Volume 21

21 Fla. L. Weekly Supp. 705a

Online Reference: FLWSUPP 2107HUNDInsurance -- Venue -- Motion to transfer venue that is not sworn and is not accompanied by supporting affidavit is denied without prejudice

21 Fla. L. Weekly Supp. 66a

Online Reference: FLWSUPP 2101GOLDInsurance -- Stacking -- Uninsured/underinsured motorist -- Where insureds' policy clearly and unambiguously excludes stacking of uninsured/underinsured motorist coverage, and statute provides that limitations accepted by insureds will continue unless insureds request deletion of limitation and pay appropriate premium for additional coverage. insurer was not obligated to provide stacking coverage at non-stacking rate when insureds notified insurer that they wanted to revoke written election against stacked coverage and insurer failed to provide premium statement showing increased charge for increased coverage

21 Fla. L. Weekly Supp. 700b

Online Reference: FLWSUPP 2107VIELInsurance -- Proposal for settlement -- Extension of time within which to respond

21 Fla. L. Weekly Supp. 571a

Online Reference: FLWSUPP 2106MORAInsurance -- Property -- Appraisal -- Insurer's motion to abate litigation and compel appraisal is denied as to invoiced items that were entirely omitted from comparative estimate and is granted as to invoiced items for which comparative estimate assigned price different from price charged by plaintiff

21 Fla. L. Weekly Supp. 440a

Online Reference: FLWSUPP 2105COASInsurance -- Venue -- Domestic insurance company's motion to transfer venue from Broward County to Miami-Dade County is granted where incident occurred, treatment was rendered and fact witnesses reside in Miami-Dade County and insurer does not maintain office for transaction of customary business in Broward County

21 Fla. L. Weekly Supp. 576b

Online Reference: FLWSUPP 2106ASCEInsurance -- Personal injury protection -- Reimbursement by insurer of commercial vehicle -- Where insured of PIP carrier was injured while operating taxicab which was insured under commercial liability policy, PIP carrier is entitled to reimbursement of PIP benefits paid pursuant to section 627.7405, which allows for reimbursement of PIP carriers of private passenger vehicles by insurer of commercial vehicles involved in accident -- Taxicab is commercial motor vehicle -- By terms of PIP statute, right of reimbursement remains applicable notwithstanding section 627.733(1)(b), which excludes taxicabs from security requirements of No-Fault Law

21 Fla. L. Weekly Supp. 576a

Online Reference: FLWSUPP 2106CITYInsurance -- Personal injury protection -- Reimbursement by insurer of commercial vehicle -- Sedan-style police cruiser owned and operated by city qualifies as commercial vehicle under statute -- Literal application of definition of private passenger motor vehicle in PIP statute would result in absurd result of excluding police cruiser from definition of commercial vehicle

21 Fla. L. Weekly Supp. 617a

Online Reference: FLWSUPP 2107LINCInsurance -- Personal injury protection -- Reimbursement by insurer of commercial vehicle -- Sedan is private passenger motor vehicle within meaning of PIP statute, notwithstanding that it was used for taxi service

21 Fla. L. Weekly Supp. 94a

Online Reference: FLWSUPP 2101PALMInsurance -- Personal injury protection -- Reimbursement by insurer of commercial vehicle -- PIP insurer is entitled to reimbursement of all no-fault benefits paid to its insured for injuries sustained in public school bus irrespective of fact that bus was not required to be insured under no-fault law

21 Fla. L. Weekly Supp. 307a

Online Reference: FLWSUPP 2104DESDInsurance -- Personal injury protection -- Jurors -- Challenge -- No abuse of discretion in denying challenge for cause exercised against juror on basis of her background as physical therapist -- Abuse of discretion to deny peremptory challenges against jurors where insurer asserted jurors may not be fair and impartial, and medical provider did not assert that challenges were being used in racially discriminatory manner -- New trial required

21 Fla. L. Weekly Supp. 567a

Online Reference: FLWSUPP 2106BERRInsurance -- Personal injury protection -- Disclosure and acknowledgment form -- Where medical provider did not opt out of class action regarding bills denied by insurer based on noncompliant D&A forms, final judgment in class action extinguished and released provider's claims for bills that were denied due to noncompliant D&A forms

21 Fla. L. Weekly Supp. 188b

Online Reference: FLWSUPP 2102ALAVInsurance -- Personal injury protection -- Independent medical examination -- Failure to attend -- Insurer waived right to dispute claim based on insured's failure to attend two IMEs by requiring insured to attend examination under oath after he failed to attend IMEs -- Insured's nonattendance at unilaterally set IMEs as result of being out of country at time of IMEs does not constitute refusal

21 Fla. L. Weekly Supp. 838b

Online Reference: FLWSUPP 2108WILLInsurance -- Personal injury protection -- Fraud -- False or misleading statement relating to claim or charge -- Statute which relieves insurer or insured from paying claims to any person who knowingly submits false or misleading statement relating to claim or charges does not relieve insurer from paying claims that contained name of physician who no longer worked for provider when services were rendered where provider had no actual knowledge that billing software continued to insert name of physician in Box 31 of claim forms after physician's departure -- No merit to argument that provider acted with reckless disregard or deliberate ignorance where billing clerk took affirmative steps to change information in software and had good faith belief that she had properly done so

21 Fla. L. Weekly Supp. 581a

Online Reference: FLWSUPP 2106AGOMInsurance -- Personal injury protection -- Evidence -- Motions to preclude mention of payments made by insurer, Medicare and permissive statutory fee schedule granted

21 Fla. L. Weekly Supp. 338a

Online Reference: FLWSUPP 2104MANNInsurance -- Personal injury protection -- Discovery -- Documents -- Motion to compel better responses to medical provider's request to produce is granted

21 Fla. L. Weekly Supp. 335b

Online Reference: FLWSUPP 2104ANGLInsurance -- Personal injury protection -- Demand letter is legally insufficient for failing to clearly specify amount due and owing by insurer -- Assignment of benefits attached to demand letter is legally insufficient

21 Fla. L. Weekly Supp. 858a

Online Reference: FLWSUPP 2109MACLNOT FINAL VERSION OF OPINION
Subsequent Changes at 22 Fla. L. Weekly Supp. 20aInsurance -- Personal injury protection -- Demand letter -- Sufficiency -- Demand letter with attached and referenced itemized billing ledger substantially complied with requirements of section 627.736(10) -- There is no requirement that CPT codes be included in demand letter

21 Fla. L. Weekly Supp. 693c

Online Reference: FLWSUPP 2107ORTEInsurance -- Personal injury protection -- Demand letter -- Where medical provider sent demand letter before bills were overdue and then filed complaint 12 days prematurely, proper remedy is dismissal -- No merit to argument that defect in pre-suit notice is cured by passage of time

21 Fla. L. Weekly Supp. 565a

Online Reference: FLWSUPP 2106MITCInsurance -- Personal injury protection -- Demand letter -- Medical provider was not required to send additional demand letter when seeking to amend complaint to add additional dates of service

21 Fla. L. Weekly Supp. 184b

Online Reference: FLWSUPP 2102KISHInsurance -- Personal injury protection -- Demand letter -- No merit to contention that insurer waived affirmative defense of insufficient pre-suit demand letter where insurer asserted defense with sufficient particularity and did not waive it in answers to discovery -- Demand letter that contained itemized statement of exact amount due for each date of service and type of benefits claimed to be due was sufficient; statute does not require medical provider to compute total of amounts owed

21 Fla. L. Weekly Supp. 234a

Online Reference: FLWSUPP 2103SOMMInsurance -- Personal injury protection -- Demand letter -- Where statute requires that copy of assignment of benefits accompany demand letter, providing assignment is condition precedent to suit -- Proper remedy for medical provider's failure to include assignment with demand letter is abatement or stay of claim until provider notifies court of compliance with statute -- Trial court erred in ordering provider to file amended complaint with assignment attached

21 Fla. L. Weekly Supp. 927a

Online Reference: FLWSUPP 2109ROYInsurance -- Personal injury protection -- Demand letter -- Medical provider's failure to attach to demand letter back side of assignment of benefits that contained only signature of assignor is technical matter that did not prevent demand letter from substantially complying with statute -- Further, insurer waived signature issue by failing to raise issue until after suit was filed

21 Fla. L. Weekly Supp. 496a

Online Reference: FLWSUPP 2106ROJAInsurance -- Personal injury protection -- Demand letter -- Sufficiency -- Demand letter that stated total amount billed and did not account for prior payments by insurer did not satisfy statutory condition precedent

21 Fla. L. Weekly Supp. 425c

Online Reference: FLWSUPP 2105LDICInsurance -- Personal injury protection -- Demand letter -- Demand letters fail to satisfy condition precedent to suit where balance shown by statements attached to demand letters does not match balances demanded in letters and it is unclear what specific treatments, dates of treatment and charges are claimed by letters

21 Fla. L. Weekly Supp. 180a

Online Reference: FLWSUPP 2102NDIAInsurance -- Personal injury protection -- Interest -- Method of calculating

21 Fla. L. Weekly Supp. 188a

Online Reference: FLWSUPP 2102MSOLInsurance -- Personal injury protection -- Interest -- Insurer was statutorily required to pay interest on overdue charges

21 Fla. L. Weekly Supp. 988c

Online Reference: FLWSUPP 2110PEREInsurance -- Personal injury protection -- Summary judgment -- In ruling on motion for summary judgment, trial court erred in considering documents that were not served on insured or filed with court prior to hearing on motion

21 Fla. L. Weekly Supp. 197a

Online Reference: FLWSUPP 2102NHERInsurance -- Personal injury protection -- Coverage -- Claimant who failed to maintain insurance on own vehicle -- Inoperable vehicle -- Vehicle that was temporarily inoperable due to mechanical failure and claimant's inability to pay for repairs was not required to be insured -- Partial summary judgment regarding coverage is entered in favor of medical provider

21 Fla. L. Weekly Supp. 568a

Online Reference: FLWSUPP 2106SAMPInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy which states that insurer will pay benefits in at least two different ways at insurer's option does not clearly elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 470a

Online Reference: FLWSUPP 2106SPYRInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Where PIP policy states that any amounts payable shall be subject to any and all limitations, including all fee schedules, insurer clearly and unambiguously elected permissive statutory fee schedule and was entitled to limit reimbursement in accordance with fee schedule

21 Fla. L. Weekly Supp. 195b

Online Reference: FLWSUPP 2102MARPInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Policy which provides that insurer will pay 80% of reasonable expenses but limits payment to lesser of amount provided by any fee schedule whether mandatory or permissive as contained in Florida Motor Vehicle No-Fault Law and also provides that insurer may use independent sources of information to determine if medical expenses are reasonable does not unambiguously elect to pay benefits pursuant to section 627.736(5)(a)2-5

21 Fla. L. Weekly Supp. 182a

Online Reference: FLWSUPP 2102GHERInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Motion for summary judgment and judicial determination that insurer is obligated to pay 80% of entire medical bill because insurer is barred by stipulation from contesting reasonableness of charges, insurer did not expressly elect permissive statutory fee schedule as reimbursement method in policy, and policy is ambiguous as to whether insurer will pay unreasonable charges is denied -- Insurer did not stipulate that it would not challenge reasonableness of charges, and reasonableness was always at issue -- Insurer is not required to expressly elect permissive fee schedule as its reimbursement method in policy in order to dispute reasonableness of expenses in excess of that fee schedule -- PIP policy is not ambiguous as to insurer's duty to pay only reasonable charges where one part of policy states that insurer will pay 80% of all medically necessary expenses without mentioning a reasonableness requirement, but another part of policy unambiguously permits insurer to reduce or reject unreasonable charges -- Even if policy were ambiguous, PIP statute allows medical providers to recover only reasonable charges

21 Fla. L. Weekly Supp. 285b

Online Reference: FLWSUPP 2103KHVOInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Where PIP policy specifically advises insured that any amounts payable shall be subject to any and all limitations authorized by PIP statute, including all fee schedules, policy provided sufficient notice of election to use statutory fee schedule as basis for calculating reimbursement

21 Fla. L. Weekly Supp. 350b

Online Reference: FLWSUPP 21041STInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy that clearly subjects payments to any limitations in PIP statute, including all fee schedules, unambiguously elects to limit reimbursement to permissive statutory fee schedule -- No merit to argument that insurer is required to incorporate statutory language or specific fee schedules into policy to effectuate election to apply fee schedule limitations

21 Fla. L. Weekly Supp. 336a

Online Reference: FLWSUPP 2104NEWLInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reference in policy to amounts payable being subject to any and all limitations authorized by section 627.736 or any other provisions of No-Fault Law, including fee schedules, does not clearly and unambiguously elect to limit reimbursement pursuant to Medicare Part B fee schedule -- No merit to argument that policy may be construed to pay lesser coverage because doing so would benefit insured -- Policies are construed according to plain meaning with ambiguities construed against insurer

21 Fla. L. Weekly Supp. 1083a

Online Reference: FLWSUPP 2110BOONInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy providing that insurer will pay 80% of reasonable expenses but also providing that amount payable “shall be subject to any and all limitation” authorized by PIP statute does not provide clear and unambiguous notice of intent to limit reimbursement to Medicare Part B fee schedule

