences a business relationship between

Advanced Diagnostic and Geico – not between Advanced

Diagnostic and these patients. (Doc. # 51 at ¶ 59).

Accordingly, Count I is dismissed without prejudice to

the extent it asserts a claim for tortious interference with

a business relationship.1 See Vibo Corp. v. U.S. Flue-Cured

Tobacco Growers, Inc., No. 17-22034-WILLIAMS, 2018 WL

1. In its response to Geico’s Motion, Advanced Diagnostic has

not moved for leave to amend. (Doc. # 56).

11149759, at *7 (S.D. Fla. May 15, 2018) (“Here, . . . the

tortious interference claim must be dismissed because

Plaintiff has not identif[ied] any legal rights at stake, and

it [has] not allege[d] any instances of customers[,

distributors or retailers] not performing pursuant to those

legal rights. . . . Absent an allegation of an identifiable

agreement [or understanding] . . . that they would return for

future business, [Plaintiff] has failed to state a claim. The

mere hope that some of its past customers may choose to buy

again cannot be the basis for a tortious interference claim.”

(internal quotation marks and citations omitted)).

B. Defamation Per Se

Next, Geico moves to dismiss Count II – Advanced

Diagnostic’s claim for defamation per se – arguing that it

(1) “fail[s] to identify any specific Insureds who received

the allegedly defamatory EOBs,” (2) “fail[s] to plead any

facts to plausibly allege that the statements in the EOBs

actually tended to injure Advanced Diagnostic in its trade or

profession,” and (3) has “not . . . ple[d] express malice or

. . . overcome the qualified privilege pertaining to EOBs

sent from GEICO to its own Insureds, regarding claims on the

Insureds’ insurance policies.” (Doc. # 54 at 14-17).

“Under Florida law, to state a claim for defamation –

libel or slander – the plaintiff must allege: (1) the

defendant published a false statement; (2) about the

plaintiff; (3) to a third party; and (4) that the falsity of

the statement caused injury to the plaintiff.” Rubinson v.

Rubinson, 474 F. Supp. 3d 1270, 1274 (S.D. Fla. 2020)

(internal quotation marks and citations omitted). “To

successfully plead a claim for defamation per se, the

plaintiff must allege the ‘identity of the particular person

to whom the remarks were made with a reasonable degree of

certainty’ to afford the defendant ‘enough information to

determine affirmative defenses.’” Aflalo v. Weiner, No. 17-

61923-CIV-MORENO, 2018 WL 3235529, at *4 (S.D. Fla. July 2,

2018) (citation and emphasis omitted).

“A written publication constitutes libel per se under

Florida law if, when considered alone and without innuendo,

it (1) charges that a person has committed an infamous crime;

(2) tends to subject one to hatred, distrust, ridicule,

contempt, or disgrace; or (3) tends to injure one in his trade

or profession.” Alan v. Wells Fargo Bank, N.A., 604 F. App’x

863, 865 (11th Cir. 2015). “The significance of the

classification of a communication as actionable per se lies

in the fact that its victim need not plead or prove malice

(except where a privilege is involved) or special damage

because malice and the [occurrence] . . . of damage are both

presumed from the nature of the defamation.” Rubinson, 474 F.

Supp. 3d at 1274-75 (quoting Wolfson v. Kirk, 273 So.2d 774,

777 (Fla. 4th DCA 1973)).

“In a libel per se action, consideration is given only

to the ‘four corners’ of the publication.” Aflalo, 2018 WL

3235529, at *2 (citation and emphasis omitted). Such per se

“defamatory statement[s] must impute conduct to

[counterclaimants] ‘incompatible with the essential functions

of their respective jobs.’” Klayman v. Jud. Watch, Inc., 22

F. Supp. 3d 1240, 1249 (S.D. Fla. 2014) (citation omitted).

Here, Advanced Diagnostic alleges that “[s]ince on or

about November 2, 2020, [Geico] has sent [d]efamatory EOBs to

at least 198 [Geico]-insured [p]atients.” (Doc. # 51 at ¶

65). These EOBs contained the following allegedly false and

defamatory statements: “This claim is denied because the

provider is not in compliance with the licensing and operating

requirements of the Florida Health Care Clinic Act, Fla. Stat.

400.990, et seq.” (Id. at ¶¶ 38, 40). Advanced Diagnostic

contends this falls under the third category of defamation

per se, as it “tend[s] to injure [Advanced Diagnostic] in its

trade or profession.” (Id. at ¶ 66).

1. Specificity

First, Geico argues that Count II has not sufficiently

identified the individuals who received the defamatory EOBs.

(Doc. # 54 at 15). The Court disagrees. The counterclaim

explains that the 198 individuals are insured by Geico,

received medical care from an Advanced Diagnostic clinic, and

received an EOB from Geico denying their claim. (Doc. # 51 at

¶¶ 36-39, 65). Geico attaches examples of such EOBs to its

counterclaim (Doc. # 51-2). This sufficiently identifies

“‘the particular person to whom the remarks were made with a

reasonable degree of certainty’ to afford the [counterclaim-

]defendant ‘enough information to determine affirmative

defenses.’” Ward v. Triple Canopy, Inc., No. 8:17-cv-802-SCB-

MAP, 2017 WL 3149431, at *3 (M.D. Fla. July 25, 2017) (quoting

Buckner v. Lower Fla. Keys Hosp. Dist., 403 So.2d 1025, 1027

(Fla. 3d DCA 1981)); see also Williamson v. Digit. Risk, LLC,

No. 6:18-cv-767-GAP-TBS, 2018 WL 3870064, at *3 (M.D. Fla.

