17 Fla. L. Weekly Supp. 991a

Online Reference: FLWSUPP 1710LOPE

Insurance — Personal injury protection — Valid peer review report is required as prerequisite only to withdraw benefits that were previously provided, not to deny them from the inception — Trial court erred in striking peer review and granting summary judgment in favor of provider

UNITED AUTOMOBILE INS. CO., Appellant, vs. FLORIDA WELLNESS & REHABILITATION CENTER, INC., a/a/o WESLEY LOPEZ, Appellee. Circuit Court, 11th Judicial Circuit (Appellate) in and for Miami-Dade County. Case No. 08-269 AP & 08-265 AP. L.C. Case No. 07-06087 CC 05. June 2, 2010. An appeal from the County Court for Miami-Dade County, Florida, the Honorable Bronwyn C. Miller presiding. Counsel: Lara J. Edelstein, for Appellant. Marlene S. Reiss, for Appellee.

(Before GORDON, SHAPIRO, and ARECES, JJ.)

(SHAPIRO, J.) In this PIP case, the insurer, United Automobile Insurance Company (United Auto), denied all payments for the medical treatment of the insured, Wesley Lopez. The medical provider, Florida Wellness & Rehabilitation Center, Inc., sued, and United Auto defended by denying that the bills were reasonable, related, and necessary. The medical provider moved for summary judgment, asserting that the expenses were reasonable, related, and necessary. In considering the merits of the motion for summary judgment, the trial court excluded United Auto’s peer review report. The medical provider asserts that it was proper for the trial court not to consider the peer review because it was not prepared prior to United Auto’s denial of its claims.

However, cases released after the trial court’s decision to strike the peer review below make it clear that a valid peer review report is required as a prerequisite only to withdraw benefits that were previously provided, not to deny them from the inception. See United Auto. Ins. Co. v. Perez, 21 So. 3d 886, 887 (Fla. 3d DCA 2009); United Auto. Ins. Co. v. A 1st Choice Healthcare Systems, 21 So. 3d 124, 127 (Fla. 3d DCA 2009) Partners in Health Chiropractic v. United Auto. Ins. Co., 21 So. 3d 858 (Fla. 3d DCA 2009); United Auto Ins. Co. v. Santa Fe Med. Center, 21 So. 3d 60, 65 (Fla. 3d DCA 2009). In the instant case, United Auto denied all of the bills submitted by the medical provider. Therefore, the trial court erred when it struck the peer review and granted summary judgment in favor of the medical provider.

Accordingly, we REVERSE the order granting summary judgment. We also REVERSE the award of fees and costs to the medical provider. (GORDON and ARECES, JJ., concur.)