21 Fla. L. Weekly Supp. 1070a

Online Reference: FLWSUPP 2110ALUMInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy providing that insurer will pay 80% of reasonable expenses but also providing that amount payable “shall be subject to any and all limitation” authorized by PIP statute does not provide clear and unambiguous notice of intent to limit reimbursement to Medicare Part B fee schedule

21 Fla. L. Weekly Supp. 1066a

Online Reference: FLWSUPP 2110PALAInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Policy that clearly subjects all payments to any limitations of PIP statute, including all fee schedules, unambiguously elects to limit reimbursement to permissive statutory fee schedule -- Failure to reference Medicare and inclusion of language regarding payment of reasonable charges does not render policy ambiguous

21 Fla. L. Weekly Supp. 1062a

Online Reference: FLWSUPP 2110RIVEInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 1059a

Online Reference: FLWSUPP 2110COLOInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 1056a

Online Reference: FLWSUPP 2110SANCInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 1053b

Online Reference: FLWSUPP 2110VAZQInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Policy that clearly subjects all payments to any limitations of PIP statute, including all fee schedules, unambiguously elects to limit reimbursement to permissive statutory fee schedule -- Failure to reference Medicare and inclusion of language regarding payment of reasonable charges does not render policy ambiguous

21 Fla. L. Weekly Supp. 989a

Online Reference: FLWSUPP 2110POLIInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Policy that provides that all payments shall be subject to limitations authorized by all fee schedules unambiguously elects to limit reimbursement to statutory fee schedules

21 Fla. L. Weekly Supp. 971a

Online Reference: FLWSUPP 2109RASHInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 968a

Online Reference: FLWSUPP 2109MESAInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 964a

Online Reference: FLWSUPP 2109JPERInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 961a

Online Reference: FLWSUPP 2109PIMEInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 958a

Online Reference: FLWSUPP 2109DUARInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 955a

Online Reference: FLWSUPP 2109UGAZInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule where sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 951a

Online Reference: FLWSUPP 2109GUERInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 948a

Online Reference: FLWSUPP 2109MARIInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule where sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 945a

Online Reference: FLWSUPP 2109ARIOInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 942a

Online Reference: FLWSUPP 2109BARRInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 939a

Online Reference: FLWSUPP 2109OLIVInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule render policy provision ambiguous per se -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule -- Sufficiency of policy language was never considered in Virtual Imaging opinion, and policy provision at issue here is much broader and open to wider construction than policy language in Virtual Imaging -- Policy provision that makes vague references to “any and all limitations...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 831a

Online Reference: FLWSUPP 2108CHISInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy providing that insurer will pay 80% of reasonable expenses but also providing that amount payable “shall be subject to any and all limitation” authorized by PIP statute does not provide clear and unambiguous notice of intent to limit reimbursement to Medicare Part B fee schedule

21 Fla. L. Weekly Supp. 825b

Online Reference: FLWSUPP 2108ARANInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy providing that insurer will pay 80% of reasonable expenses but also providing that amount payable “shall be subject to any and all limitation” authorized by PIP statute does not provide clear and unambiguous notice of intent to limit reimbursement to Medicare Part B fee schedule

21 Fla. L. Weekly Supp. 823a

Online Reference: FLWSUPP 2108MADIInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Policy provision that makes vague references to amounts payable being “subject to any and all limitations authorized by [PIP statute]...including, but not limited to, all fee schedules” does not unambiguously elect to limit reimbursement to permissive statutory fee schedule -- Florida Supreme Court's opinion in Virtual Imaging does not compel finding that policy provision at issue unambiguously elects use of statutory fee schedule where sufficiency of policy language was never considered in Virtual Imaging opinion -- Divergent judicial opinions from county and circuit courts as to whether policy provision at issue clearly elects to limit reimbursement to permissive statutory fee schedule demonstrates that policy provision is far from clear and unambiguous

21 Fla. L. Weekly Supp. 800a

Online Reference: FLWSUPP 2108EUMInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charge -- Permissive fee schedules -- Policy language stating that amounts payable shall be subject to any and all limitations authorized by section 627.736 or any other provision of No-Fault Law, including, but not limited to, all fee schedules, did not constitute a clear and unambiguous election to limit reimbursement to 200% of Medicare Fee Schedule -- Insurer required to reimburse provider at contracted rate of 80% of reasonable charges for medical services provided

21 Fla. L. Weekly Supp. 796a

Online Reference: FLWSUPP 2108ZIInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy which states that insurer will pay 80% of reasonable expenses and provides that amounts payable shall be subject to any and all limitations authorized by PIP statute including all fee schedules does not clearly and unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 561a

Online Reference: FLWSUPP 2106FLOWInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Policy language providing that insurer will pay 80% of reasonable expenses but also providing that amount payable “shall be subject to any and all limitations” authorized by PIP statute does not provide clear and unambiguous notice of intent to limit reimbursement to Medicare Part B fee schedule -- Question certified

21 Fla. L. Weekly Supp. 96a

Online Reference: FLWSUPP 2101AGNEInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Policy language providing that insurer will pay 80% of reasonable expenses but also providing that amount payable “shall be subject to any and all limitation” authorized by PIP statute does not provide clear and unambiguous notice of intent to limit reimbursement to Medicare Part B fee schedule

21 Fla. L. Weekly Supp. 686a

Online Reference: FLWSUPP 2107HENDInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy which stated within the limitations of liability paragraphs that insurer would pay 80% of reasonable expenses and provided that amounts payable shall be subject to any and all limitations authorized by PIP statute as enacted, amended or otherwise continued in law, including, but not limited to, all fee schedules does not clearly and unambiguously elect to limit reimbursement to permissive statutory fee schedule -- Plaintiff's contention that policy is insufficient for referencing “all fee schedules” rather than citing Medicare fee schedule is rejected

21 Fla. L. Weekly Supp. 603a

Online Reference: FLWSUPP 2107NEALInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy which states that insurer will pay 80% of reasonable expenses and makes general references to section 627.736 and fee schedules does not clearly and unambiguously elect to limit reimbursement pursuant to Medicare Part B fee schedule

21 Fla. L. Weekly Supp. 75c

Online Reference: FLWSUPP 2101BROWInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy that references “applicable fee schedule,” but is devoid of any reference to section 627.736(5)(a)2.f or specific limitations of which insurer intends to avail itself, does not clearly and unambiguously notify insured and medical provider of insurer's intent to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 159a

Online Reference: FLWSUPP 2102MRIInsurance -- Personal injury protection -- Declaratory action -- Coverage -- Medical expenses -- Policies that provide that insurers will pay PIP claims based on “reasonable” amount and do not mention Medicare fee schedules or other statutory limitations are insufficient to allow insurers to utilize permissive fee schedule methodology of section 627.736(5)(a)2-5 in calculating PIP benefits -- Insurers are not allowed to rely on Medicare Outpatient Prospective Payment System to pay less than minimum level under fee schedule methodology

21 Fla. L. Weekly Supp. 586a

Online Reference: FLWSUPP 2106BURTInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy endorsement that specifically states that insurer will pay 80% of schedule of maximum charges contained in section 627.736(5)(A)2 allows insurer to apply permissive statutory fee schedules and limitations

21 Fla. L. Weekly Supp. 925a

Online Reference: FLWSUPP 2109BROWInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Policy that provides that insurer may reduce payments to lesser amounts that result from application of fee schedules does not clearly and unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 89a

Online Reference: FLWSUPP 2101YOUNInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Where policy cites to permissive statutory fee schedule but allows insurer at its own discretion to choose to reimburse insured according to fee schedule or reimburse reasonable expenses, policy is ambiguous as to reimbursement method for any given claim and does not specifically elect fee schedule method for reimbursement

21 Fla. L. Weekly Supp. 88a

Online Reference: FLWSUPP 2101SIMMInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Where policy cites to permissive statutory fee schedule but allows insurer at its own discretion to choose to reimburse insured according to fee schedule or reimburse reasonable expenses, policy is ambiguous as to reimbursement method for any given claim and does not specifically elect fee schedule method for reimbursement

21 Fla. L. Weekly Supp. 434a

Online Reference: FLWSUPP 2105DELGInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Insurer's failure to unambiguously elect permissive payment methodology of section 627.736(5)(a)2. in its policy prevents insurer from limiting reimbursement based on Medicare Part B fee schedule

21 Fla. L. Weekly Supp. 997b

Online Reference: FLWSUPP 2110KEHRInsurance -- Personal injury protection -- Coverage -- Medical expenses -- PIP policy providing that insurer will pay 80% of reasonable expenses “subject to the applicable fee schedules and payment limitations” in PIP statute fails to clearly and unambiguously elect to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 627a

Online Reference: FLWSUPP 2107MONDInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Policy that clearly and unambiguously subjects payments to all fee schedules authorized by PIP statute unambiguously elects to limit reimbursement to permissive statutory fee schedule

21 Fla. L. Weekly Supp. 580a

Online Reference: FLWSUPP 2106INFAInsurance -- Personal injury protection -- Small claims -- Doctrine of de minimis non curat lex does not preclude small claims action seeking $58.82 in PIP benefits

21 Fla. L. Weekly Supp. 78a

Online Reference: FLWSUPP 2101SCHUInsurance -- Personal injury protection -- Small claims -- Doctrine of de minimis non curat lex does not preclude small claims action seeking $3.36 in PIP benefits

21 Fla. L. Weekly Supp. 697c

Online Reference: FLWSUPP 2107MILFInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Countervailing expert testimony on reasonableness of charges creates genuine issue of material fact precluding entry of summary judgment -- Fact that insurer paid medical provider's bill at 200% of Medicare fee schedule does not preclude insurer from disputing reasonableness of charges

21 Fla. L. Weekly Supp. 589a

Online Reference: FLWSUPP 2106VENEInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary judgment -- Court declines to consider opposing affidavit that was untimely filed and untimely served -- Even if affidavit were considered, testimony as to amounts of fee schedules alone is insufficient to raise disputed issue of fact as to reasonableness of charges -- Final judgment is entered in favor of medical provider

21 Fla. L. Weekly Supp. 201b

Online Reference: FLWSUPP 2102ROBIInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonable, related, and necessary treatment -- Affidavit of physician was not competent evidence of relatedness and medical necessity of treatment provided to insured where affiant and treating physician were licensed under different chapters of Florida Statutes -- Chiropractic treatment -- Affidavit of chiropractor submitted by insurer was sufficient to raise disputed issue of material fact only with respect to “daily consecutive treatment” for certain dates, but raises no disputed issue of material fact as to any other issue -- Discussion of deficiencies in affidavit

21 Fla. L. Weekly Supp. 691a

Online Reference: FLWSUPP 2107HERNInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary judgment -- Opposing affidavit filed by insurer does not preclude summary judgment in favor of medical provider on issue of reasonableness of charges where affidavit was inconsistent with insurer's previous litigation position that reduction of provider's bill was based on application of statutory fee schedule, which was not elected as reimbursement method in policy

21 Fla. L. Weekly Supp. 487b

Online Reference: FLWSUPP 2106LEXCInsurance -- Personal injury protection -- Summary judgment -- Reasonableness of charges -- Opposing affidavits filed by insurer did not preclude summary judgment in favor of medical provider on issue of reasonableness of charges where affidavits relied relying on Medicare fee schedule to prove unreasonableness of charges, policy was purchased prior to effective date of legislation allowing such schedules to be used as alternative reimbursement method if insurers elected such method in policies, and insurer had not elected to rely on Medicare fee schedule in its policies

21 Fla. L. Weekly Supp. 711a

Online Reference: FLWSUPP 2107WIL2Insurance -- Personal injury protection -- Summary disposition -- Reasonableness of charges -- Medical provider met burden of establishing reasonableness of MRI charge -- Opposing affidavit of insurer's expert was self-serving, conclusory, based on hearsay, and lacked foundation for opinion that amount charged was unreasonable -- Provider's motion for summary disposition on issue of reasonableness is granted

21 Fla. L. Weekly Supp. 399d

Online Reference: FLWSUPP 2105WILLInsurance -- Personal injury protection -- Small claims -- Summary disposition -- On appeal of summary disposition of small claims case, issue is not whether trial court erred by finding absence of genuine issue of material fact, but whether trial court abused its discretion by finding there was no triable issue -- No merit to argument that medical provider's affidavit in support of reasonableness of medical bill is insufficient to support summary disposition because it fails to address every factor mentioned in section 627.736(5)(a) -- Statute does not mandate that consideration be given to every factor -- No error in rejecting affidavit of litigation adjuster filed in opposition to summary disposition where affidavit was conclusory and self-serving -- Further, trial court did not err in determining that litigation adjuster lacked sufficient personal knowledge to render opinion on reasonableness of charges

21 Fla. L. Weekly Supp. 368a

Online Reference: FLWSUPP 2104FULTInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Where PIP policy expressly states that insurer will pay 80% of all medically necessary expenses and does not incorporate language of permissive statutory fee schedule, insurer is not entitled to apply fee schedule limitations -- Neither section 627.7407, which incorporates No-Fault Law into existing policies to add PIP coverage, nor policy's reference to payment in accordance with No-Fault Law alters express promise of contract to pay 80% of all medically necessary expenses -- No merit to argument that reasonable amount payable under PIP statute is now capped by permissive fee schedule -- Question certified: Does section 627.736(5)(a)2 through 5 (2008) limit the insured or his assignee from claiming the reasonable amount of services in excess of that subsection's schedule where the policy of insurance expresses no such limitation but instead, expressly promises reimbursement of all medically necessary expenses?

