• Post category:Volume 15

STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Appellant, vs. HEATHER SCHETTER, Appellee.

15 Fla. L. Weekly Supp. 863a

Insurance -- Personal injury protection -- Declaratory judgment -- While PIP statute does not require insurer to produce PIP log on presuit request from assignee/medical provider, on remand county court may address argument that furnishing log was required by policy -- Insurer's production of PIP log after provider filed suit is not tantamount to confession of judgment -- Attorney's fees -- Appellate -- Offer of judgment -- Where real issue in case was whether insurer was obligated to produce PIP log, case was not action for damages to which offer of judgment statute applies, and insurer's motion for appellate attorney's fees is denied

Continue ReadingSTATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Appellant, vs. HEATHER SCHETTER, Appellee.
  • Post category:Volume 15

STEPHANIE CASKEY-DELUDE, Appellant, vs. CINCINNATI INSURANCE CO., Appellee.

15 Fla. L. Weekly Supp. 1168a

Insurance -- Med Pay -- Attorney's fees -- Prevailing insured -- Error to deny insured's motion for attorney's fees where insurer settled claim after suit was filed -- Insurer that made ambiguous offer to pay medical payment coverage before insured filed suit for benefits, but did not attempt to pay sums due, did not make effective tender prior to suit

Continue ReadingSTEPHANIE CASKEY-DELUDE, Appellant, vs. CINCINNATI INSURANCE CO., Appellee.
  • Post category:Volume 15

ERIC LAMPINSTEIN, D.C. (a/a/o Laura Roca), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 633c

Attorney's fees -- Insurance -- Personal injury protection -- Justiciable issues -- Insurer's obligation to provide PIP log on presuit request from assignee/medical provider -- Insurer's motion for fee award is denied -- Case law determining insurer is not obligated to provide PIP log under certain statutory provisions did not address any obligation that might arise under other provisions

Continue ReadingERIC LAMPINSTEIN, D.C. (a/a/o Laura Roca), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

EMERGENCY PHYSICIANS OF CENTRAL FLORIDA, as assignee of Jenny Lowe, Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 293a

Attorney's fees -- Insurance -- Personal injury protection -- Justiciable issues -- Exhaustion of benefits -- Where issue of effect of exhaustion of benefits on pending claim is not settled in Florida, it cannot be said that medical provider's claim could not be supported by application of then-existing law to facts -- Although insurer claims to possess evidence that provider's bill was received by insurer after benefits were exhausted, where insurer withheld such evidence from provider until two days before hearing on motion for summary judgment, it would be manifestly unjust to allow insurer to claim that provider should have known all along that facts did not support claim -- Motion for attorney's fees and costs denied

Continue ReadingEMERGENCY PHYSICIANS OF CENTRAL FLORIDA, as assignee of Jenny Lowe, Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

UNITED AUTOMOBILE INSURANCE COMPANY, Appellant, v. MANUEL E. BROOKNER, DC, PA, a/a/o NANCY VIVERA, Appellee.

15 Fla. L. Weekly Supp. 984a

Attorney's fees -- Insurance -- Personal injury protection -- Amount -- No abuse of discretion in setting amount of attorney fee award where trial court was provided with competent substantial evidence of hours expended, details of services performed and reasonable hourly rate -- Costs -- Where expert witness had to review records spanning two years and testified that he had expectation of being paid and that it was burdensome for him to work as expert witness, there is competent substantial evidence supporting decision to award expert witness fee -- No abuse of discretion in denying continuance requested by insurer where trial court, dissatisfied with insurer's attempt to lay predicate and foundation for admission of attorney's affidavits and timesheets, asked attorney if he wanted to continue hearing and denied continuance when attorney stated that he did not want case to be continued

Continue ReadingUNITED AUTOMOBILE INSURANCE COMPANY, Appellant, v. MANUEL E. BROOKNER, DC, PA, a/a/o NANCY VIVERA, Appellee.
  • Post category:Volume 15

MALINDA NOYES, Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 708a

Attorney's fees -- Insurance -- Personal injury protection -- Amount -- Hourly rate -- Reasonable hourly rates set for insured's attorney and paralegal -- Contingency risk multiplier -- Where no attorney in community would accept PIP case without multiplier, attorney was not able to mitigate risk of nonpayment, case posed substantial risk to attorney, and insured's chances of success at outset were even at best, multiplier of 1.5 is appropriate -- No merit to argument that, because insured easily found attorney to handle her personal injury case and thereafter attorney suggested PIP case to recover medical expenses, insured had no difficulty obtaining counsel and is not entitled to multiplier where there is no evidence that insured could have found attorney to handle PIP case without expectation of multiplier -- Costs, expert witness fees and prejudgment interest awarded

Continue ReadingMALINDA NOYES, Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

CORDOVA INJURY CLINIC, P.A. d/b/a CORDOVA INJURY CLINIC, a/a/o Miranda Jimenez, Plaintiff, vs. PROGRESSIVE SELECT INSURANCE COMPANY f/k/a Progressive Auto Pro Insurance Company, Defendant.

