Florida Statute 627.638 - Full Text and Legal Analysis

The 2025 Florida Statutes

Title XXXVII
INSURANCE

Chapter 627
INSURANCE RATES AND CONTRACTS

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627.638 Direct payment for hospital, medical services.—

(1) Any health insurance policy insuring against loss or expense due to hospital confinement or to medical and related services may provide for payment of benefits directly to any recognized hospital, licensed ambulance provider, doctor, or other person who provided the services, in accordance with the provisions of the policy. To comply with this section, the words “or to the hospital, licensed ambulance provider, doctor, or person rendering services covered by this policy,” or similar words appropriate to the terms of the policy, shall be added to applicable provisions of the policy.

(2) Whenever, in any health insurance claim form, an insured specifically authorizes payment of benefits directly to any recognized hospital, licensed ambulance provider, physician, dentist, or other person who provided the services in accordance with the provisions of the policy, the insurer shall make such payment to the designated provider of such services. The insurance contract may not prohibit, and claims forms must provide an option for, the payment of benefits directly to a licensed hospital, licensed ambulance provider, physician, dentist, or other person who provided the services in accordance with the provisions of the policy for care provided. The insurer may require written attestation of assignment of benefits. Payment to the provider from the insurer may not be more than the amount that the insurer would otherwise have paid without the assignment.

(3) Any insurer who has contracted with a preferred provider, as defined in s. 627.6471(1)(b), for the delivery of health care services to its insureds shall make payments directly to the preferred provider for such services.

History.—s. 581, ch. 59-205; s. 3, ch. 76-168; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 487, 497, 809(2nd), ch. 82-243; s. 79, ch. 82-386; s. 1, ch. 85-160; s. 114, ch. 92-318; s. 4, ch. 2005-231; s. 2, ch. 2008-212; ss. 1, 2, ch. 2009-124.

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Amendments to 627.638

Annotations, Discussions, Cases:

Cases Citing Statute 627.638

Total Results: 3

ABRAHAM K. KOHL, DC v. Blue Cross

955 So. 2d 1140, 2007 WL 837176

District Court of Appeal of Florida | Filed: Mar 21, 2007 | Docket: 1659131

Cited 4 times | Published

benefits and health insurance contracts. See § 627.638(2), Fla. Stat. (2005)("Whenever, in any health

Security First Insurance Co. v. State, Office of Insurance Regulation

177 So. 3d 627, 2015 Fla. App. LEXIS 9445, 2015 WL 3824166

District Court of Appeal of Florida | Filed: Jun 22, 2015 | Docket: 60251203

Cited 2 times | Published

insurance contracts.” 955 So.2d at 1143 (citing § 627.638(2), Fla. Stat. (2005)). The Fourth District recognized

Pennsylvania Blue Shield v. Wolfe

575 So. 2d 1361, 1991 Fla. App. LEXIS 2101, 1991 WL 31819

District Court of Appeal of Florida | Filed: Mar 12, 1991 | Docket: 64657059

Cited 1 times | Published

DCA), review denied, 482 So.2d 347 (Fla.1985); § 627.638, Fla.Stat. (1989). With regard to the specific

This Florida statute resource is curated by Graham W. Syfert, Esq., a Jacksonville, Florida personal injury and workers' compensation attorney. Attorney Syfert regularly works with Chapter 627 in the context of insurance coverage law and represents clients throughout Northeast Florida. For legal consultation, call 904-383-7448.