21 Fla. L. Weekly Supp. 200a

Online Reference: FLWSUPP 2102TELUInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Insurer failed to create genuine issue of material fact regarding reasonableness of charges where insurer's expert, who opined that charges were unreasonable and that amount equal to 200% of Medicare Part B fee schedule was only reasonable amount, relied exclusively on undisclosed “underlying data” which insurer failed to produce or make available for inspection

21 Fla. L. Weekly Supp. 440b

Online Reference: FLWSUPP 2105CWILInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Where, in addition to fee schedules submitted by insurer to rebut medical provider's prima facie case that charges at issue were reasonable, provider admitted that it accepted Medicare payments and that it accepted far less from other insurers for same services, jury had sufficient evidence to support finding that amount billed by provider was not reasonable -- Motion for judgment notwithstanding verdict and motion for new trial are denied

21 Fla. L. Weekly Supp. 592a

Online Reference: FLWSUPP 2106JRODInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Where affidavit of insurer's expert opining that 200% of Medicare fee schedule is reasonable charge does not take into consideration any amount except Medicare fee schedule and fails to attach underlying data, insurer has not demonstrated that opinion is based upon sufficient facts or data and has failed to rebut medical provider's affidavit as to reasonableness of charges

21 Fla. L. Weekly Supp. 590a

Online Reference: FLWSUPP 2106DINGInsurance -- Personal injury protection -- Expert witness -- Insurer's actuary is not qualified to render opinion on reasonableness of x-ray charges where proposed witness has never worked for or provided billing services for x-ray providers, has no knowledge of what hospitals or other x-ray providers in county charge for x-ray examination and review and, in reaching his opinion, excludes from consideration evidence of usual and customary charges and payment accepted by medical provider and any amounts above 200% of Medicare Part B fee schedule

21 Fla. L. Weekly Supp. 707a

Online Reference: FLWSUPP 2107TRUOInsurance -- Personal injury protection -- Expert witness -- Insurer's actuary is not qualified to render opinion on reasonableness of medical provider's charges

21 Fla. L. Weekly Supp. 871a

Online Reference: FLWSUPP 2109MONTInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Related and necessary treatment -- Directed verdict -- Trial court properly granted medical provider's motion for directed verdict on issues of relatedness and medical necessity of treatment where provider presented expert testimony that treatment was related and necessary, insurer's expert conceded that his determination that treatment was not related or necessary was not reliable and not a just determination, and insurer did not severely impeach provider's expert

21 Fla. L. Weekly Supp. 201b

Online Reference: FLWSUPP 2102ROBIInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonable, related, and necessary treatment -- Affidavit of physician was not competent evidence of relatedness and medical necessity of treatment provided to insured where affiant and treating physician were licensed under different chapters of Florida Statutes -- Chiropractic treatment -- Affidavit of chiropractor submitted by insurer was sufficient to raise disputed issue of material fact only with respect to “daily consecutive treatment” for certain dates, but raises no disputed issue of material fact as to any other issue -- Discussion of deficiencies in affidavit

21 Fla. L. Weekly Supp. 306b

Online Reference: FLWSUPP 2104WESTInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonable, related, and necessary treatment -- Testimony by insurer's expert regarding alleged deficient recordkeeping on part of treating physician was not sufficient to refute testimony by insured that treatment she received was related to injuries sustained in automobile accident -- Trial court erred in denying insured's motion for directed verdict on issue of relatedness -- Remand with directions to enter directed verdict on this issue and for new trial on remaining issues of medical necessity and reasonableness of bills

21 Fla. L. Weekly Supp. 878a

Online Reference: FLWSUPP 2109EUGEInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Verdict finding that none of services provided to insured were medically necessary was contrary to manifest weight of evidence where insurer failed to present any evidence to contradict provider's testimony that treatment provided to insured was medically necessary -- Testimony of insurer's expert that all services rendered were not “reimbursable” does not address issue of medical necessity -- Error to deny motion for directed verdict

21 Fla. L. Weekly Supp. 370a

Online Reference: FLWSUPP 2104OROZInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Insurer failed to create genuine issue of material fact regarding reasonableness of medical provider's charges where insurer's expert, who opined as to recommended amounts for charges, relied exclusively on several undisclosed databases and failed to state that provider's charges were unreasonable -- Insurer failed to create genuine issue of material fact as to relatedness and medical necessity of charges where opinion of insurer's expert that charges were not related or necessary was based on alleged insufficient record keeping by provider, which was not raised as affirmative defense, and where expert's affidavit was self-serving and conclusory

21 Fla. L. Weekly Supp. 432a

Online Reference: FLWSUPP 2105CADEInsurance -- Personal injury protection -- Expert witnesses -- Witness's thirty years of experience working in insurance industry consulting with numerous medical providers and familiarity with reimbursement levels qualifies witness as expert on issue of reasonableness of charges under Daubert standard -- Motion to strike affidavit is denied

21 Fla. L. Weekly Supp. 115a

Online Reference: FLWSUPP 2102GLOBInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonable, related and necessary treatment -- Trial court did not err in declining to exclude adjuster's deposition testimony as to amount insurer calculated for possible negotiation of bills as evidence of offer to compromise claim -- Trial court erred, however, in deeming insurer's establishment of reasonable settlement sum to be admission of amount of reasonable benefits owed

21 Fla. L. Weekly Supp. 625a

Online Reference: FLWSUPP 2107NGARInsurance -- Personal injury protection -- Where nothing in record indicates that jury did not follow instructions to determine amount of reasonable medically necessary expenses in reaching $1,000 verdict and instead took into consideration $1,000 deductible that was mentioned at trial notwithstanding motions in limine and applied deductible to expenses before reaching verdict, trial court abused discretion by granting new trial

21 Fla. L. Weekly Supp. 432b

Online Reference: FLWSUPP 2105DCADInsurance -- Personal injury protection -- Expert witness -- Insurer's actuary is qualified to render opinion on reasonableness of charges where proposed witness has worked in insurance industry consulting with numerous medical providers and is familiar with reimbursement levels in area where medical provider is located -- Insurer may challenge medical necessity of treatment at any time, including after payment of claim -- Affidavit citing errors and deficiencies in documentation of claimed services creates questions of fact as to necessity of treatment

21 Fla. L. Weekly Supp. 712a

Online Reference: FLWSUPP 2107RAMIInsurance -- Personal injury protection -- Summary disposition -- Reasonableness of charges -- Medical provider met burden of proving its charges were within range of what is reasonable for CPT codes at issue -- Opposing affidavit of claims representative who was not expert and excluded consideration of any amount above 200% of Medicare or 100% of workers' compensation fee schedules was insufficient to create triable issue -- Summary disposition is granted in favor of provider

21 Fla. L. Weekly Supp. 979a

Online Reference: FLWSUPP 2110IMAGInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Insurer could use Medicare fee schedules to determine reasonable amount to be paid in PIP benefits notwithstanding failure to elect use of fee schedules in policy, but fee schedules cannot be sole basis for determination of reasonable amount -- No error in striking affidavit of expert who used fee schedules as sole basis to determine reasonable amount that should be paid and entering summary disposition in favor of medical provider

21 Fla. L. Weekly Supp. 837a

Online Reference: FLWSUPP 2108AYERInsurance -- Personal injury protection -- Summary disposition -- Reasonableness of charges -- Medical provider met burden of proving its charge for MRI was reasonable -- Opposing affidavit of non-expert which was self-serving, conclusory and lacked foundation for affiant's opinion is insufficient to create genuine issue of material fact -- Summary judgment is granted in favor of provider

21 Fla. L. Weekly Supp. 836a

Online Reference: FLWSUPP 2108DESIInsurance -- Personal injury protection -- Summary judgment -- Reasonableness of charges -- Medical provider met burden of proving its charge for MRI is reasonable -- Opposing affidavit of non-expert PIP adjuster which was based on hearsay and was conclusory and self-serving was insufficient to create genuine issue of material fact -- Summary judgment is granted in favor of provider

21 Fla. L. Weekly Supp. 818a

Online Reference: FLWSUPP 2108AUGUInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary disposition -- Opposing affidavit filed by insurer does not preclude summary disposition in favor of medical provider on issue of reasonableness of MRI charge where affidavit is conclusory and lacks foundation, and affiant is not qualified to render opinion on reasonableness of MRI charge -- Fact that Medicare and workers' compensation allow less than amount billed by provider does not, by itself, create factual issue as to reasonableness of charge

21 Fla. L. Weekly Supp. 812a

Online Reference: FLWSUPP 2108MOORInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary judgment -- Opposing affidavits filed by insurer do not preclude summary judgment in favor of medical provider on issue of reasonableness of MRI charge where affidavits are conclusory and lack foundation, and affiants are not qualified to render opinion on reasonableness of MRI charge -- Fact that Medicare and workers' compensation allow less than amount billed by provider does not, by itself, create factual issue as to reasonableness of charge

21 Fla. L. Weekly Supp. 811a

Online Reference: FLWSUPP 2108BUTLInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary judgment -- Opposing affidavit filed by insurer does not preclude summary judgment in favor of medical provider on issue of reasonableness of MRI charge where affidavit is conclusory and lacks foundation, and affiant is not qualified to render opinion on reasonableness of MRI charge -- Fact that Medicare and workers' compensation allow less than amount billed by provider does not, by itself, create factual issue as to reasonableness of charge

21 Fla. L. Weekly Supp. 709a

Online Reference: FLWSUPP 2107PIERInsurance -- Personal injury protection -- Summary judgment -- Reasonableness of charges -- Medical provider met burden of proving that its charge for MRI services was reasonable -- Opposing affidavit of litigation adjuster who was not expert and excluded consideration of evidence of any amounts above 200% of Medicare fee schedule is insufficient to create genuine issue of material fact -- Summary judgment is granted in favor of provider

21 Fla. L. Weekly Supp. 703a

Online Reference: FLWSUPP 2107GARCInsurance -- Personal injury protection -- Expert witness -- Insurer's actuary is not qualified to render opinion on reasonableness of MRI charges where proposed witness has never worked for or provided billing services for MRI providers, has no knowledge of what hospitals or other MRI providers in county charge for MRIs, and, in reaching his opinion, excluded from consideration evidence of usual and customary charges and payment accepted by medical provider and any amounts above 200% of Medicare Part B fee schedule

21 Fla. L. Weekly Supp. 702a

Online Reference: FLWSUPP 2107SCOTInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary judgment entered in favor of provider on issue of reasonableness where it is undisputed that medical provider's charge was within range of what most MRI providers charge for CPT code at issue -- Opinion of insurer's witness that 200% of Medicare fee schedule is reasonable is insufficient to create disputed issue of fact because opinion was not based on witness's own perceptions and was conclusory

21 Fla. L. Weekly Supp. 1080a

Online Reference: FLWSUPP 2110DUNCInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary disposition -- Opposing affidavits filed by insurer do not preclude summary disposition in favor of medical provider on issue of reasonableness of MRI charge where affidavits are conclusory and lack foundation, and affiants are not qualified to render opinion on reasonableness of MRI charge -- Fact that Medicare, workers' compensation and health insurance pay less than amount billed by provider does not, by itself, create factual issue as to reasonableness of charge

21 Fla. L. Weekly Supp. 1079a

Online Reference: FLWSUPP 2110DMARInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary disposition -- Opposing affidavit filed by insurer do not preclude summary disposition in favor of medical provider on issue of reasonableness of MRI charge where affidavit is conclusory and lacks foundation, and affiant is not qualified to render opinion on reasonableness of MRI charge -- Fact that Medicare, workers' compensation and health insurance pay less than amount billed by provider does not, by itself, create factual issue as to reasonableness of charge

21 Fla. L. Weekly Supp. 1077a

Online Reference: FLWSUPP 2110BBROInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary disposition -- Opposing affidavit filed by insurer do not preclude summary disposition in favor of medical provider on issue of reasonableness of MRI charge where affidavit is conclusory and lacks foundation, and affiant is not qualified to render opinion on reasonableness of MRI charge -- Fact that Medicare, workers' compensation and health insurance pay less than amount billed by provider does not, by itself, create factual issue as to reasonableness of charge

21 Fla. L. Weekly Supp. 1075a

Online Reference: FLWSUPP 2110DAMUInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary disposition -- Opposing affidavits filed by insurer do not preclude summary disposition in favor of medical provider on issue of reasonableness of MRI charge where affidavits are conclusory and lack foundation, and affiants are not qualified to render opinion on reasonableness of MRI charge -- Fact that Medicare, workers' compensation, and health insurance pay less than amount billed by provider does not, by itself, create factual issue as to reasonableness of charge