15 Fla. L. Weekly Supp. 706a

Attorney's fees -- Insurance -- Personal injury protection -- Amount -- Reasonable hourly rates set for most effective and experienced PIP plaintiff's lawyer in area and exceptional paralegal -- Amount of time spent on case pre-suit was professionally responsible and effective -- Contingency risk multiplier -- Where evidence established that plaintiffs could not obtain competent counsel in PIP cases in area without expectation of multiplier, attorney was not able to mitigate risk of nonpayment, case was problematic due to multiple issues, attorney accepted case despite substantial probability that he would not prevail, and medical provider stipulated that it had even chance to succeed at outset of case, 2.0 multiplier is appropriate -- No merit to argument that multiplier is not justified where provider, who had difficulty obtaining competent counsel in past cases until he found and retained current attorney, had no difficulty obtaining counsel in this case -- Costs, prejudgment interest and expert witness fee awarded

Continue ReadingCORDOVA INJURY CLINIC, P.A. d/b/a CORDOVA INJURY CLINIC, a/a/o Miranda Jimenez, Plaintiff, vs. PROGRESSIVE SELECT INSURANCE COMPANY f/k/a Progressive Auto Pro Insurance Company, Defendant.
  • Post category:Volume 15

CHARLES B. NEAL, d/b/a NEAL CHIROPRACTIC CLINIC, a/a/o Melody Zachary, Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 703b

Attorney's fees -- Insurance -- Personal injury protection -- Amount -- Reasonable hourly rates set for most effective and experienced PIP plaintiff's lawyer in area and exceptional paralegal -- Amount of time spent on case pre-suit was professionally responsible and effective -- Contingency risk multiplier -- Where evidence established that plaintiffs could not obtain competent counsel in PIP cases in area without expectation of multiplier, attorney was not able to mitigate risk of nonpayment, case was problematic due to multiple issues, attorney accepted case despite substantial probability that he would not prevail, and medical provider stipulated that it had even chance to succeed at outset of case, 2.0 multiplier is appropriate -- No merit to argument that multiplier is not justified where provider, who had difficulty obtaining competent counsel in past cases until he found and retained current attorney, had no difficulty obtaining counsel in this case -- Costs, prejudgment interest and expert witness fee awarded

Continue ReadingCHARLES B. NEAL, d/b/a NEAL CHIROPRACTIC CLINIC, a/a/o Melody Zachary, Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

ALVIN WILLIAMS, Plaintiff, vs. PERMANENT GENERAL ASSURANCE CORPORATION, Defendant.

15 Fla. L. Weekly Supp. 399a

Attorney's fees -- Insurance -- Personal injury protection -- Contingency risk multiplier of 1.25 is awarded where relevant market requires multiplier to obtain competent counsel in PIP matters, insured had difficulty obtaining counsel, and likelihood of success at outset was 40% - 70% -- Expert witness fee, costs and prejudgment interest awarded

Continue ReadingALVIN WILLIAMS, Plaintiff, vs. PERMANENT GENERAL ASSURANCE CORPORATION, Defendant.
  • Post category:Volume 15

WILLIAM SIMPSON, Plaintiff, vs. PERMANENT GENERAL ASSURANCE CORPORATION, Defendant.

15 Fla. L. Weekly Supp. 398b

Attorney's fees -- Insurance -- Personal injury protection -- Contingency risk multiplier of 1.25 is awarded where relevant market requires multiplier to obtain competent counsel in PIP matters, insured had difficulty obtaining counsel, and likelihood of success at outset was 40% - 70% -- Expert witness fee, costs and prejudgment interest awarded

Continue ReadingWILLIAM SIMPSON, Plaintiff, vs. PERMANENT GENERAL ASSURANCE CORPORATION, Defendant.
  • Post category:Volume 15

JAMES WHITE, Plaintiff, vs. PERMANENT GENERAL ASSURANCE CORPORATION, Defendant.

15 Fla. L. Weekly Supp. 398a

Attorney's fees -- Insurance -- Personal injury protection -- Contingency risk multiplier of 1.25 is awarded where relevant market requires multiplier to obtain competent counsel in PIP matters, insured had difficulty obtaining counsel, and likelihood of success at outset was 40% - 70% -- Expert witness fee, costs and prejudgment interest awarded

Continue ReadingJAMES WHITE, Plaintiff, vs. PERMANENT GENERAL ASSURANCE CORPORATION, Defendant.
  • Post category:Volume 15

MERCURY INSURANCE COMPANY OF FLORIDA, Appellant, vs. A BAYOU CHIROPRACTIC CENTER, P.A., d/b/a ART OF CHIROPRACTIC, a/a/o Sidney White, Appellee.