Aug. 15, 2018) (“While the Plaintiff does not identify all of

those to whom the allegedly defamatory statements were made,

she does identify specific groups of people: members of

Taylor’s teams, Defendants’ operations leaders, and the

Plaintiff’s former clients. Identifying specific groups of

people to whom defamatory statements were published is

sufficient; a plaintiff is not required to identify every

individual member of each group by name.”).

2. Injury to Trade or Profession

Next, Geico argues that Count II fails to plausibly

allege that the statements in the EOBs tended to injure

Advanced Diagnostic’s trade or profession. (Doc. # 54 at 15).

Yet, a person reading the EOB could reasonably understand it

to implicate Advanced Diagnostic’s ability to conduct its

business – that is, lawfully operate a clinic in Florida.

Indeed, the EOB specifically stated that Advanced Diagnostic

is not in compliance with the Florida Health Care Clinic Act.

(Doc. # 51 at ¶ 66). Thus, if this statement is false,

Advanced Diagnostic has sufficiently alleged the statement

tends to injure its trade or profession. See Mackroy-Snell v.

Lake Wales Charter Schs., No. 8:06-cv-1380-JSM-MAP, 2006 WL

2864317, at *6 (M.D. Fla. Oct. 5, 2006) (“Plaintiff has

alleged that LWCS board members stated publicly that

‘Plaintiff was terminated for poor job performance’, when in

fact Plaintiff had performed all requisite job duties

properly and effectively. If proven, such statement could be

injurious to Plaintiff’s trade or profession. Of course, this

is a fact that must be proven. This issue is more

appropriately addressed at the summary judgment stage.”).

3. Qualified Privilege

Last, Geico argues that “the statements in the EOBs are

subject to a qualified privilege” and Advanced Diagnostic has

not pled express malice. (Doc. # 54 at 16). Advanced

Diagnostic responds that this privilege determination is

inappropriate at this stage, and that it has sufficiently

pled bad faith and improper means. (Doc. # 56 at 11-14).

“As a general rule, there is a presumption of malice

where statements are defamatory per se.” Shaw v. R.J. Reynolds

Tobacco Co., 818 F. Supp. 1539, 1542 (M.D. Fla. 1993).

However, “a qualified privilege exists for communications

‘made in good faith on any subject matter by one having an

interest therein, or in reference to which he has a duty . .

. if made to a person having a corresponding interest or

duty.’” Gills v. Armfield, No. 8:10-cv-895-JDW-TBM, 2011 WL

13175840, at *5 (M.D. Fla. Mar. 30, 2011) (quoting Nodar v.

Galbreath, 462 So.2d 803, 809 (Fla. 1984)). In such cases,

“the plaintiff then has the burden of rebutting a presumption

of good faith.” Shaw, 818 F. Supp. at 1542. “The elements of

a qualified privilege include: (1) good faith; (2) an interest

in the subject by the speaker or a subject in which the

speaker has a duty to speak; (3) a corresponding interest or

duty in the listener or reader; (4) a proper occasion; and

(5) publication in a proper manner.” Gills, 2011 WL 13175840,

at *5. “Generally, immunity is an affirmative defense that

should be pled by the party asserting it, and which may

thereafter be considered after the facts are fleshed out by

summary judgment or trial.” Fariello v. Gavin, 873 So.2d 1243,

1245 (Fla. 5th DCA 2004).

Here, even assuming the statements in the EOBs are

protected by a qualified privilege, the Court finds that

Advanced Diagnostic has sufficiently alleged actual malice.

The counterclaim avers that Geico intentionally and

unjustifiably made these false statements and that Geico did

so in bad faith to “avoid[] paying for medical benefits.”

(Doc. # 51 at ¶¶ 35, 55, 68). Taking these allegations as

true and making all reasonable inferences in Advanced

Diagnostic’s favor, the Court finds this sufficient. The

Court will be in a better position to determine privilege and

malice at summary judgment. See Stewart Title Guar. Co. v.

Title Dynamics, Inc., No. 2:04-cv-316-VMC-SPC, 2005 WL

2548419, at *5 (M.D. Fla. Oct. 11, 2005) (“Since Prince

alleges malice in its complaint[,] . . . Prince reserves the

ability to set forth facts which may overcome the economic

interest privilege. Furthermore, the Court finds that the

mere existence of a conceivably sustainable affirmative

defense . . . does not mandate the dismissal of a claim;

rather, the claim should be permitted to advance to the next

stage of litigation where the claim and the affirmative

defenses may be fleshed out.”). Therefore, the Motion is

denied as to Count II.

Accordingly, it is

ORDERED, ADJUDGED, and DECREED:

(1) Plaintiffs and Counterclaim-Defendants’ Motion to

Dismiss Counterclaims (Doc. # 54) is GRANTED in part and

DENIED in part.

(2) Count I is DISMISSED without prejudice.

(3) Plaintiff and Counterclaim-Defendants’ answers to the

counterclaim (Doc. # 51) are due by July 21, 2021.

DONE and ORDERED in Chambers, in Tampa, Florida, this

7th day of July, 2021.

tina 90. Husmerby Coe

VIR IA M. HERNANDEZ’*COVINGTON

UNITED STATES DISTRICT JUDGE

17

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