21 Fla. L. Weekly Supp. 586b

Online Reference: FLWSUPP 2106HAMInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary judgment -- Deposition of insurer's expert opining that 80% of 200% of Medicare fee schedule is reasonable charge for MRIs is not competent evidence where deponent relied only on case law and PIP statute in making that determination, and his interpretation of PIP statute was not based on sufficient facts, data or experience -- Affidavit of adjuster who has no experience in MRI industry cannot create factual issue

21 Fla. L. Weekly Supp. 239a

Online Reference: FLWSUPP 2103DESHInsurance -- Personal injury protection -- Coverage -- Medical benefits -- MRI -- Medical necessity -- Affidavit and deposition of insurer's expert asserting that provider's documentation was deficient, indicating that necessity for MRI so late in treatment of insured was questionable, and averring to fact that, in expert's opinion, the MRI was not medically necessary, was sufficient to create genuine issue of material fact regarding necessity of MRI -- Trial court erred in entering final summary judgment in favor of provider -- Precedent standing for proposition that MRIs can be determined to be medically reasonable and necessary as matter of law when adverse party presents no evidence to the contrary does not apply in this case in which there were disputed issues of material fact on the issue

21 Fla. L. Weekly Supp. 273a

Online Reference: FLWSUPP 2103BARRNOT FINAL VERSION OF OPINION
Subsequent Changes at 22 Fla. L. Weekly Supp. 835bInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Mobile x-rays -- Summary judgment is entered for insurer regarding medical necessity of mobile x-rays where insurer presented evidence of absence of documentation that insured was not ambulatory or could not be transferred to stationary x-ray equipment, and medical provider did not present any evidence on medical necessity of mobile x-rays

21 Fla. L. Weekly Supp. 489a

Online Reference: FLWSUPP 2106SEOTInsurance -- Personal injury protection -- Affirmative defenses -- Failure of medical provider to comply with chiropractic record keeping requirements set by administrative rule is valid basis for affirmative defense that medical treatment was not lawfully rendered -- Error to fail to allow insurer to prove that provider failed to lawfully comply with record keeping requirements

21 Fla. L. Weekly Supp. 578a

Online Reference: FLWSUPP 2106PEREInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Exhaustion of policy limits -- Where insurer wrongly paid medical bills in accordance with permissive reimbursement limitation of section 627.736(5)(a)2.f, despite fact that policy obligated it to pay 80% of reasonable medical expenses, insurer's exhaustion of benefits will not shield insurer from having to pay in excess of policy limits

21 Fla. L. Weekly Supp. 443a

Online Reference: FLWSUPP 2105AGARInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Exhaustion of policy limits -- Where insurer wrongly paid medical bills in accordance with permissive reimbursement limitation of section 627.736(5)(a)2.f despite fact that policy obligated it to pay 80% of reasonable medical expenses, insurer's exhaustion of benefits will not shield insurer from having to pay in excess of policy limits

21 Fla. L. Weekly Supp. 428b

Online Reference: FLWSUPP 2105RODRInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Exhaustion of policy limits -- In absence of any evidence of bad faith, where benefits were exhausted through payment of other medical providers before plaintiff -provider filed suit, insurer is entitled to summary judgment -- Insurer was not required to reserve funds for claim which had been reduced through erroneous application of permissive statutory fee schedule and is not liable for balance of reduced claim after exhaustion of benefits where insurer relied upon then-existing law in reducing claim

21 Fla. L. Weekly Supp. 362a

Online Reference: FLWSUPP 2104BORDInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Exhaustion of policy limits -- Where insurer wrongly paid medical bills in accordance with permissive reimbursement limitation of section 627.736(5)(a)2.f despite fact that policy obligated it to pay 80% of reasonable medical expenses, insurer's exhaustion of benefits will not shield insurer from having to pay in excess of policy limits

21 Fla. L. Weekly Supp. 274a

Online Reference: FLWSUPP 2103WELCInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Exhaustion of policy limits -- Where benefits were exhausted prior to medical provider filing suit, and there is no evidence of bad faith, insurer's motion for summary judgment is granted

21 Fla. L. Weekly Supp. 445a

Online Reference: FLWSUPP 2105GOMEInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Exhaustion of policy limits -- Where insurer wrongly paid medical bills out of order by skipping over medical provider's bill and exhausting benefits on payment of bills received after provider's bill, insurer is prohibited from asserting that insufficient benefits remained for payment of plaintiff's bill or that benefits were properly exhausted on claim

21 Fla. L. Weekly Supp. 806a

Online Reference: FLWSUPP 2108PAZInsurance -- Personal injury protection -- Coverage -- Exhaustion of policy limits -- In absence of any evidence of bad faith, where benefits were exhausted in payment of other medical providers before plaintiff medical provider filed suit, insurer is entitled to summary judgment -- Insurer was not required to reserve funds for claim reduced through erroneous application of statutory fee schedule and is not liable for balance of reduced claim after exhaustion of benefits

21 Fla. L. Weekly Supp. 698a

Online Reference: FLWSUPP 2107MACCInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Exhaustion of policy limits -- In absence of any evidence of bad faith, insurer is entitled to summary judgment where benefits were exhausted by payments to other medical providers before provider filed suit in this case -- Insurer was not required to reserve funds for claim which was reduced through erroneous application of fee schedule in 2008 PIP statute and is not liable for payment of balance of reduced claim after exhaustion of benefits

21 Fla. L. Weekly Supp. 1068b

Online Reference: FLWSUPP 2110ROCCInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Exhaustion of policy limits -- Summary judgment

21 Fla. L. Weekly Supp. 566a

Online Reference: FLWSUPP 2106PARKInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Exhaustion of policy limits -- Where benefits were exhausted prior to medical provider filing suit, and there is no allegation or proof of bad faith, insurer's motion for summary judgment is granted

21 Fla. L. Weekly Supp. 350a

Online Reference: FLWSUPP 2104MUNOInsurance -- Coverage -- Exhaustion of policy limits

21 Fla. L. Weekly Supp. 84a

Online Reference: FLWSUPP 2101PORTInsurance -- Personal injury protection -- Coverage -- Exhaustion of policy limits -- In absence of any evidence of bad faith, where benefits were exhausted in payment of other medical providers before plaintiff medical provider filed suit, insurer is entitled to summary judgment -- Insurer was not required to reserve funds for claim reduced through erroneous application of statutory fee schedule and is not liable for payment of balance of reduced claim after exhaustion of benefits

21 Fla. L. Weekly Supp. 99a

Online Reference: FLWSUPP 2101KINDInsurance -- Personal injury protection -- Evidence -- Where insurer did not make clear election in policy to pay benefits based on statutory fee schedule of section 627.736(5)(a)2 and did not issue payment based on that fee schedule, insurer may not mention statutory fee schedule or PIP insurers that have amended their policies to pay bills based on statutory fee schedule -- Where amount paid by insurer was not accepted by medical provider as payment in full, insurer is precluded from advising jury of amount paid

21 Fla. L. Weekly Supp. 700a

Online Reference: FLWSUPP 2107AMORInsurance -- Insurer entitled to summary judgment where medical provider brought suit against wrong insurer

21 Fla. L. Weekly Supp. 195a

Online Reference: FLWSUPP 2102GRANInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Inadequacy of record keeping is not lawful basis for nonpayment of PIP benefits -- Insurer's witness is precluded from testifying as to any inadequacy of medical records

21 Fla. L. Weekly Supp. 97c

Online Reference: FLWSUPP 2101RICKInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Deductible -- PIP statute and policy require that deductible be subtracted from total billing amount before statutory percentage limitations are applied

21 Fla. L. Weekly Supp. 879d

Online Reference: FLWSUPP 2109HJOHInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Deductible -- Amendment to PIP statute that altered manner in which deductible is calculated and decreased maximum deductible allowable is substantive change that cannot be applied retroactively to calculation of deductible under policy that was executed prior to amendment -- Where it is impossible to determine whether jury, having heard evidence of deductible, did or did not apply deductible to expenses before rendering verdict, new trial is required -- Trial court erred in concluding that jury's verdict was not supported by evidence where jury did not find all medical bills necessary and reasonable

21 Fla. L. Weekly Supp. 868b

Online Reference: FLWSUPP 2109COTOInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Deductible -- Where it is impossible to determine whether jury, having heard evidence of deductible, did or did not apply deductible to expenses before rendering verdict, new trial is required -- Expert witnesses -- Where prior appellate court erred in incorporating provisions of 2008 PIP statute into 2001-2002 policy to determine scope of expert's testimony, current appellate court is not bound to adhere to law of case -- Error to admit expert's deposition testimony on managed care fee schedules for purposes of evaluating reasonableness of medical charges -- Statutory changes creating new reimbursement criteria cannot be applied retroactively to policy and transactions that predate enactment of those changes

21 Fla. L. Weekly Supp. 840a

Online Reference: FLWSUPP 2108FLORInsurance -- Personal injury protection -- Coverage -- Emergency services -- Deductible -- Because insurer is mandated by statute to reserve $5,000 for emergency medical service providers, insurer should not have applied claim filed by plaintiff provider within that classification to deductible -- Exhaustion of benefits is not defense to claim for emergency medical service provider's bill applied to deductible

21 Fla. L. Weekly Supp. 798a

Online Reference: FLWSUPP 2108TASTInsurance -- Personal injury protection -- Coverage -- Emergency services -- Deductible -- Because insurer is mandated by statute to reserve $5,000 for emergency medical service providers, insurer should not have applied claim filed by plaintiff provider within that classification to deductible -- No merit to claim that provider has not met burden to prove that charge is reasonable where insurer's motion for summary judgment was based solely on application of deductible, insurer did not challenge reasonableness of charge in explanation of benefits, and insurer's utilization of permissive statutory fee schedule to pay charge establishes reasonableness of charge

21 Fla. L. Weekly Supp. 794b

Online Reference: FLWSUPP 2108ROMAInsurance -- Personal injury protection -- Coverage -- Emergency services -- Deductible -- Because insurer is mandated by statute to reserve $5,000 for emergency medical service providers, insurer should not have applied claim filed by plaintiff provider within that classification to deductible -- Exhaustion of benefits is not defense to claim for portion of emergency medical service provider's bill applied to deductible

21 Fla. L. Weekly Supp. 436b

Online Reference: FLWSUPP 2105DUSSInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Deductible -- PIP statute and policy require that deductible be subtracted from total expenses and losses before statutory percentage limitations are applied

21 Fla. L. Weekly Supp. 40b

Online Reference: FLWSUPP 2101RHERInsurance -- Personal injury protection -- Coverage -- Conditions precedent -- Examination under oath may not serve as condition precedent for PIP coverage for policies issued prior to 2012

21 Fla. L. Weekly Supp. 881a

Online Reference: FLWSUPP 2109BENJInsurance -- Personal injury protection -- Coverage -- Cancelled policy -- Collateral estoppel -- Trial court correctly barred insurer from pursuing affirmative defense that insured did not have coverage at time of accident due to cancellation of policy where issue had previously been litigated in action against insurer brought by different assignee of insured

21 Fla. L. Weekly Supp. 357a

Online Reference: FLWSUPP 2104TIMOInsurance -- Personal injury protection -- Demand letter -- Medical provider may only sue for amount billed and specified in demand letter

21 Fla. L. Weekly Supp. 442c

Online Reference: FLWSUPP 2105CASTInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Affirmative defenses -- No merit to insurer's claim that it timely tendered full payment requested in demand letter to medical provider where letter accompanying payment added condition reserving right to recover payment if any court determined that 2008 fee schedule could be applied retroactively to policies issued in 2007

21 Fla. L. Weekly Supp. 825a

Online Reference: FLWSUPP 2108MARSInsurance -- Summary disposition -- Where evidence clearly establishes that insurer paid full amount in issue subject to IRS withholding, and medical provider accepted payment without objection, summary disposition is entered in favor of insurer

21 Fla. L. Weekly Supp. 441b

Online Reference: FLWSUPP 2105BRADInsurance -- Personal injury protection -- Standing -- Motion to dismiss for lack of standing is denied where insurer admitted that medical provider has standing and did not promptly raise lack of standing as affirmative defense

21 Fla. L. Weekly Supp. 820a

Online Reference: FLWSUPP 2108MEJIInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Examination under oath -- Failure to attend -- Partial summary judgment is entered in favor of medical provider as to EUO no-show defense for all dates of service -- Reasonableness, relatedness and necessity of treatment -- Summary judgment -- Opposing affidavit does not preclude entry of summary judgment in favor of provider on issue of reasonableness, relatedness and necessity of treatment where affidavit is conclusory and speculative, affiant relies on undisclosed underlying data, and affiant bases opinion as to some dates of service on insufficient record keeping, which is not lawful basis for nonpayment of PIP benefits

21 Fla. L. Weekly Supp. 816a

Online Reference: FLWSUPP 2108BOWEInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Summary judgment -- Opposing affidavits filed by insurer do not preclude summary judgment in favor of medical provider on issues of reasonableness, relatedness and medical necessity of charges where affidavits are conclusory, and insurer failed to demonstrate that opinions are based upon sufficient facts or data or are product of reliable principles and methods and that affiants applied principles and methods reliably to facts of case -- Use of 2008 Medicare fee schedule to reduce charges was improper where policy was issued in 2007 -- Insufficient record keeping by provider is not lawful basis for nonpayment of PIP benefits