15 Fla. L. Weekly Supp. 241a

Attorney's fees -- Insurance -- Personal injury protection -- Amount -- Hourly rate -- Although $350 hourly rate appears substantial for area, it is supported by competent substantial evidence that counsel has billed other clients at rate and been awarded rate as expert witness in PIP cases -- Costs -- Expert witness fees -- No abuse of discretion in taxing expert witness fees as costs where expert was required to spend 5 hours reviewing file and preparing for deposition that lasted additional hour, and expert testified that he expected to be paid reasonable fee for services -- Contingency risk multiplier -- Abuse of discretion to award multiplier where there was no evidence that insureds who assigned claims to medical provider had difficulty obtaining counsel, and litigation was not of unusual duration or difficulty

Continue ReadingMERCURY INSURANCE COMPANY OF FLORIDA, Appellant, vs. A BAYOU CHIROPRACTIC CENTER, P.A., d/b/a ART OF CHIROPRACTIC, a/a/o Sidney White, Appellee.
  • Post category:Volume 15

J. MARK RENFROE, D.C. dba RENFROE SPINAL CENTER, Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 167a

Attorney's fees -- Insurance -- Personal injury protection -- Amount -- Reasonable hourly rates for attorneys representing medical provider are $300 and $350, and reasonable hourly rate for paralegal is $85 where case spanned more than 5 years and involved novel issue of necessity and reasonableness of dynamic motion x-ray test that required complex litigation on trial and appellate level -- Contingency risk multiplier -- Where evidence establishes that competent counsel cannot be attracted and retained in community in PIP cases without contingency risk multiplier, provider has personally experienced difficulty in finding attorneys in past but now had established relationship with counsel, counsel were not able to mitigate risk of nonpayment, case involved novel issue and posed substantial risk of loss to counsel, multiplier of 2.0 is appropriate -- Costs, expert witness fee and prejudgment interest awarded

Continue ReadingJ. MARK RENFROE, D.C. dba RENFROE SPINAL CENTER, Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

TAMPA PERSONAL INJURY CLINIC, INC., as assignee of Angela Garcia, Plaintiff, vs. NATIONAL SPECIALTY INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 157a

Attorney's fees -- Insurance -- Personal injury protection -- Amount -- Contingency risk multiplier -- Application of multiplier is not warranted where denial of benefits on ground that traffic crash report did not list insured as passenger or driver did not involve novel or complex issue and required no significant legal expertise -- Costs, expert witness fees and prejudgment interest awarded

Continue ReadingTAMPA PERSONAL INJURY CLINIC, INC., as assignee of Angela Garcia, Plaintiff, vs. NATIONAL SPECIALTY INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

UNITED AUTOMOBILE INSURANCE COMPANY, Appellant, v. EDUARDO J. GARRIDO, D.C., P.A., Appellee.

15 Fla. L. Weekly Supp. 118a

Attorney's fees -- Insurance -- Personal injury protection -- Contin-gency risk multiplier -- Abuse of discretion to award multiplier where, although medical provider's attorney and expert testified that attorney would not have taken case had there not been potential for multiplier, there was no testimony from provider that he would have had substantial difficulty in obtaining competent counsel in relevant market without fee enhancement, and attorney testified that provider could have hired another lawyer -- Further, multiplier was not warranted where attorney could mitigate risk of nonpayment by being retained in provider's numerous other cases, and insurer's expert refuted claim that case was novel or difficult

Continue ReadingUNITED AUTOMOBILE INSURANCE COMPANY, Appellant, v. EDUARDO J. GARRIDO, D.C., P.A., Appellee.
  • Post category:Volume 15

UNITED AUTOMOBILE INSURANCE COMPANY, Appellant, vs. HOLLYWOOD INJURY REHAB, a/a/o MENENDES, R., Appellee.

15 Fla. L. Weekly Supp. 1052a

Insurance -- Personal injury protection -- Withdrawal or denial of benefits -- Peer review -- Trial court did not err in refusing to consider peer review report obtained more than 30 days after receipt of claim where insurer never filed peer review report or affidavit of peer review doctor with trial court -- To ensure that peer review report and affidavit were available for appellate review, insurer had responsibility to file report and affidavit despite trial court striking report -- No error in granting summary judgment in favor of medical provider where, in absence of valid peer review report supported by physical examination and accompanying affidavit, there was nothing in record to create genuine issue of material fact or justify denial of motion for summary judgment -- Attorney's fees -- Appellate -- Fees are assessed against insurer and its counsel as sanction for filing frivolous appeal

Continue ReadingUNITED AUTOMOBILE INSURANCE COMPANY, Appellant, vs. HOLLYWOOD INJURY REHAB, a/a/o MENENDES, R., Appellee.
  • Post category:Volume 15

ASSURANCE AMERICA INSURANCE CO., Petitioner, vs. AFO IMAGING, INC. a/a/o Brittany Bogue, Respondent.

15 Fla. L. Weekly Supp. 1058a

Insurance -- Personal injury protection -- Attorney's fees -- Appellate fees are awarded to medical provider that prevailed on appeal conditioned on provider ultimately prevailing in trial court proceedings

Continue ReadingASSURANCE AMERICA INSURANCE CO., Petitioner, vs. AFO IMAGING, INC. a/a/o Brittany Bogue, Respondent.
  • Post category:Volume 15

U.S. SECURITY INSURANCE COMPANY, Appellant, vs. ADVANCE HEALTH SERVICES, III, INC. (As Assignee of Jorge Lamora), Appellee.

