Volume 10

10 Fla. L. Weekly Supp. 935a

Insurance — Personal injury protection — Fee-splitting — Medical provider’s payment of radiologist as 1099 employee to interpret insured’s MRI does not violate section 817.505 prohibition against fee-splitting where insurer has not asserted that any of the parties fall within categories of providers to which statute is applicable — Further, fee-splitting statute is applicable only where compensation is paid to induce the referral of patients or in return for referring patients, and insurer has not asserted that radiologist has been compensated in exchange for referring insured — Even if statute were applicable to medical provider, statute authorizes payment to health care provider or other health care facility for professional consultation services — Medical provider’s decision to pay radiologist to interpret MRI does not violate section 458.331 prohibition against physicians paying or receiving compensation for referral of patients to health care providers where insurer has not asserted that radiologist was compensated in exchange for referral, and statute expressly permits medical facilities to pay fee for professional consultation services — Coverage — Medical providers — Plaintiff medical provider is entitled to receive PIP benefits regardless of whether it is provider that actually rendered MRI services where insured’s benefits were validly assigned to plaintiff — Moreover, nothing in statute or definition of word “render” supports insurer’s assertion that plaintiff did not render MRI services at issue — Partial summary judgment entered in favor of medical provider

10 Fla. L. Weekly Supp. 1035a

Insurance — Personal injury protection — Discovery — Documents — Motion to compel better responses to requests to produce correspondence and notations from PIP claims file, information on insured’s physical or mental condition prior to filing of suit, and documentation of amounts paid by insurer to company that recommended usual and customary reductions and to physician performing independent medical examination/peer review or company selecting such physician denied — Motion to compel production of medical reports on insured granted — Interrogatories — Request for better answers to interrogatories regarding identity and role of persons who participated in investigation and selection of IME/peer review physician, insurer’s relationship to IME/peer review physician, total amount paid to IME/peer review physician, identity of persons knowledgeable about computer records showing payments made to IME/peer review physician, and listing of documents used to explain to adjusters policies and procedures for use of IME/peer review physicians denied

10 Fla. L. Weekly Supp. 544a

Insurance — Personal injury protection — Disability income — Motion for summary judgment on ground that insured’s claim for disability-related income loss was not accompanied by report from a medical professional indicating that insured was disabled is denied — Issue of PIP disability is question of proof appropriate for trial — Denial is without prejudice to bringing motion again after discovery if insured can provide no admissible proof that he was disabled and lost income as result of motor vehicle accident

10 Fla. L. Weekly Supp. 643a

Insurance — Personal injury protection — Demand letter is not condition precedent to initiating suit for claim paid at reduced rate

10 Fla. L. Weekly Supp. 476a

Insurance — Personal injury protection — Error to enter summary judgment in favor of insurer due to failure of plaintiff medical provider to register under section 456.0375 within 60 days of effective date of statute where statute only requires that clinics file registration form with Department of Health within 60 days and, while evidence indicated that provider was not issued license within 60 days, there was no evidence that it did not file registration form within 60 days

10 Fla. L. Weekly Supp. 207b

Insurance — Personal injury protection — Coverage — Medical expenses — Amendments to paragraph (5) of section 627.736, setting amounts to be charged for treatment and services, apply to treatment and services occurring on or after October 1, 2001

10 Fla. L. Weekly Supp. 187a

Insurance — Workers’ compensation — Employer’s liability — Plaintiff seeking to recover from insurer the amount of a judgment entered against insureds pursuant to a settlement agreement whereby the insureds admitted liability and conceded damages in specified amount, insureds assigned their rights under policy to plaintiff, and plaintiff agreed to seek to recover under the judgment only against insurer under the policy — Remand following appeals court ruling that where insurer refused both coverage and a defense to its insured for claims brought by injured employee against insured in a civil action, insurer thereby ceded to its insured control of the litigation and the right to settle the claims, insurer is bound by settlement waiving defense of workers’ compensation immunity and may not assert that defense against plaintiff’s claim for policy benefits to satisfy the judgment entered against the insured pursuant to settlement agreement, and insurer may not relitigate issue of liability by raising any affirmative defenses that could have been raised in the civil action — Insurer is not entitled to set-off of workers’ compensation payments or workers’ compensation lien on plaintiff’s recovery as these defenses could have been raised in civil action — Settlement is reasonable

10 Fla. L. Weekly Supp. 436c

Insurance — Personal injury protection — Declaratory judgments — Medical provider properly pled count for declaratory relief where it is alleged that insurer refused provider’s numerous requests for PIP log, and due to insurer’s dilatory tactics provider is unsure whether there is coverage or whether medical bill was applied to deductible

10 Fla. L. Weekly Supp. 201b

Insurance — Personal injury protection — Where non-insured passenger who resides in household with automobile liability policy having PIP coverage first submitted claim to vehicle owner’s insurer and received medical payment coverage at 20%, and then 22 months after accident assignee submitted claim to household PIP insurer, assignee is not entitled to any additional payment

10 Fla. L. Weekly Supp. 44c

Insurance — Personal injury protection — Passenger who is owner of an uninsured vehicle not being driven or operated on roads of state at time of accident because of being stored and repaired over several months at auto body shop is not barred from recovering PIP benefits — Amendment to section 320.02(1) removed requirement to register vehicles merely maintained in state although not operated or driven