21 Fla. L. Weekly Supp. 808a

Online Reference: FLWSUPP 2108HERRInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Lawfully rendered treatment -- Where it is undisputed that medical provider's medical records failed to substantially comply with Florida Minimal Recordkeeping Standards established by administrative rule, treatment was not lawful, and PIP insurer is not obligated to pay for treatment

21 Fla. L. Weekly Supp. 805a

Online Reference: FLWSUPP 2108AIRPInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness, relatedness and necessity of treatment -- Summary judgment -- Affidavit of doctor licensed under separate chapter of statutes from treating physician is not competent evidence of reasonableness, relatedness and necessity of treatment -- Summary judgment is precluded where there are genuine issues of material fact concerning credibility of insured and wife, who staged another automobile accident during course of treatment, and affirmative defense based on failure to comply with chiropractic record keeping requirements

21 Fla. L. Weekly Supp. 263a

Online Reference: FLWSUPP 2103KREJInsurance -- Personal injury protection -- Claims -- Lost wages -- Where insured did not submit claim for wage loss and supporting documentation prior to serving pre-suit demand letters demanding lost wages, insured failed to satisfy conditions precedent to submitting demand letter and filing suit -- Abatement of proceedings to allow insured to comply with conditions precedent is not appropriate

21 Fla. L. Weekly Supp. 495a

Online Reference: FLWSUPP 2106PRAEInsurance -- Personal injury protection -- Coverage -- Where insured was injured while driving friend's vehicle with express or implied permission of friend, insurer of friend's vehicle, not insurer of vehicle owned by sister and brother-in-law with whom insured resided, was responsible for PIP coverage -- Even if insured were not covered by friend's policy, she was covered by separate policy issued by same insurer on vehicle that insured, herself, owns

21 Fla. L. Weekly Supp. 929a

Online Reference: FLWSUPP 2109DICKInsurance -- Personal injury protection -- Declaratory action -- Motion to dismiss petition seeking declaration as to whether section 627.736(1) provides for $10,000 in PIP coverage or $2,500 in PIP coverage when medical record is silent as to whether injured person did or did not have emergency medical condition is denied -- Failure to attach policy does not warrant dismissal where dispute stems from statutory provisions described in petition -- No merit to claim that petition does not state cause of action for declaratory relief where allegations of petition evince present and actual dispute over scope of coverage -- Declaratory action is not barred by statutory requirement that all claims to recover PIP benefits related to same medical provider for same injured person be brought in one action

21 Fla. L. Weekly Supp. 487a

Online Reference: FLWSUPP 2106JARAInsurance -- Personal injury protection -- Attorneys -- Disqualification -- Conflict of interest -- Insurer did not have standing to seek disqualification of medical provider's attorney based on attorney's withdrawal from representation of insured where there is no privity of contract between insurer and provider's attorney, and conflict does not clearly call into question fair or efficient administration of justice in manner that would allow insurer to stand in shoes of insured and establish standing to seek disqualification

21 Fla. L. Weekly Supp. 699a

Online Reference: FLWSUPP 2107MAMOInsurance -- Personal injury protection -- Complaint -- Amendment -- Substitution of insurer -- Motion to amend complaint to substitute insurer that is entirely separate and distinct corporate entity from insurer against whom action has been pending is denied

21 Fla. L. Weekly Supp. 676b

Online Reference: FLWSUPP 2107NEWCInsurance -- Personal injury protection -- Plaintiff not required to submit demand letter as condition precedent to filing amended complaint -- Motion to amend to include additional charges for unpaid benefits for dates of service not mentioned in original complaint and which could not have been known to plaintiff at time of original complaint is granted

21 Fla. L. Weekly Supp. 133a

Online Reference: FLWSUPP 2102MORAInsurance -- Personal injury protection -- Claims -- Failure to submit -- Anticipatory breach -- Although there may have been question of fact as to whether PIP policy was cancelled at time of accident in view of insurer's previous rescission of cancellations when late premium payments were made, anticipatory breach of policy did not excuse insured from obligation to timely submit medical bills to insurer -- Insurer cannot be liable for medical bills that were not timely and properly submitted

21 Fla. L. Weekly Supp. 181a

Online Reference: FLWSUPP 2102ALVAInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Inadequacy of record keeping is not lawful basis for nonpayment of PIP benefits -- Affirmative defenses -- Insurer waived defense of inadequate demand letter by failing to complain of defective demand letter until after suit was filed -- Where policy does not unambiguously indicate that insurer will utilize statutory fee schedule, insurer must pay 80% of reasonable expenses -- CPT codes -- National Correct Coding Initiative edits, which bar physicians from administering certain services to patients on same day, are utilization limitations prohibited by PIP statute -- Unbundling -- No merit to unbundling defense based on impermissible NCCI edits

21 Fla. L. Weekly Supp. 373a

Online Reference: FLWSUPP 2104WALKInsurance -- Personal injury protection -- Affirmative defenses -- Amendment -- Insurer's motion to amend affirmative defenses is denied where motion is untimely as to defenses which were known to insurer six months prior to filing answer, insurer waived right to assert defenses not raised in answer, and medical provider would be prejudiced by allowing amendment

21 Fla. L. Weekly Supp. 146a

Online Reference: FLWSUPP 2102GRIMInsurance -- Personal injury protection

21 Fla. L. Weekly Supp. 82c

Online Reference: FLWSUPP 2101FRANInsurance -- Personal injury protection -- Late payment penalty -- Where medical provider submitted two demand letters to insurer, each relating to different dates of treatment provided to insured, insurer was required to pay provider two separate $250 late payment penalties

21 Fla. L. Weekly Supp. 1069b

Online Reference: FLWSUPP 2110LCOHInsurance -- Personal injury protection -- Penalty and postage -- Insurer that paid medical expenses and interest after receipt of demand letter cannot defend against action for penalty and postage by claiming that services for which it paid were not related or medically necessary -- No merit to argument that insurer is obligated to pay penalty only if full amount is paid after receipt of demand letter

21 Fla. L. Weekly Supp. 339a

Online Reference: FLWSUPP 2104SETAInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Insurer that elected to reimburse medical provider pursuant to permissive statutory fee schedule erred in adjusting charges downward by applying coding policies and payment methodologies used on Medicare claims -- No merit to argument that exhaustion of PIP benefits renders insured's motion for summary judgment for balance of unpaid bills moot where insured seeks to recover 20% not paid by PIP benefits under Medpay coverage -- Where insurer paid 80% of charges because it determined charges were reasonable, it cannot argue remaining 20% of charges is not reasonable -- No merit to argument that fact that insurer did not pay 80% of full 200% of Medicare Part B fee schedule indicates that reasonableness of charges is at issue where reduction was not based on reasonableness of charges, but on insurer's improper application of Medicare payment methodologies

21 Fla. L. Weekly Supp. 430a

Online Reference: FLWSUPP 2105VEGAInsurance -- Post-judgment interest -- Checks for full amount of final judgment on motion for attorney's fees and costs, which checks contained notation that checks were full and final payment of fees, costs, and interest, per judgment, and were unaccompanied by letter or conditions, were effective to stop accrual of interest on judgment -- Checks did not constitute conditional tender

21 Fla. L. Weekly Supp. 628a

Online Reference: FLWSUPP 2107PEREInsurance -- Personal injury protection -- Claim for penalty and interest for late payment of benefits -- Error in allowing paralegal's hearsay testimony that medical provider told her that he did not receive PIP check that insurer claims to have timely mailed was not harmless where testimony was material to case and likely influenced jury when deciding whether insurer mailed check, and there is reasonable probability that jury would have reached different conclusion if testimony had not been allowed -- New trial required

21 Fla. L. Weekly Supp. 930a

Online Reference: FLWSUPP 2109TAYLInsurance -- Homeowners -- Water extraction contractor's execution of waiver and release of lien releasing claim of lien against homeowners/insureds did not waive and release contractor's claims against insurer

21 Fla. L. Weekly Supp. 174b

Online Reference: FLWSUPP 2102HILLInsurance -- Homeowners -- Standing -- Assignment -- Company that provided water removal services on homeowner's property has standing to bring action against insurer for unpaid balance of claim based on post-loss assignment of benefits

21 Fla. L. Weekly Supp. 569a

Online Reference: FLWSUPP 2106ISOLInsurance -- Venue -- Medical provider has right to bring action against foreign insurer in county where insurer has agents -- Insurer that has not established substantial inconvenience or undue expense has not met burden of demonstrating that transfer is appropriate under forum non conveniens statute

21 Fla. L. Weekly Supp. 581b

Online Reference: FLWSUPP 2106GOMEInsurance -- Personal injury protection -- Expert witnesses -- Where insurer disclosed on day before pre-trial conference that it was substituting new expert for previously disclosed expert, and allowing substitution would result in unfair prejudice to medical provider that is incurable and would result in fourth continuance attributable to insurer, motion to strike new expert is granted

21 Fla. L. Weekly Supp. 303a

Online Reference: FLWSUPP 2104VALDInsurance -- Personal injury protection -- Exclusions -- Provision excluding coverage for injury sustained by named insured or relative while occupying motor vehicle owned by named insured but not insured under policy is allowable under Florida law -- Exclusion applied in instant case in which wife was injured while riding in car owned by her husband but not insured under wife's policy where wife's policy identified wife as “named insured,” but also provided that “named insured” included a spouse if a resident of the same household

21 Fla. L. Weekly Supp. 734a

Online Reference: FLWSUPP 2108SHUTInsurance -- Garage policy -- Illusory policy -- Exclusion of coverage for theft of vehicles from unprotected lot did not render illusory a garage policy for used auto sales lot that insurer knew was an unprotected lot where the policy provided coverage for risks other than theft -- No merit to argument that insurer engaged in inequitable conduct by adding exclusion to policy just one day before issuance of policy where the same exclusion appeared in initial quote from insurer

21 Fla. L. Weekly Supp. 41b

Online Reference: FLWSUPP 2101WILKInsurance -- Trial -- Witness tampering -- Sanctions -- No abuse of discretion in dismissing medical provider's case with prejudice where provider, who served on state board that has power to revoke chiropractic licenses, threatened insurer's medical expert with loss of his license

21 Fla. L. Weekly Supp. 626a

Online Reference: FLWSUPP 2107HHERInsurance -- Personal injury protection -- Discovery -- Adjuster notes -- Trial court erred in failing to provide in camera inspection to review adjuster's notes generated prior to receipt of demand letter to determine applicability of work product privilege -- In separate case, because of absence of transcript of hearing on motion to compel production of same adjuster's notes before different a trial judge, trial court's ruling requiring insurer to produce notes is affirmed

21 Fla. L. Weekly Supp. 119a

Online Reference: FLWSUPP 2102SOUTInsurance -- Personal injury protection -- Discovery -- Work product -- Adjuster's notes -- In PIP case in which breach of contract or coverage are still in issue and in which there is no bad faith claim, discovery of adjuster's notes is prohibited by work product privilege

21 Fla. L. Weekly Supp. 493d

Online Reference: FLWSUPP 2106GARAInsurance -- Discovery -- Work product -- Error to compel production of adjuster's notes

21 Fla. L. Weekly Supp. 493c

Online Reference: FLWSUPP 2106MENEInsurance -- Discovery -- Work product -- Error to compel production of adjuster's notes

21 Fla. L. Weekly Supp. 27a

Online Reference: FLWSUPP 2101STATInsurance -- Personal injury protection -- Discovery -- Work product -- Adjuster's notes -- In PIP case in which breach of contract or coverage are still in issue and in which there is no bad faith claim, discovery of adjuster's notes is prohibited by work product privilege

21 Fla. L. Weekly Supp. 804a

Online Reference: FLWSUPP 2108TRUJInsurance -- Personal injury protection -- Discovery -- Documents -- HMO and PPO contracts between medical provider and other insurers are confidential, trade secret, proprietary documents that are not discoverable and cannot reasonably lead to discoverable evidence -- Medicare fee schedule rates are not relevant to determine whether provider's charges are reasonable

21 Fla. L. Weekly Supp. 280b

Online Reference: FLWSUPP 2103DINGInsurance -- Personal injury protection -- Discovery -- Trade secrets -- Protective order regarding disclosure of data relied upon by insurer's expert witness on issue of reasonableness of charges

21 Fla. L. Weekly Supp. 32a

Online Reference: FLWSUPP 2101ENRIInsurance -- Discovery -- Surveillance video -- Order compelling insurer that conducted surveillance allegedly demonstrating that insured did not receive treatment on days billed to disclose surveillance video before deposing medical provider's employees satisfies jurisdictional burden for common-law certiorari relief by demonstrating material injury that may not be remedied on plenary appeal -- Abuse of discretion to order disclosure of video before depositions where insurer attempted to depose provider's employees within reasonable time and did not delay deposing witnesses

21 Fla. L. Weekly Supp. 358b

Online Reference: FLWSUPP 2104KERSInsurance -- Personal injury protection -- Discovery -- Documents -- Work product -- Adjuster's notes in claims file that were revealed on in camera inspection to be relevant and to be part of ordinary claims process, not work product, are not privileged -- Question certified: When an insurer in a PIP case disputes coverage or extent of damages, but an in camera inspection of the insurer's adjuster notes in a “claims file” reveals non-work product (which are created as part of the ordinary claims process) that are potentially relevant on the issue of coverage and extent of damages, may the court require production of these non-work product adjuster notes as an exception to the general rule that an insurer's “claims file” is not discoverable until the coverage issue has been resolved?