15 Fla. L. Weekly Supp. 309b

Attorney's fees -- Insurance -- Personal injury protection -- Prevailing party -- Hours -- Abuse of discretion to fail to separate issue of insured's unreasonable refusal to attend independent medical examinations, on which insurer prevailed, from issue of whether payment of PIP benefits were recoverable for services rendered within 30 days prior to IME cutoff, on which medical provider prevailed, when calculating reasonable number of hours expended by provider's counsel -- Contingency risk multiplier -- Abuse of discretion to award 2.5 contingency risk multiplier for litigation of novel legal issue where issue was first decided in sister case, payment of benefits within 30 days of IME cutoff did not become issue until four years into litigation when provider stipulated that failure to attend IME was unreasonable, and there is no competent substantial evidence that provider had substantial difficulties finding counsel -- Abuse of discretion to fail to reduce fee award by taking into account that provider recovered only $356 of $3,550 initially sought

Continue ReadingU.S. SECURITY INSURANCE COMPANY, Appellant, vs. ADVANCE HEALTH SERVICES, III, INC. (As Assignee of Jorge Lamora), Appellee.
  • Post category:Volume 15

PARTNERS IN HEALTH PA LM BEACH, INC., (a/a/o Elusane Joseph), Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 499a

Insurance -- Personal injury protection -- Standing -- Assignment -- Validity -- Insurer's motion for final judgment on pleadings is denied -- No merit to claim that use of abbreviation of medical provider's name in body of assignment and variation of provider's name in heading of assignment created confusion or otherwise invalidated assignment -- Pleadings allege equitable assignment

Continue ReadingPARTNERS IN HEALTH PA LM BEACH, INC., (a/a/o Elusane Joseph), Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

ROBERTS ORTHOPAEDIC CLINIC, P.A., as assignee of Suheily Lopez, Plaintiff, vs. SENTRY INSURANCE, A MUTUAL COMPANY F/K/A VIKING INSURANCE COMPANY OF WISCONSIN, AND DOING BUSINESS AS PEAKE PROPERTY AND CASUALTY INSURANCE, Defendant.

15 Fla. L. Weekly Supp. 1030a

Insurance -- Personal injury protection -- Declaratory judgment -- Unsworn, unsigned fax letter from insurer's adjuster and cancellation language included on installment notice did not satisfy requirement that insurer provide statement under oath of corporate officer, claim manager, or superintendent setting forth any policy or coverage defense as requested in demand letter -- Standing -- Assignment is facially sufficient to create standing for medical provider to maintain declaratory judgment action -- Suit for declaratory relief is appropriate where provider was left in doubt as to its rights

Continue ReadingROBERTS ORTHOPAEDIC CLINIC, P.A., as assignee of Suheily Lopez, Plaintiff, vs. SENTRY INSURANCE, A MUTUAL COMPANY F/K/A VIKING INSURANCE COMPANY OF WISCONSIN, AND DOING BUSINESS AS PEAKE PROPERTY AND CASUALTY INSURANCE, Defendant.
  • Post category:Volume 15

GARY H. WEISS, D.C., a/a/o Lee Ancell, Appellant, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Appellee.

15 Fla. L. Weekly Supp. 141a

Insurance -- Personal injury protection -- Standing -- Where suit was filed in name of treating physician, and physician's name is on every relevant document in suit, but tax identification number provided on claim form pertains to non-party corporation owned by physician and his wife, physician has standing to enforce claim either as individual or as representative for corporation -- Error to enter summary judgment for insurer

Continue ReadingGARY H. WEISS, D.C., a/a/o Lee Ancell, Appellant, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Appellee.
  • Post category:Volume 15

THE HEALTHPLACE, INC., (as assignee of Trinidad Bachez), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 1119b

Insurance -- Personal injury protection -- Standing -- Assignment -- Where there is no proof that entity named in assignment and plaintiff/medical provider are different entities, assignment is sufficient to confer standing

Continue ReadingTHE HEALTHPLACE, INC., (as assignee of Trinidad Bachez), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

LEONARD LINARDOS, D.C., P.A., D/B/A WEST COAST SPINE AND INJURY CENTER, A/A/O LATANYA CROSS, Plaintiff, vs. UNITED SERVICES AUTOMOBILE ASSOCIATION, Defendant.

15 Fla. L. Weekly Supp. 613a

Insurance -- Personal injury protection -- Standing -- Assignment -- Medical provider/professional association lacks standing where, prior to executing purported assignment to professional association, insured assigned benefits for same services and charges to medical provider in individual capacity, and prior assignment was not mutually revoked at time of assignment to professional association -- Further, where assignment attached to demand letter was invalid, condition precedent to suit has not been satisfied -- Summary judgment granted in favor of insurer

Continue ReadingLEONARD LINARDOS, D.C., P.A., D/B/A WEST COAST SPINE AND INJURY CENTER, A/A/O LATANYA CROSS, Plaintiff, vs. UNITED SERVICES AUTOMOBILE ASSOCIATION, Defendant.
  • Post category:Volume 15

THE HEALTHPLACE, INC., (as assignee of Victor Vachez), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 1012a

Insurance -- Personal injury protection -- Standing -- Assignment -- Where record contains insufficient evidence to resolve dispute as to whether plaintiff is same entity named in assignment, trial court is precluded from entering summary judgment on standing issue -- Waiver -- Defense of lack of standing was waived where defense was not raised in answer or other pleading

Continue ReadingTHE HEALTHPLACE, INC., (as assignee of Victor Vachez), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

