10 Fla. L. Weekly Supp. 134a
Insurance — Personal injury protection — Discovery — Interrogatories — Motion to compel better answers — Although insurer does not currently have information it would need to fully and properly answer questions about number of peer reviews performed and income earned from peer reviews in past year by physician who performed peer review upon which insurer based its denial of claim, insurer is ordered to obtain information from physician and serve better answers to interrogatories
ILDEFONSO VILAR, Plaintiff, v. ALLSTATE INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 01 CC 2633 20 S. December 11, 2002. Mark E. Herr, Judge. Counsel: Alexander Billias, Morgan, Colling and Gilbert, P.A., Orlando, for Plaintiff. Mary Adkins, Cameron, Hodges & Coleman, Ocala, for Defendant.
ORDER ON PLAINTIFF’S MOTION TOCOMPEL BETTER ANSWERS TOPEER REVIEW INTERROGATORIES
This matter having come before the Court on November 22, 2002 on Plaintiff’s Motion to Compel Better Answers to Peer Review Interrogatories, (certificate date August 28, 2002), and the Court having reviewed the file, having heard argument of counsel and being fully advised in the premises:
PROCEDURAL BACKGROUND AND FACTS
This personal injury protection litigation involves, inter alia, an NCV/EMG performed on Plaintiff and submitted to Allstate for payment. Kenneth Fischer, M.D. performed a peer review of the NCV/EMG. Allstate denied payment for the NCV/EMG based on Dr. Fischer’s peer review. On February 8, 2002, Plaintiff served its Peer Review Interrogatories on Allstate. On July 22, 2002, Allstate served its Verified Answers to Peer Review Interrogatories. Allstate’s answer to peer review interrogatories numbers 4, 5, 6, 7, 14, 15, and 16 was: “Unknown. Kenneth Fischer, M.D. may have the information requested.”
Plaintiff’s Peer Review Interrogatories are as follows:
1. Please identify the person answering these interrogatories, and if applicable, the person’s official position or relationship to whom the interrogatories are directed?
2. Please state specifically what was KENNETH FISCHER, M.D. hired by Allstate Insurance Company to do in this case and what his compensation was or is to be.
3. Please give an approximation of the portion of professional Peer Review or work KENNETH FISCHER, M.D. has devoted to service as an expert (such as he was hired to be in this case) and state the percentage of the work which is performed for the Defendant and the percentage performed for Plaintiff.
4. Please state the approximate number of Peer Review that KENNETH FISCHER, M.D. has performed in the last twelve- (12) months, and indicate whether they were performed for the Plaintiff or Defendant.
5. Please state an approximate number of hours KENNETH FISCHER, M.D. has expended over the past twelve- (12) months working as an expert.
6. Please state the approximate amount of income KENNETH FISCHER, M.D. has earned arising out of PEER REVIEW work over the last twelve- (12) months.
7. Please state specifically each case in which KENNETH FISCHER, M.D. has actually testified by way of deposition or trial, for the last three (3) years prior to the date of these interrogatories, give the full legal name of the case and the identity of the insurance company who requested the PEER REVIEW.
8. For the expert witness, state his/her profession or occupation, the field in which he/she is allegedly an expert, and the number of years he/she has worked in his/her field. A copy of each expert’s curriculum vitae may be attached in the alternative.
9. As to the expert witness listed above, state:
(a) The subject matter in which the expert is expected to testify.
(b) The substance of the facts upon which or about the expert is expected to testify.
(c) The substance of the opinion or opinions to which each such expert is expected to testify.
(d) The summary of the grounds for such opinion.
10. Is KENNETH FISCHER, M.D.’s testimony expected to be offered by deposition or is it expected to be offered in person at trial.
11. Has the above expert been retained by this Defendant to conduct testing, examinations, or inspections relative to this cause? If so, please identify each item or object that has been tested, analyzed, examined or inspected; the name of the expert(s) conducting such test(s) and the findings resulting from said test.
12. Did the expert listed above submit a report relative to his/her opinions in this case? If so, state the date of the reports and give a summary of the contents.
13. State the name and address of all person(s) other than experts whom you do not expect to call as witnesses at trial having first hand knowledge of any relevant facts regarding treatment of the Plaintiff.
14. Please state the approximate number of peer reviews that KENNETH FISCHER, M.D. has performed in the last twelve- (12) month period, and indicate whether they were performed for the Plaintiff or Defendant.
15. Please state the approximate number of hours KENNETH FISCHER, M.D. has expended over the past twelve- (12) months performing peer reviews.
16. Please state the approximate amount of income KENNETH FISCHER, M.D. has earned arising out of peer review work over the last twelve- (12) months.
17. Please disclose the cases in which Concentra has been hired to schedule examinations and/or retain experts to perform records reviews at the request of Allstate Insurance Company, its agents or attorneys, in the State of Florida for the preceding three (3) years. (Disclose means providing the full name of the case, address and telephone number).
18. Please indicate the gross amount of fees Allstate Insurance Company, its agents or attorneys, have paid KENNETH FISCHER, M.D. for the services described in Interrogatory question number two (2) for the years:
1999
2000
2001
19. Please state specifically what Concentra was hired to do in this case and what its compensation was.
20. Please state specifically each case in which Concentra corporate representatives have actually testified in PIP cases involving Allstate Insurance Company by way of deposition or trial, for the last three (3) years prior to the date of these interrogatories, give the full legal name of the case and the identity of the Plaintiff’s attorney.
21. Please list all the medical records, documentation, and billing records that were submitted or provided to Concentra that were used by KENNETH FISCHER, M.D. formulate his opinion about the medical necessity, reasonableness, and relatedness of Plaintiff’s injuries and medical treatment at issue in this lawsuit.
LAW AND ANALYSIS
It is hereby ORDERED and ADJUDGED that;
Pursuant to Allstate Ins. Co. v. Boecher, 733 So. 2d 993 (Fla. 1999), Plaintiff’s Motion to Compel Better Answers to Peer Review Interrogatories is hereby GRANTED. Although Allstate does not currently possess or maintain the information it would need to fully and properly answer Plaintiff’s Peer Review Interrogatories, Allstate shall obtain said information from Kenneth Fischer, M.D. and/or Concentra and serve better answers to Plaintiff’s Peer Review Interrogatories. Accordingly, Defendant shall serve its better answers to Plaintiff’s Peer Review Interrogatories by December 22, 2002.
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