21 Fla. L. Weekly Supp. 28b

Online Reference: FLWSUPP 2101DABUInsurance -- Personal injury protection -- Pre-suit discovery -- Insured's action against insurer -- Trial court erred in entering summary judgment for insurer based on failure to provide pre-suit discovery pursuant to section 627.736(6)(b) -- Statute does not impose any discovery obligation on insured and is addressed only to discovery required when medical providers sue for PIP benefits as assignees of insureds -- Moreover, there is no support for conclusion that total forfeiture of PIP benefits is warranted for failure to comply with section 627.736(6)(b) -- Documents required to be produced under statute are limited and do not include provider's licenses

21 Fla. L. Weekly Supp. 427b

Online Reference: FLWSUPP 2105LACAInsurance -- Personal injury protection -- Discovery -- Medical provider is required to provide reimbursement amounts it was willing to accept or accepted for CPT codes at issue from patients insured by HMO, PPO, Medicare and Medicaid, and uninsured patients, as such payments are relevant to issue of reasonableness of charges

21 Fla. L. Weekly Supp. 808b

Online Reference: FLWSUPP 2108PULIInsurance -- Personal injury protection -- Discovery -- Interrogatories -- Motion for reconsideration of order requiring medical provider to disclose reimbursement amounts it received from other insurance carriers and uninsured patients for CPT codes at issue is denied where provider has not demonstrated that reimbursement amounts constitute trade secrets, insurer has demonstrated that reimbursement amounts are reasonably necessary to defend against provider's claim that its bills are reasonable, and order requiring disclosure contained sufficient safeguards to protect against disclosure of confidential information or trade secrets

21 Fla. L. Weekly Supp. 1069a

Online Reference: FLWSUPP 2110SIRKInsurance -- Personal injury protection -- Discovery -- Medical provider's negotiated rates with other insurers are not relevant to determination of what insurer must pay provider for MRI -- Motion to compel is denied

21 Fla. L. Weekly Supp. 690a

Online Reference: FLWSUPP 2107COMPInsurance -- Personal injury protection -- Discovery -- Documents -- HMO and PPO contracts between medical provider and other insurers are confidential, trade secrets, and proprietary documents that are not discoverable and cannot reasonably lead to discoverable evidence -- Medicare fee schedule rates are not relevant to determine whether provider's charges are reasonable

21 Fla. L. Weekly Supp. 278a

Online Reference: FLWSUPP 2103BANIInsurance -- Personal injury protection -- Discovery -- Medical provider is ordered to produce documents relating to negotiated rates, billing practices, data utilized to calculate usual and customary charges, method of calculating charges for CPT codes billed, Charge Master and Charge Master team members, ordering of radiology procedures by emergency department physicians, and performance reviews of physicians who treated insured, subject to execution of mutually agreeable confidentiality agreement

21 Fla. L. Weekly Supp. 1051a

Online Reference: FLWSUPP 2110MISTInsurance -- Personal injury protection -- Discovery -- Medical provider ordered to produce bills submitted to and payments made by Medicare, any Florida workers' compensation insurer, and any health insurer for CPT codes at issue, and any contract entered into with those entities -- Provider is ordered to produce bills submitted to and payments made by private pay customers for CPT codes at issue

21 Fla. L. Weekly Supp. 721a

Online Reference: FLWSUPP 2107FLORInsurance -- Discovery -- Medical provider is not required to provide information regarding payments received from payors with whom it has contractual agreements where comparison of amounts provider was paid under such agreements with amount insurer paid is not relevant or reasonably calculated to lead to discovery of admissible evidence since provider does not have contractual agreement with insurer

21 Fla. L. Weekly Supp. 707b

Online Reference: FLWSUPP 2107SOSSInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- Summary disposition -- Opposing affidavits filed by insurer do not preclude summary disposition in favor of medical provider on issue of reasonableness of MRI charge where affidavits were conclusory and lacked foundation, and affiants were not qualified to render opinion on reasonableness of MRI charge -- Fact that Medicare, workers' compensation, and health insurance pay less than amount billed by provider does not, by itself, create factual issue as to reasonableness of charge

21 Fla. L. Weekly Supp. 701a

Online Reference: FLWSUPP 2107DIAZInsurance -- Personal injury protection -- Discovery -- Reasonableness of charges -- Medical provider must answer interrogatories seeking identity of each payor/insurer to whom the provider has submitted bills, amount each payor/insurer was billed, and amount each payor/insurer paid to provider -- Provider must produce billing statements issued to insurers and patients and explanations of benefits and other documents reflecting reimbursement received

21 Fla. L. Weekly Supp. 688a

Online Reference: FLWSUPP 2107BAIRInsurance -- Personal injury protection -- Discovery -- Motion for reconsideration of order requiring medical provider to disclose reimbursement amounts it received from other insurance carriers and uninsured patients for CPT codes at issue is denied -- Provider has not demonstrated that reimbursement amounts constitute trade secrets, insurer has demonstrated that disclosure of reimbursement amounts is reasonably necessary to defend against provider's claim that its bills are reasonable, and order requiring disclosure contains sufficient safeguards to protect against disclosure of confidential information or trade secrets

21 Fla. L. Weekly Supp. 678a

Online Reference: FLWSUPP 2107ELLIInsurance -- Personal injury protection -- Discovery -- Reasonableness of charges -- Medical provider must provide information regarding amounts provider has accepted from private insurers for CPT codes at issue

21 Fla. L. Weekly Supp. 675a

Online Reference: FLWSUPP 2107CISNInsurance -- Personal injury protection -- Discovery -- Medical provider must produce computer-generated procedure report that includes amounts provider billed and accepted for all payors for CPT codes at issue

21 Fla. L. Weekly Supp. 501a

Online Reference: FLWSUPP 2106FRANInsurance -- Personal injury protection -- Discovery -- Medical records of nonparties -- Error to order insurer to comply with request to produce records of peer review reports that medical expert prepared before and after he prepared report concerning insured where medical provider has not complied with statutory requirement to provide notice to affected nonparties that are subjects of those reports

21 Fla. L. Weekly Supp. 375a

Online Reference: FLWSUPP 2104QUINCriminal law -- Driving while license suspended or revoked -- Evidence -- Statements of defendant -- Corpus delicti -- Defendant's admission to his identity to deputy at scene of traffic stop is not admissible where other evidence admitted is not sufficient to establish prima facie case of driving while license suspended or revoked with knowledge

21 Fla. L. Weekly Supp. 338b

Online Reference: FLWSUPP 2104NMANInsurance -- Discovery -- Documents -- Enforcement of discovery order

21 Fla. L. Weekly Supp. 352a

Online Reference: FLWSUPP 2104CASTInsurance -- Personal injury protection -- Discovery -- Admissions -- Where request for admissions asks insurer to admit or deny that it received certain bills from non-party MRI providers for same CPT code billed by plaintiff medical provider, insurer's inclusion of amount it ultimately paid on each bill in response is non-responsive to provider's narrow request and an improper assertion of argument regarding insurer's right to reduce charges -- Improper portion of each response is stricken

21 Fla. L. Weekly Supp. 132a

Online Reference: FLWSUPP 2102PARKInsurance -- Personal injury protection -- Discovery -- Non-party expert witness -- Error to require disclosure of financial information from non-party expert witness beyond limitations established by rule 1.280(b)(5)(A)(iii) and Elkins v. Syken, and without finding of “most unusual or compelling circumstances” -- Error to require disclosure of non-party compulsory medical examination reports without prior notice to affected non-parties

21 Fla. L. Weekly Supp. 565b

Online Reference: FLWSUPP 2106PAREInsurance -- Discovery -- Medical provider is not required to produce contracts between provider and insurance companies or explanations of benefits/reviews from workers' compensation carriers, Medicaid, or Medicare -- Provider is required to produce explanations of benefits/reviews from private insurance companies or provide affidavit substantiating claim that production would entail undue burden and expense

21 Fla. L. Weekly Supp. 583b

Online Reference: FLWSUPP 2106MARRInsurance -- Personal injury protection -- Discovery -- Interrogadtories -- Medical provider must disclose whether it has contracts with private health insurers -- Provider is not required to disclose amounts paid, average amounts paid, or range of reimbursement amounts paid for CPT codes at issue by private insurers -- Provider must disclose average reimbursement amount received for CPT codes at issue from other PIP insurers

21 Fla. L. Weekly Supp. 695b

Online Reference: FLWSUPP 2107RODRInsurance -- Personal injury protection -- Discovery -- Failure to respond -- Sanctions -- Insurer that failed to respond to four court orders regarding discovery is found in contempt of discovery rules where attorney and law firm have history of involvement in cases in which insurer has failed to respond to discovery, delay prejudiced medical provider and created significant problems of judicial administration, and insurer has offered no credible reasonable justification for failure to comply with orders -- Affirmative defenses are stricken, insurer is precluded from presenting evidence in support of material misrepresentation claim, and provider is awarded attorney's fees and costs as well as monetary sanctions for contempt

Online Reference: FLWSUPP 2106RETTInsurance -- Personal injury protection -- Discovery -- Amounts emergency services provider charged to and received from HMO/PPO insurer for CPT codes at issue are discoverable, notwithstanding insurer's contention that reasonableness of charge is not at issue and only remaining issue is whether bill from emergency services provider can be applied to deductible under section 627.736(4)(c)

21 Fla. L. Weekly Supp. 366b

Online Reference: FLWSUPP 2104SCHLInsurance -- Personal injury protection -- Discovery -- Electronic service -- Because insurer was pro se litigant until its attorney filed notice of appearance and designation of email address, non-electronic service of discovery request simultaneous with summons and complaint was proper -- Motion to strike is denied

21 Fla. L. Weekly Supp. 442b

Online Reference: FLWSUPP 2105ORIGInsurance -- Discovery -- Depositions -- Insurer is ordered to produce corporate representative for deposition

21 Fla. L. Weekly Supp. 442a

Online Reference: FLWSUPP 2105SANDInsurance -- Discovery -- Depositions -- Insurer is ordered to produce corporate representative for deposition

21 Fla. L. Weekly Supp. 335c

Online Reference: FLWSUPP 2104LATIInsurance -- Discovery -- Interrogatories -- Motion to compel better answers to interrogatories relating to any contractual relationships between medical provider and other providers or insurers regarding CPT codes at issue is granted

21 Fla. L. Weekly Supp. 305b

Online Reference: FLWSUPP 2104DELFInsurance -- Discovery -- Trial court erred in compelling production of portions of insurer's claim file which had been identified in privilege log without conducting in camera review

21 Fla. L. Weekly Supp. 564a

Online Reference: FLWSUPP 2106HUNTInsurance -- Personal injury protection -- Discovery -- Admissions -- Motion for relief from admissions is timely where case was not been set for trial, summary judgment hearing has not been held, deposition of corporate representative has not been taken, and discovery remains to be completed

21 Fla. L. Weekly Supp. 593b

Online Reference: FLWSUPP 2106WRIGInsurance -- Personal injury protection -- Discovery -- Admissions -- Medical provider is entitled to summary judgment based on deemed admissions where insurer did not respond to request for admissions for two years, did not file motion for relief from technical admissions when it finally filed response to request for admissions, and failed to appear at hearing on motion for summary judgment

21 Fla. L. Weekly Supp. 593a

Online Reference: FLWSUPP 2106DACRInsurance -- Discovery -- Depositions duces tecum -- Motion for protective order granted in part

21 Fla. L. Weekly Supp. 97b

Online Reference: FLWSUPP 2101TRICInsurance -- Personal injury protection -- Discovery -- Depositions -- Sanction imposed for insurer's inclusion of requests in subpoena duces tecum that were not included in notice of taking deposition

21 Fla. L. Weekly Supp. 685b

Online Reference: FLWSUPP 2107CROFInsurance -- Personal injury protection -- Discovery -- Depositions -- Insurer is ordered to produce its corporate representative for deposition, and scope of deposition is defined

21 Fla. L. Weekly Supp. 992a

Online Reference: FLWSUPP 2110OLIVInsurance -- Discovery -- Depositions -- Error to prohibit insurer from deposing medical provider regarding reasonableness of charges

21 Fla. L. Weekly Supp. 938a

Online Reference: FLWSUPP 2109DURRInsurance -- Personal injury protection -- Discovery -- Depositions -- Managing member of medical provider's limited liability company is required to submit to deposition despite not having provided treatment to insured where deposition testimony is related to issues raised by insurer's defense that provider has engaged in fraudulent billing and fabrication of medical records -- No merit to argument that deposition would unduly burden and inconvenience managing member -- Provider's offer to present chief operating officer for deposition does not preclude deposition of managing member