THE HEALTHPLACE, INC., (as assignee of Victor Vachez), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 1011c

Insurance -- Personal injury protection -- Insurer breached PIP policy by failing to furnish medical provider with explanation of benefits and copy of policy and endorsements requested in demand letter -- Standing -- Assignment to name that differed from plaintiff's name is sufficient to confer standing

Continue ReadingTHE HEALTHPLACE, INC., (as assignee of Victor Vachez), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

KEVIN J. YATES, D.C., P.A. D/B/A YATES CHIROPRACTIC ASSOCIATES, as assignee of Dawson Rodriguez, Plaintiff, vs. PROGRESSIVE SELECT INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 1105a

Insurance -- Personal injury protection -- Standing -- Assignment -- Medical provider who used unregistered fictitious name on assignment cannot recover PIP benefits -- Provider also lacked standing to issue demand letter

Continue ReadingKEVIN J. YATES, D.C., P.A. D/B/A YATES CHIROPRACTIC ASSOCIATES, as assignee of Dawson Rodriguez, Plaintiff, vs. PROGRESSIVE SELECT INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

OROZCO MEDICAL CENTER, INC. (As Assignee of Juliet Garcia), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 1119c

NOT FINAL VERSION OF OPINION
Subsequent Changes at 16 Fla. L. Weekly Supp. 191a

Insurance -- Personal injury protection -- Standing -- Assignment -- Motion for summary judgment is denied where there is genuine issue of material fact as to validity of assignment

Continue ReadingOROZCO MEDICAL CENTER, INC. (As Assignee of Juliet Garcia), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

LINDA GORDON, Plaintiff(s), vs. PROGRESSIVE AMERICAN INSURANCE, Defendant(s).

15 Fla. L. Weekly Supp. 61b

Insurance -- Personal injury protection -- Demand letter -- Sufficiency -- Where demand letter and attached itemization does not specifically state services rendered, exact amount owed or date of relevant treatment, and amount claimed exceeds unpaid balance shown on payment ledger, demand letter is not sufficient -- Standing -- Assignment -- Insured who assigned benefits to medical provider and has not obtained revocation of assignment lacks standing -- Assignment did not automatically revert back to insured when provider was paid in full

Continue ReadingLINDA GORDON, Plaintiff(s), vs. PROGRESSIVE AMERICAN INSURANCE, Defendant(s).
  • Post category:Volume 15

PEACHTREE CASUALTY INS. CO., Appellant, vs. VOLANDA RUCKER, Appellee.

15 Fla. L. Weekly Supp. 880b

Insurance -- Personal injury protection -- Standing -- Assignment -- Insurer's tender of payment to medical providers after insured filed suit does not amount to confession of judgment such that insurer waived standing defense against insured who assigned benefits to providers -- Record does not support insured's argument that providers reassigned cause of action to her and she remained responsible for payment

Continue ReadingPEACHTREE CASUALTY INS. CO., Appellant, vs. VOLANDA RUCKER, Appellee.
  • Post category:Volume 15

STEPHEN BOND, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 820a

Insurance -- Personal injury protection -- Demand letter -- Sufficiency -- Demand letter that failed to name any medical provider who rendered services or include itemized statement of each exact amount at issue was legally insufficient -- 2003 amendment to section 627.736(11)(a) eliminated argument that insurer's anticipatory breach of policy by denying coverage based on unpaid premium relieved insured of requirement to file demand letter -- Standing -- Assignment -- Where insured had assigned benefits to medical provider and did not obtain revocation of assignment prior to filing demand letter, insured did not have standing to seek payment for bills at issue

Continue ReadingSTEPHEN BOND, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

OROZCO MEDICAL CENTER INC., a/a/o MELANI LINARES, Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 932c

Insurance -- Personal injury protection -- Standing -- Assignment that explicitly states that it is not assignment of any cause of action did not assign right to bring suit to medical provider -- Further, demand letter with insufficient assignment attached failed to satisfy condition precedent of submitting valid pre-suit demand letter -- Summary judgment granted in favor of insurer

Continue ReadingOROZCO MEDICAL CENTER INC., a/a/o MELANI LINARES, Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

OROZCO MEDICAL CENTER, INC. (As Assignee of Tiffany Campbell-Williams), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 729a

Insurance -- Personal injury protection -- Explanation of benefits -- Insurer breached PIP policy by failing to provide EOB and failing to provide copy of policy and endorsements requested in demand letter -- Standing -- Assignment that assigned benefits but not cause of action is sufficient

Continue ReadingOROZCO MEDICAL CENTER, INC. (As Assignee of Tiffany Campbell-Williams), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

UNITED AUTOMOBILE INS. CO., Appellant, vs. DIAGNOSTIC MEDICAL CENTER, (a/a/o MADELIN NUNEZ), Appellee.