21 Fla. L. Weekly Supp. 266a

Online Reference: FLWSUPP 2103MOREInsurance -- Personal injury protection -- Discovery -- Depositions -- Areas of inquiry in deposition of litigation adjuster are limited to exclude questions as to how insurer calculated payments, which are not relevant since medical provider has burden to prove reasonableness of charges

21 Fla. L. Weekly Supp. 814a

Online Reference: FLWSUPP 2108VALEInsurance -- Personal injury protection -- Depositions -- Documents -- Scope of inquiry and documents and data to be produced by insurer are established -- Insurer is not required to create data, but must compile summary of existing data

21 Fla. L. Weekly Supp. 583a

Online Reference: FLWSUPP 2106BUSHInsurance -- Personal injury protection -- Discovery -- Depositions -- In deposition of insurer's designated representative, medical provider is entitled to inquire about reimbursement levels in community as reflected by amounts insurer has paid other diagnostic imaging providers in county for CPT codes at issue -- Insurer is required to bring entire PIP claim file and underwriting file to deposition and to produce random samplings of explanations of review showing amounts insurer paid to other providers

21 Fla. L. Weekly Supp. 567b

Online Reference: FLWSUPP 2106TERLInsurance -- Discovery -- Depositions -- In deposition of insurer's designated representative, medical provider is entitled to inquire about reimbursement levels for CPT codes at issue in county where provider is located and service was performed

21 Fla. L. Weekly Supp. 697a

Online Reference: FLWSUPP 2107NARVInsurance -- Discovery -- Depositions -- In deposition of insurer's designated representative, medical provider is entitled to inquire about payments made to other similar providers in same geographical area for CPT codes at issue

21 Fla. L. Weekly Supp. 810a

Online Reference: FLWSUPP 2108RAMIInsurance -- Personal injury protection -- Discovery -- Depositions -- At deposition of insurer's corporate representative, medical provider may inquire as to reimbursement levels in community as reflected by amounts insurer has paid other similarly placed providers in community -- Insurer is required to bring to deposition complete PIP file and any documents that identify person who decided allowable amount for claim

21 Fla. L. Weekly Supp. 624a

Online Reference: FLWSUPP 2107HERRInsurance -- Discovery -- Depositions -- Error to compel claims adjuster to travel from Orange County to Broward County for deposition

21 Fla. L. Weekly Supp. 694b

Online Reference: FLWSUPP 2107AORTInsurance -- Discovery -- Depositions -- Failure to attend -- Sanctions -- Failure of medical provider's representative to stay in contact with his attorney does not negate representative's responsibility to attend deposition

21 Fla. L. Weekly Supp. 264a

Online Reference: FLWSUPP 2103TURNInsurance -- Discovery -- Depositions -- Failure to attend -- Sanctions -- Where medical provider has shown willful disregard for multiple court orders compelling attendance at depositions, and provider's counsel repeatedly informed court that he would not comply with orders, complaint is dismissed with prejudice and attorney's fees are awarded

21 Fla. L. Weekly Supp. 977a

Online Reference: FLWSUPP 2109FERNInsurance -- Personal injury protection -- Attorney's fees -- Discovery -- Depositions -- Failure to attend -- Sanctions -- Where medical provider's representative failed to attend deposition in aid of execution of final judgment for attorney's fees and costs, representative is ordered to appear for deposition, complete fact information sheet, and pay costs incurred due to his failure to appear -- Representative's failure to stay in contact with his attorney does not negate his responsibility to appear for deposition

21 Fla. L. Weekly Supp. 677d

Online Reference: FLWSUPP 2107FOLKInsurance -- Discovery -- Depositions -- Expert witness fee -- Treating physician is entitled to expert witness fee for his deposition testimony

21 Fla. L. Weekly Supp. 692a

Online Reference: FLWSUPP 2107NAVAInsurance -- Default -- Vacation -- Due diligence -- Where motion to vacate default was filed more than three months after insurer's counsel was aware of default and more than two months after attorney was assigned to draft motion, insurer did not act with due diligence in seeking relief from default -- Fact that motion for default and default were served on insurer directly, rather than on its counsel, does not render default void and subject to attack at any time where insurer delayed seeking relief for months after its counsel learned of default -- Motion to vacate denied

21 Fla. L. Weekly Supp. 33a

Online Reference: FLWSUPP 2101ORTIInsurance -- Personal injury protection -- Continuance -- Denial -- Abuse of discretion to deny continuance requested by insurer to allow medical expert to testify where expert's testimony would have been favorable to insurer on only disputed issue, insurer was diligent in attempting to secure attendance of witness by service of subpoena and oral confirmation of witness's availability, and insurer represented that witness was available to testify on next day

21 Fla. L. Weekly Supp. 976a

Online Reference: FLWSUPP 2109DIKEInsurance -- Confession of judgment -- Where, despite sending demand letter demanding payment of $12,950, provider filed jurisdictional statement stating claim did not exceed $99.99 in order to pay lowest available filing fee, and insurer thereafter tendered $99.99 to provider and filed confession of judgment, insurer made valid confession of judgment -- Provider's objection to confession of judgment is overruled, and motion to amend complaint to increase amount at issue is denied -- Provider's strategic decision to claim that lesser amount was in issue is not tantamount to fraud or sham

21 Fla. L. Weekly Supp. 781a

Online Reference: FLWSUPP 2108NORGInsurance -- Complaint -- Amendment -- Motion to amend complaint to add claims for first party bad faith and declaratory judgment is granted

21 Fla. L. Weekly Supp. 935a

Online Reference: FLWSUPP 2109RILEInsurance -- Complaint -- Amendment -- Motion for leave to amend complaint to reflect entirely different party is denied

21 Fla. L. Weekly Supp. 419a

Online Reference: FLWSUPP 2105MEZAInsurance -- Uninsured motorist -- Complaint -- Amendment -- Motion to amend complaint to add count for bad faith handling of UM claim and action for declaratory judgment seeking to establish plaintiff's total damages arising from accident is granted, but bad faith claim is stayed until underlying UM claim has been resolved

21 Fla. L. Weekly Supp. 130b

Online Reference: FLWSUPP 2102TATUInsurance -- Automobile -- Ambiguity in policy's out-of-state coverage clause is construed against insurer and in favor of coverage

21 Fla. L. Weekly Supp. 91a

Online Reference: FLWSUPP 2101PEDRInsurance -- Personal injury protection -- Attorney's fees -- Proposal for settlement -- Where insurer withdrew proposal for settlement within seven days of offering proposal, proposal was void, and order finding entitlement to attorney's fees pursuant to void proposal is also void -- Motion for reconsideration filed 21 months after entry of void judgment was timely filed -- Insurer remains entitled to cost judgment

21 Fla. L. Weekly Supp. 135b

Online Reference: FLWSUPP 2102SALIInsurance -- Attorney's fees -- Prevailing party -- Reversal of underlying judgment mandates reversal of section 627.428(1) fee award

21 Fla. L. Weekly Supp. 793a

Online Reference: FLWSUPP 2108CREEInsurance -- Personal injury protection -- Affirmative defenses that have no basis in law or fact are stricken, and attorney's fees are awarded as sanction for failure to withdraw defenses -- Motions for partial summary judgment are denied where no record evidence was attached to motions, and adjuster's deposition transcript was filed less than 20 days before hearing

21 Fla. L. Weekly Supp. 431a

Online Reference: FLWSUPP 2105ROMEInsurance -- Personal injury protection -- Attorney's fees -- Offer of judgment -- Where medical provider rejected insurer's $1.00 offer of judgment in PIP suit in which insurer raised affirmative defense that demand letter was not sent to designated recipient, provider sent second demand letter during pendency of suit, and insurer paid amount demanded in second letter, insurer's payment to provider was not confession of judgment entitling provider to award of attorney's fees -- Final judgment that did not award provider anything was at least 25% of amount offered by insurer and entitles insurer to award of attorney's fees

21 Fla. L. Weekly Supp. 186a

Online Reference: FLWSUPP 2102SOLEInsurance -- Personal injury protection -- Attorney's fees -- Where insurer initially refused to pay medical bill, then when paying bill late insurer refused to pay interest on late payment, causing medical provider to file suit for past-due interest, insurer is liable for provider's attorney's fees irrespective of amount of interest recovered -- No merit to arguments that provider is not entitled to attorney's fees because it could have resolved dispute by contacting insurer rather than filing suit or because amount in dispute is de minimis

21 Fla. L. Weekly Supp. 597b

Online Reference: FLWSUPP 2106ANZOInsurance -- Personal injury protection -- Attorney's fees -- Amount

21 Fla. L. Weekly Supp. 700c

Online Reference: FLWSUPP 2107BAPTInsurance -- Personal injury protection -- Attorney's fees -- Where insurer's nominal proposal for settlement was rejected by medical provider six months before exhaustion of benefits that resulted in summary judgment in favor of insurer, motion for attorney's fees based on proposal for settlement was frivolous and not in good faith -- Attorney's fees and costs are awarded to provider

21 Fla. L. Weekly Supp. 628b

Online Reference: FLWSUPP 2107LEZA

NOT FINAL VERSION OF OPINION
Subsequent Changes at 22 Fla. L. Weekly Supp. 515aInsurance -- Personal injury protection -- Coverage -- Medical expenses -- Reasonableness of charges -- No abuse of discretion in allowing testimony by insurer's expert about general reimbursement levels in county which referred to fee schedules -- Attorney's fees -- Proposal for settlement -- Abuse of discretion to deny insurer's motion for attorney's fees and costs where there was no showing that insurer's $100 proposal for settlement was not made in good faith

21 Fla. L. Weekly Supp. 392a

Online Reference: FLWSUPP 2105JMORInsurance -- Attorney's fees -- Offer of judgment -- No abuse of discretion in finding that insurer had good faith basis for making nominal offer of judgment where, at time of offer, insurer had medical report and peer review as support for belief that reasonable, related and necessary amount of bills was below insured's deductible -- Fact that offer of judgment was made prior to insurer amending pleadings to include affirmative defense of no bona fide dispute on which it ultimately prevailed does not preclude award of attorney's fees where insured, who had not been billed by medical provider prior to expiration of statute of limitations, was aware at all times that there was no bona fide dispute justifying his action

21 Fla. L. Weekly Supp. 1055a

Online Reference: FLWSUPP 2110ESPIInsurance -- Attorney's fees -- Proposal for settlement -- Voluntary dismissal with prejudice is judgment for purposes of entitlement to attorney's fees under section 768.79(6) -- Insurer had reasonable basis for nominal proposal for settlement where plaintiff was not listed as passenger on police crash report

21 Fla. L. Weekly Supp. 347a

Online Reference: FLWSUPP 2104HARTInsurance -- Personal injury protection -- Attorney's fees -- Justiciable issue -- Insurer is entitled to award of attorney's fees under section 57.105 where medical provider knew or should have known that it could not prevail when insurer served notice of intent to seek section 57.105 sanctions informing provider that it had been paid in full per statutory fee schedule, yet provider did not file notice of voluntary dismissal until after 21-day safe harbor period had expired

21 Fla. L. Weekly Supp. 265a

Online Reference: FLWSUPP 2103MCCLInsurance -- Attorney's fees -- Justiciable issue -- Attorney's fees are awarded to insurer where, despite being served with notice of intent to seek section 57.105 sanctions, medical provider waited until after 21-day safe harbor period to file notice of voluntary dismissal

21 Fla. L. Weekly Supp. 125b

Online Reference: FLWSUPP 2102IMPEInsurance -- Attorney's fees -- Justiciable issue -- Because proceedings to award attorney's fees under section 57.105 are special statutory proceedings, trial court did not have authority to grant motion for enlargement of 21-day safe harbor provision of section 57.105(4) -- However, where it is unknown whether insurer will suffer prejudice from error, and any prejudice insurer does suffer can be easily remedied on appeal, petition for writ of certiorari is denied

21 Fla. L. Weekly Supp. 693a

Online Reference: FLWSUPP 2107CONCInsurance -- Attorney's fees -- Claim or defense not supported by material facts or applicable law -- Court cannot extend deadline for responding to motion for section 57.105 attorney's fees and costs

21 Fla. L. Weekly Supp. 270a

Online Reference: FLWSUPP 2103HERNInsurance -- Personal injury protection -- Attorney's fees -- Justiciable issue -- Unauthenticated hearsay PIP payout sheet is insufficient evidence of exhaustion of benefits to support imposition of statutory fee award

21 Fla. L. Weekly Supp. 571b

Online Reference: FLWSUPP 2106EHERInsurance -- Personal injury protection -- Attorney's fees -- Justiciable issues -- Where medical provider knew or should have known when insurer served notice of intent to move for sanctions that it could not prevail because it had been paid in full per statutory fee schedule which was properly incorporated into contract, yet provider did not voluntarily dismiss complaint until after expiration of 21-day safe harbor period, insurer is entitled to recover its attorney's fees and costs

21 Fla. L. Weekly Supp. 199a

Online Reference: FLWSUPP 2102BOGRInsurance -- Personal injury protection -- Attorney's fees -- Proposal for settlement -- Insurer's $1 proposal for settlement, which included attorney's fees, was not made in good faith where offer did not bear reasonable relationship to amount of damages or realistic assessment of liability since insurer had already confessed judgment and acknowledged liability for medical provider's attorney's fees and costs -- Justiciable issues -- Continuing to litigate despite exhaustion of benefits does not warrant section 57.105 sanction against provider

21 Fla. L. Weekly Supp. 936a

Online Reference: FLWSUPP 2109ROSSInsurance -- Attorney's fees -- Justiciable issues -- Insurer has failed to prove that voluntarily dismissed case warrants fee award under section 57.105(1) where insurer claims that medical provider was procedurally barred from bringing suit due to its failure to opt out of class action, but insurer produced no evidence that provider actually received notice of class action

21 Fla. L. Weekly Supp. 268a

Online Reference: FLWSUPP 2103KUNTInsurance -- Personal injury protection -- Attorney's fees -- Justiciable issues -- Medical provider who used unregistered fictitious name on assignment knew or should have known that claim was not supported by material facts and applicable law

21 Fla. L. Weekly Supp. 838a

Online Reference: FLWSUPP 2108CANTInsurance -- Homeowners -- Attorney's fees -- Amount

21 Fla. L. Weekly Supp. 50a

Online Reference: FLWSUPP 2101MCMUInsurance -- Attorney's fees -- Florida Insurance Guaranty Association -- Action to recover section 627.428 attorney's fees from FIGA -- Award of attorney's fees pursuant to section 627.428 can constitute covered claim under FIGA Act if there is explicit provision in insurance contract which states that attorney's fees awards are part of coverage -- Trial court erred in denying motion to amend complaint to include insurance policy and dismissing claim as precluded as matter of law

21 Fla. L. Weekly Supp. 276a

Online Reference: FLWSUPP 2103NGOInsurance -- Attorney's fees -- Contempt -- Where insurer originally made no effort to comply with court order requiring it to state basis for disputing claimed attorney's fees and costs with particularity and to cite supporting authority for any objections, sanctions against insurer are warranted -- Insurer's tardy objection to duplicative time entries is preserved, although further sanctions may be imposed if objection is determined to be unreasonable, and all other objections are deemed waived

21 Fla. L. Weekly Supp. 600b

Online Reference: FLWSUPP 2106NAPLInsurance -- Attorney's fees -- Justiciable issues -- Attorney's fees are assessed against insurer and its counsel for filing motion to dismiss that had no support in fact or law -- Insurer's request that attorney's fees be awarded as consequence of medical provider's discovery violations is denied where violations were not in bad faith and were partially due to insurer's ill-advised motion to dismiss

21 Fla. L. Weekly Supp. 206a

Online Reference: FLWSUPP 2102ROHRInsurance -- Personal injury protection -- Attorney's fees -- Contingency risk multiplier -- Where insured had no difficulty retaining counsel without promise of contingency risk multiplier, application of multiplier is not appropriate -- Neither fact that insured retained and terminated other attorneys prior to current attorney's representation nor fact that insured was difficult and demanding client warrants application of multiplier -- Because insured's counsel did not prevail on issue of multiplier, costs associated with litigating multiplier issue are not awarded -- Fees and costs associated with litigating amount of fees are not awarded

21 Fla. L. Weekly Supp. 713a

Online Reference: FLWSUPP 2107WASSInsurance -- Personal injury protection -- Attorney's fees -- Choice of law -- Where claim for treatment of Florida resident by Florida medical provider for accident that occurred in New York was paid pursuant to hybrid of New York and Florida law, but policy was issued in Florida with expectation of Florida law applying to all disputes, and Florida is forum state, motion to apply New York law to issue of attorney's fees is denied

21 Fla. L. Weekly Supp. 706a

Online Reference: FLWSUPP 2107MCGUInsurance -- Personal injury protection -- Attorney's fees -- Choice of law -- Where claim for treatment of Florida resident by Florida medical provider for accident that occurred in New York was paid pursuant to hybrid of New York and Florida law, but policy was issued in Florida with expectation that Florida law would apply to all disputes and Florida is forum state, motion to apply New York law to issue of attorney's fees is denied

21 Fla. L. Weekly Supp. 150a

Online Reference: FLWSUPP 2102URBAInsurance -- Homeowners -- Attorney's fees -- Where insurer was investigating bona fide coverage issue and had not denied benefits directly or indirectly at time insured filed suit four months after submission of claim, insured is not entitled to attorney's fees under confession of judgment doctrine

21 Fla. L. Weekly Supp. 554a

Online Reference: FLWSUPP 2106DESDInsurance -- Personal injury protection -- Jurors -- Challenges -- Peremptory -- No abuse of discretion in denying challenge for cause based on juror's background as massage therapist, experience in medical field, and purportedly equivocal responses on whether she could be fair and impairtial -- Abuse of discretion to deny peremptory challenges of two jurors where insurer asserted jurors may not be fair and impartial, and there was no objection that challenges were being made in discriminatory manner -- New trial required -- Attorney's fees -- Appellate -- Provider who partially prevailed on appeal entitled to award of attorney's fees, contingent upon provider ultimately prevailing below

21 Fla. L. Weekly Supp. 865a

Online Reference: FLWSUPP 2109CARMInsurance -- Attorney's fees -- Appellate -- Justiciable issues -- Claim or defense not supported by material facts or applicable law -- Where medical provider presented colorable argument for extension of existing law, and insurer and its counsel knew or should have known that provider's conduct did not warrant motion for sanctions and attorney's fees under section 57.105, insurer's motion for sanctions is denied and provider is awarded appellate attorney's fees for its defense against insurer's motion

21 Fla. L. Weekly Supp. 1016c

Online Reference: FLWSUPP 2110PALMInsurance -- Attorney's fees -- Appellate fees are granted to insurer subject to trial court determining that insurer's proposal for settlement met statutory criteria

21 Fla. L. Weekly Supp. 697b

Online Reference: FLWSUPP 2107COASInsurance -- Attorney's fees -- Prevailing medical provider -- Amount

21 Fla. L. Weekly Supp. 267a

Online Reference: FLWSUPP 2103LEEInsurance -- Personal injury protection -- Standing -- Assignment -- Validity -- Where purported assignment does not convey any rights and is merely direction to pay, medical provider lacks standing to maintain suit -- Lack of standing cannot be cured post suit

21 Fla. L. Weekly Supp. 352b

Online Reference: FLWSUPP 2104PAREInsurance -- Personal injury protection -- Standing -- Assignment -- Instruction to pay medical provider all applicable medical benefits confers standing

21 Fla. L. Weekly Supp. 344b

Online Reference: FLWSUPP 2104PHILInsurance -- Personal injury protection -- Standing -- Assignment -- Where insured executed document assigning benefits to medical provider who rendered services, submitted bills to insurer, and filed suit against insurer, provider is real party in interest -- There is no distinction between direction to pay and assignment of benefits -- Even if express assignment did not exist, equitable assignment conveys standing to provider

21 Fla. L. Weekly Supp. 356a

Online Reference: FLWSUPP 2104DUBBInsurance -- Personal injury protection -- Standing -- Assignment -- Where assignment was made to individual physician, not to corporate plaintiff, plaintiff lacks standing to bring suit

21 Fla. L. Weekly Supp. 355a

Online Reference: FLWSUPP 2104OJEDInsurance -- Personal injury protection -- Standing -- Assignment -- Where assignment was made to individual physician, not to corporate plaintiff, plaintiff lacks standing to bring suit

21 Fla. L. Weekly Supp. 354a

Online Reference: FLWSUPP 2104PENDInsurance -- Personal injury protection -- Standing -- Assignment -- Where assignment was made to individual physician, not to corporate plaintiff, plaintiff lacks standing to bring suit

21 Fla. L. Weekly Supp. 572a

Online Reference: FLWSUPP 2106COOPInsurance -- Personal injury protection -- Standing -- Assignment -- Valid assignment and equitable assignment provide medical provider with standing -- Payment of policy proceeds after suit was filed is functional equivalent of confession of judgment

21 Fla. L. Weekly Supp. 274b

Online Reference: FLWSUPP 2103TIMPInsurance -- Homeowners -- Water extraction services -- No merit to argument that failure to attach homeowner's policy to complaint filed by company that provided water extraction services warrants dismissal of complaint where complaint states that plaintiff is not in possession of policy but that policy would be provided by insurer during discovery -- Standing -- Assignment -- Complaint and attached assignment stating that homeowner assigned all insurance rights, benefits and proceeds to plaintiff in exchange for services rendered as result of property damage are sufficient to establish prima facie case that there was agreement between plaintiff and homeowner for performance of water extraction services in exchange for assignment of rights under policy -- Arguments regarding deficiencies in assignment and inconsistency between assignment and allegations of complaint are factual disputes not appropriate for resolution in motion to dismiss -- Plaintiff was not required to obtain consent of insurer to have valid after-loss assignment

21 Fla. L. Weekly Supp. 670a

Online Reference: FLWSUPP 2107CASEInsurance -- Homeowners -- Standing -- Assignment -- Where homeowner's policy contains non-assignment provision and loss settlement provision, company that performed water extraction services on homeowner's property has no standing to bring action against insurer until after homeowner has fulfilled her obligation to adjust loss with insurer

21 Fla. L. Weekly Supp. 441a

Online Reference: FLWSUPP 2105BROWInsurance -- Homeowners -- Standing -- Assignment -- Provision in homeowners policy that prohibits assignment of policy does not bar assignment of after-loss claim

21 Fla. L. Weekly Supp. 427a

Online Reference: FLWSUPP 2105MOORInsurance -- Homeowners -- Standing -- Assignment -- No merit to argument that after-loss assignment of claim proceeds to restoration company violates lien or public adjuster's statutes

21 Fla. L. Weekly Supp. 780a

Online Reference: FLWSUPP 2108LEUNInsurance -- Homeowners -- Standing -- Assignment -- Company that provided water extraction service on homeowner's property has standing to bring action against insurer for unpaid balance of claim for company's services -- Anti-assignment provision in homeowner's policy does not apply to assignment after loss -- No merit to claim that all obligations owed by insurer to company have been satisfied by binding appraisal award -- Award resulting from appraisal demand made by homeowner after effective date of assignment is not binding on company -- Insurer's motion for summary judgment is denied

21 Fla. L. Weekly Supp. 714a

Online Reference: FLWSUPP 2107JIMEInsurance -- Dismissal -- Assignment -- Medical provider claiming benefits pursuant to written assignment is not required by rule 1.130 to attach assignment of benefits to complaint -- Motion to dismiss is denied

21 Fla. L. Weekly Supp. 201a

Online Reference: FLWSUPP 2102POOLInsurance -- Standing -- Assignment -- Rule 1.130 does not require medical provider/assignee to attach written assignment of benefits to complaint -- Motion to dismiss is denied

21 Fla. L. Weekly Supp. 1100a

Online Reference: FLWSUPP 2110IMPEInsurance -- Personal injury protection -- Void policy -- Material misrepresentations on application -- Declaratory action is proper vehicle for insurer to obtain judicial determination that it may void policy ab initio due to a material mispresentation -- Policy in instant case may be voided ab initio where insured incorrectly stated on application that he had not been involved in any automobile accidents in the past three years as driver or passenger and had not made a claim for medical injuries in Florida within the past three years -- Misrepresentations were material where insurer would not have accepted the risk had application disclosed the true facts -- Final summary judgment entered in favor of insurer -- Final judgment extinguishes claims of others whose rights were derived under the insurance policy

21 Fla. L. Weekly Supp. 803b

Online Reference: FLWSUPP 2108RCASInsurance -- Personal injury protection -- Affirmative defenses -- Accord and satisfaction -- Cashing of checks containing language stating that checks were for full and final PIP benefits for bills constituted accord and satisfaction -- Affidavit filed by medical provider stating that checks were not cashed with intent of accepting them as full and final payment is not sufficient to create issue of fact

21 Fla. L. Weekly Supp. 435a

Online Reference: FLWSUPP 2105TEJAInsurance -- Personal injury protection -- Affirmative defense of accord and satisfaction fails where there is no evidence that dispute existed between insurer and medical provider prior to issuance of check on which insurer relies for defense, and language on check is not conspicuous -- Summary judgment -- No merit to argument that unfiled adjuster notes demonstrate existence of factual issue as to whether provider and insurer reached oral agreement to resolve benefits -- Adjuster notes withheld by insurer under claim of privilege may not subsequently be used to defeat summary judgment, and assignment clearly requires that any agreement to settle benefits must be in writing

21 Fla. L. Weekly Supp. 270c

Online Reference: FLWSUPP 2103ROMAInsurance -- Personal injury protection -- Affirmative defenses -- Accord and satisfaction -- Insurer's explanation of review indicating that reductions in claim were made in accordance with statutory fee schedule and check containing statement that it was full and final payment of PIP benefits did not constitute accord and satisfaction under statutory law -- Payment based on application of statutory fee formula is liquidated amount that cannot give rise to accord and satisfaction -- Further, elements of statutory accord and satisfaction were not met where there was no communication of bona fide dispute between parties prior to issuance of insurer's check, and “full and final” language on check in same size and color font as surrounding text was not conspicuous -- No common law accord and satisfaction occurred where there is no evidence dispute existed prior to insurer's issuance of payment