15 Fla. L. Weekly Supp. 967a

Insurance -- Personal injury protection -- Standing -- Assignment -- Insured may execute assignments in favor of multiple medical providers -- Affirmative defenses -- Amendment -- Denial -- Abuse of discretion to not allow insurer to amend affirmative defenses to add exhaustion of benefits defense where proffered affirmative defense does not prejudice medical provider -- Error to enter summary judgment despite existence of disputed issue of fraud

Continue ReadingUNITED AUTOMOBILE INS. CO., Appellant, vs. DIAGNOSTIC MEDICAL CENTER, (a/a/o MADELIN NUNEZ), Appellee.
  • Post category:Volume 15

OROZCO MEDICAL CENTER, INC., a/a/o ALEJANDRA MERCADO, Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 1213c

Insurance -- Personal injury protection -- Standing -- Assignment -- Where assignment explicitly states that it does not assign any cause of action, medical provider lacks standing to bring suit for PIP benefits -- Further, provider failed to satisfy condition precedent to bringing suit by failing to submit valid demand letter where assignment attached to demand letter did not confer right to bring suit

Continue ReadingOROZCO MEDICAL CENTER, INC., a/a/o ALEJANDRA MERCADO, Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

DIGITAL MEDICAL DIAGNOSTICS, Appellant, vs. ALLSTATE INS. CO., Appellee.

15 Fla. L. Weekly Supp. 1147b

Insurance -- Personal injury protection -- Standing -- Assignment -- Error to find that assignment is invalid because it was not executed by medical provider where clause requiring execution by provider refers only to agreement to arbitrate, not entire assignment, and is without effect because it lacks consideration -- Assignment is unilateral contract that became binding when provider furnished medical services -- Moreover, insurer with no privity to assignment has no standing to challenge its validity -- Equitable assignment -- Even if contract creating assignment were deficient as legal matter, where intent of parties to enter into assignment is clear, equitable assignment was created

Continue ReadingDIGITAL MEDICAL DIAGNOSTICS, Appellant, vs. ALLSTATE INS. CO., Appellee.
  • Post category:Volume 15

DAVID E. YACHTER, D.C., P.A., Florida Corporation (assignee of Dorsainvil, Josette), Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 189a

Insurance -- Personal injury protection -- Standing -- Assignment -- Motion for summary judgment asserting that medical provider/professional association lacks standing because assignment is to medical provider personally is denied where factual dispute exists as to intent to form equitable assignment

Continue ReadingDAVID E. YACHTER, D.C., P.A., Florida Corporation (assignee of Dorsainvil, Josette), Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

ARTIBONITE INJURY CARE CENTER, (a/a/o Rigobert Leger), Plaintiff, v. NEW HAMPSHIRE INDEMNITY COMPANY, INC., Defendant.

15 Fla. L. Weekly Supp. 188b

Insurance -- Personal injury protection -- Standing -- Assignment -- Validity -- No merit to claims that assignment does not identify policy being assigned or that there is no evidence that assignment attached to demand letter and to complaint was executed before suit was filed -- Affidavit clarifies any ambiguity in assignment -- There is no requirement that assignment be signed by medical provider or witnesses -- Even if assignment were invalid, assignment combined with affidavit demonstrates existence of equitable assignment -- Motion for summary judgment denied

Continue ReadingARTIBONITE INJURY CARE CENTER, (a/a/o Rigobert Leger), Plaintiff, v. NEW HAMPSHIRE INDEMNITY COMPANY, INC., Defendant.
  • Post category:Volume 15

NDNC NEUROLOGICAL TREATMENT CENTER, INC. (a/a/o Jocelia Figueroa), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 1016b

Insurance -- Personal injury protection -- Arbitration -- Where parties did not request trial de novo within deadline for such request, trial court must enter judgment in accordance with decision of arbitrator

Continue ReadingNDNC NEUROLOGICAL TREATMENT CENTER, INC. (a/a/o Jocelia Figueroa), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

SOUTH FLORIDA PAIN & REHABILITATION CENTER (a/a/o Andrew Knowles), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 936a

Attorney's fees -- Insurance -- Personal injury protection -- Arbitration -- Trial de novo -- Insurer that prevailed in trial de novo following arbitration award in favor of medical provider is not entitled to award of attorney's fees under arbitration statute that provides for assessment of fees against party that requests trial de novo if judgment is not more favorable than arbitration decision where insurer, not provider, requested trial -- Insurer is entitled to award of costs under section 57.041

Continue ReadingSOUTH FLORIDA PAIN & REHABILITATION CENTER (a/a/o Andrew Knowles), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
  • Post category:Volume 15

FRED J. SAGER, a/a/o Chailissea Austin, Plaintiff(s), vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant(s).

15 Fla. L. Weekly Supp. 1228a

Insurance -- Personal injury protection -- Arbitration -- Where parties did not request trial de novo within deadline for such request, trial court must enter judgment in accordance with decision of arbitrator

Continue ReadingFRED J. SAGER, a/a/o Chailissea Austin, Plaintiff(s), vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant(s).
  • Post category:Volume 15

ANTHONY SGRO, Plaintiff, vs. ARMSTRONG TRAILER MANUFACTURING CO., INC., a Florida corporation; M.S.A. ENTERPRISES, INC., a Florida corporation; MARK HARRISON; and BRUCE HUNT, Defendants.

15 Fla. L. Weekly Supp. 278b

Arbitration -- Where neither party filed motion for trial de novo within twenty days of service of arbitrator's decision, court must enforce decision

Continue ReadingANTHONY SGRO, Plaintiff, vs. ARMSTRONG TRAILER MANUFACTURING CO., INC., a Florida corporation; M.S.A. ENTERPRISES, INC., a Florida corporation; MARK HARRISON; and BRUCE HUNT, Defendants.
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BANAT INVESTMENT CORPORATION, Plaintiff, vs. CERTAIN INTERESTED UNDERWRITERS AT LLOYD’S, LONDON SUBSCRIBING TO CERTIFICATE NO. JH961576A, an Unincorporated foreign association of Individuals, Defendant.

15 Fla. L. Weekly Supp. 361a

Insurance -- Commercial property -- Surplus lines -- Appraisal -- Insurer did not waive binding appraisal provision of policy by disputing coverage and not requiring appraisal until after suit was filed -- Insured has not shown waiver of appraisal by delay, repudiation of contract, prejudice to insured or because ongoing repairs make appraisal impossible or impractical -- Hurricane mediation -- No merit to claim that section 627.7015 bars enforcement of appraisal provision because insurer failed to notify insured of right to participate in hurricane mediation program under statute bcause statute does not apply to surplus lines insurance -- Suit stayed pending outcome of appraisal

Continue ReadingBANAT INVESTMENT CORPORATION, Plaintiff, vs. CERTAIN INTERESTED UNDERWRITERS AT LLOYD’S, LONDON SUBSCRIBING TO CERTIFICATE NO. JH961576A, an Unincorporated foreign association of Individuals, Defendant.
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AFFIRMATIVE INSURANCE COMPANY, Appellant, v. AMERICAN HEALTH & REHABILITATION CENTER a/a/o VERILUS TOUTOUTE, Appellee.

15 Fla. L. Weekly Supp. 311a

NOT FINAL VERSION OF OPINION
Subsequent Changes at 15 Fla. L. Weekly Supp. 570a

Insurance -- Personal injury protection -- Application -- Misrepresentations -- Refund of premiums -- Trial court erred in directing verdict in favor of medical provider where insured's testimony as to whether he received refund check was inconsistent, and insurer presented copy of refund check and testimony that check was mailed in normal course of business

Continue ReadingAFFIRMATIVE INSURANCE COMPANY, Appellant, v. AMERICAN HEALTH & REHABILITATION CENTER a/a/o VERILUS TOUTOUTE, Appellee.
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SPINE REHABILITATION CENTER, INC., (as assignee of Luis Leyva), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 378a

Insurance -- Personal injury protection -- Application -- Misrepresentations -- Insurer waived alleged misrepresentation in application by failing to return premiums to insured

Continue ReadingSPINE REHABILITATION CENTER, INC., (as assignee of Luis Leyva), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
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SPINE REHABILITATION CENTER, INC., (as assignee of Jenry Valdes), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 185a

Insurance -- Personal injury protection -- Application -- Misrepresentations -- Insurer waived alleged material misrepresentation by failing to return premium to insured

Continue ReadingSPINE REHABILITATION CENTER, INC., (as assignee of Jenry Valdes), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.
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AFFIRMATIVE INSURANCE COMPANY, Appellant, v. AMERICAN HEALTH & REHABILITATION CENTER a/a/o Verilus Toutoute, Appellee.

15 Fla. L. Weekly Supp. 570a

Insurance -- Personal injury protection -- Application -- Misrepresentations -- Refund of premiums -- Trial court erred in directing verdict in favor of medical provider where insured's testimony as to whether he received refund check was inconsistent, and insurer presented copy of refund check and testimony that check was mailed in normal course of business -- Further, court erred as matter of law in taking rescission issue away from jury based on belief that misrepresentation did not impose additional risk on insurer where uncontroverted testimony established that policy's premium rate would have been 15% higher had there been no misrepresentation

Continue ReadingAFFIRMATIVE INSURANCE COMPANY, Appellant, v. AMERICAN HEALTH & REHABILITATION CENTER a/a/o Verilus Toutoute, Appellee.
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SOUTH FLORIDA INSTITUTE OF MEDICINE, (a/a/o MICHAEL DUNCAN), Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 174a

Insurance -- Personal injury protection -- Application -- Misrepresentations -- Where insured failed to inform insurer of licensed son residing in household, and insurer would not have issued policy at same premium had it known of son, insurer may deny coverage for injuries sustained by son while driving vehicle owned by father and insured by different insurer -- No merit to argument that coverage must be extended to son under Innocent Insured Doctrine where son is not unrelated third-party beneficiary of mother's policy and represents additional risk not reflected in premium -- Son should look to insurer of father's vehicle for coverage

Continue ReadingSOUTH FLORIDA INSTITUTE OF MEDICINE, (a/a/o MICHAEL DUNCAN), Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.
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MARIA ELENA MARTINEZ, Appellant, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY a/s/o CATHY PIERCE, et al., Appellees.

15 Fla. L. Weekly Supp. 583a

Insurance -- Automobile -- Appeals -- Timeliness -- Appeal was timely filed where motion for rehearing tolled rendition of final default judgment until order disposing of motion was rendered -- Absence of transcript -- Issues not raised below -- Affirmance of lower court ruling

Continue ReadingMARIA ELENA MARTINEZ, Appellant, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY a/s/o CATHY PIERCE, et al., Appellees.
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UNITED AUTOMOBILE INSURANCE COMPANY, Appellant, vs. OPEN MAGNETIC IMAGING, INC., a/a/o Rosa Crespo, Appellee.

15 Fla. L. Weekly Supp. 219a

Insurance -- Personal injury protection -- Summary judgment -- Peer review report -- Error to strike peer review report as untimely because report was not obtained during 30-day period allowed for obtaining proof that services were not reasonable, related or necessary -- However, where insurer did not object to order striking report or request rehearing on order, issue was not preserved for appeal

Continue ReadingUNITED AUTOMOBILE INSURANCE COMPANY, Appellant, vs. OPEN MAGNETIC IMAGING, INC., a/a/o Rosa Crespo, Appellee.
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UNITED AUTOMOBILE INSURANCE COMPANY, Appellant, v. JOSE IGNACIO CARVALLO, Appellee.

15 Fla. L. Weekly Supp. 565b

Insurance -- Personal injury protection -- Evidence -- Peer review -- Insurer waived right to appellate review of exclusion of peer review report and peer review doctor's testimony as to reasonableness, relatedness and medical necessity of treatment where insurer failed to proffer report or testimony -- Where trial court did nothing to interfere with reasonable proffer, there is no fundamental error

Continue ReadingUNITED AUTOMOBILE INSURANCE COMPANY, Appellant, v. JOSE IGNACIO CARVALLO, Appellee.
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AFFIRMATIVE INSURANCE COMPANY, Appellant, v. AMERICAN HEALTH & REHABILITATION CENTER, INC., a/a/o KENYATA MAJOR, Appellee.

15 Fla. L. Weekly Supp. 221b

Insurance -- Personal injury protection -- Coverage -- Where court determined that insured's misrepresentation on application for personal injury protection coverage was not material and did not void the policy and entered judgment in favor of provider/assignee in its claim against PIP insurer for treatment provided to insurer, and insurer did not appeal that judgment, insurer was collaterally estopped from bringing consolidated appeal challenging, on ground that insured's misrepresentations voided coverage, judgments in favor of provider/assignee for treatment provided to insured's passengers for injuries sustained in same accident -- Possible mistake of law in judgment in favor of provider as assignee of named insured does not disqualify it as final judgment for purposes of collateral estoppel -- Mistake of law cannot be remedied by rule 1.540(b) motion filed by PIP insurer

Continue ReadingAFFIRMATIVE INSURANCE COMPANY, Appellant, v. AMERICAN HEALTH & REHABILITATION CENTER, INC., a/a/o KENYATA MAJOR, Appellee.
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B&T MEDICAL CENTER, LLC, as assignee of DIANIBEL RODRIGUEZ, Petitioner, v. PROGRESSIVE AMERICAN INSURANCE COMPANY, a foreign corporation, Respondent.

15 Fla. L. Weekly Supp. 420a

Insurance -- Personal injury protection -- Discovery -- Depositions -- Certiorari challenge to order denying motion for protective order seeking to prevent depositions of medical provider's owner, firm administrator, and physical therapist/chiropractic assistant who allegedly provided treatment to insured fails where there is no merit to claims that insurer waived all affirmative defenses except coverage and seeks to take depositions only to inquire into unpled issues -- No abuse of discretion in denying motion to stay depositions until disposition of appeal -- Attorney's fees -- Insurer's motion for section 57.105(1) attorney's fees is denied in view of ambiguity surrounding reason insurer sought to take depositions

Continue ReadingB&T MEDICAL CENTER, LLC, as assignee of DIANIBEL RODRIGUEZ, Petitioner, v. PROGRESSIVE AMERICAN INSURANCE COMPANY, a foreign corporation, Respondent.
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MERCURY INSURANCE COMPANY OF FLORIDA, Appellant, v. FRANCISCO ANTUNEZ, Appellee.

15 Fla. L. Weekly Supp. 962a

Insurance -- Personal injury protection -- Appeals -- Amended judgment -- Where insurer voluntarily dismissed appeal of final judgment after window for filing appeal had closed, time for filing appeal was not renewed by subsequent entry of amended final judgment and second amended final judgment that, in correcting error in calculation of interest and scrivener's error in text, did not make material changes to judgment -- In subsequent appeal, only amended portions of judgment may be challenged, and insurer is barred from contesting any issue that was or could have been raised in first appeal

Continue ReadingMERCURY INSURANCE COMPANY OF FLORIDA, Appellant, v. FRANCISCO ANTUNEZ, Appellee.
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MARTINEZ CHIROPRACTIC CENTER, INC., (Manuel Alonso, Patient), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

15 Fla. L. Weekly Supp. 163a

Insurance -- Personal injury protection -- Discovery -- Admissions -- Insurer's motion for relief from technical admissions is denied where insurer cannot demonstrate justifiable reason for failure to timely respond to request for admissions despite being put on notice of noncompliance three times, and allowing insurer relief from technical admissions would prejudice medical provider by creating substantial delay in resolution of matter

Continue ReadingMARTINEZ CHIROPRACTIC CENTER, INC., (Manuel Alonso, Patient), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.