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Volume 10

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METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY, Appellant, vs. RICHARD R. SHAKER, D.C., P.A., Appellee.

10 Fla. L. Weekly Supp. 679a

Insurance — Appeals — Where issue of standing based on purported invalidity of assignment was directly raised on appeal, and issue of whether policy was assignable was only raised by mention in statement of facts, court could have considered the issue of transferability of policy waived but was not required to do so — Evidence — Trial court’s denial of admissibility of affidavit on ground that there was issue as to whether affiant had personal knowledge is affirmed where, even if ruling was close call, there is no demonstrated prejudice because decision is order denying summary judgment

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NARESH B. DAVE, M.D., P.A., (As assignee of Judy Blanco), Plaintiff, v. ALLSTATE INSURANCE COMPANY, Defendant.

10 Fla. L. Weekly Supp. 1036d

Insurance — Personal injury protection — Assignment — Validity — Fact that name of insurer and name of medical provider are not contained in assignment is not fatal — Assignment complies with requirements for valid contract between parties, services were provided as result of assignment and in reliance on assignment, and insurer made payments in reliance on assignment — Defendant’s motion for summary judgment on ground that plaintiff lacked standing denied

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SEMEGON CHIROPRACTIC HEALTH CENTER, P.A., (Marjorie Spangler), Plaintiff(s), vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant(s).

10 Fla. L. Weekly Supp. 907a

Insurance — Personal injury protection — Standing — Assignment — Revocation — Where medical provider had standing pursuant to assignment at time suit was filed, subsequent revocation of assignment by insured would only be effective as to dates of service not already encompassed in provider’s suit — If suit insured filed after revocation does not encompass any dates of service after date medical provider’s suit was filed, insured’s suit should be dismissed

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RAYMOND D. CLITES, D.C., P.A. (As Assignee of Robert Williams), Plaintiff(s), v. METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY, Defendant (s).

10 Fla. L. Weekly Supp. 888a

Insurance — Personal injury protection — Standing — Assignment — Validity — Document stating it is direct assignment of rights and benefits under policy constitutes valid assignment of claim — Revocation language in separate document does not revoke assignment as to services rendered during nine-month period between signing of documents — No merit to argument that medical provider has no standing or case is not ripe due to fact that insured did not sustain a loss and, therefore, medical provider received nothing by assignment because loss is sustained by PIP insured when insured receives medical treatment arising out of motor vehicle accident, not when insurer refuses payment — Summary judgment on issue of invalidity of assignment due to failure of insured and medical provider to obtain insurer’s consent to assignment is not appropriate where there remains issue as to whether assignment was made after loss was incurred and, therefore, no consent is necessary — Issues of material fact also remain as to argument that plaintiff failed to comply with statute by not getting medical provider to sign box 12 of HCFA form where, because medical provider has valid assignment, it is reasonable to infer that provider is not misrepresenting fact that it is authorized to receive payment — Insurer’s motion for summary judgment denied

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NEW HAMPSHIRE INDEMNITY COMPANY, Plaintiff/Petitioner, v. EQUINOX BUSINESS CREDIT CORP., a Florida Foreign For-Profit Corporation, d/b/a EQUINOX FACTORS; WELLNESS CONCEPTS, INC., a Florida Foreign For-Profit Corporation; WELLNESS CONCEPTS, INC., a dissolved Florida Corporation; JEFFREY CULLERS d/b/a ATLANTIC CHIROPRACTIC & MASSAGE; JEFFREY CULLERS and/or BRUCE MARING, D.C., d/b/a INJURY CARE OF ORMOND BEACH; and BRUCE MARING, D.C., individually, Defendants\Respondents.

10 Fla. L. Weekly Supp. 172a

Insurance — Personal injury protection — Claim forms — HCFA form which does not contain certification that medical provider has truthfully and accurately completed form, utilize correct codes, and comply with HCFA directions does not put insurer on notice of claim and is not properly payable — Medical provider who accepts assignment of benefits must provide copy of assignment to insurer as condition precedent to suit against insurer and must comply with policy terms and conditions — Countersignature — HCFA form which does not contain signature of insured, but indicates “signature on file,” does not put insurer on notice of loss — Medical provider who knows or should have known that information in HCFA form is false, misleading, incomplete or patently deceptive, or who acts in deliberate ignorance of truth, falsity or completeness of the information cannot recover direct payment from insurer — HCFA form must contain name and address of medical provider who actually rendered medical services to insured, not of billing or factoring company — Medical provider must certify on form that services were performed; “signature of file” notation is legally insufficient certification — Medical provider who has used unregistered fictitious name on HCFA form or assignment of benefits cannot recover benefits — Summary judgment granted in favor of insurer

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NEW HAMPSHIRE INDEMNITY COMPANY, Plaintiff/Petitioner, v. EQUINOX BUSINESS CREDIT CORP., a Florida Foreign For-Profit Corporation, d/b/a EQUINOX FACTORS; WELLNESS CONCEPTS, INC., a Florida Foreign For-Profit Corporation; WELLNESS CONCEPTS, INC., a dissolved Florida Corporation; JEFFREY CULLERS d/b/a ATLANTIC CHIROPRACTIC & MASSAGE; JEFFREY CULLERS and/or BRUCE MARING, D.C., d/b/a INJURY CARE OF ORMOND BEACH; and BRUCE MARING, D.C., individually, Defendants\Respondents.

10 Fla. L. Weekly Supp. 172a

Insurance — Personal injury protection — Claim forms — HCFA form which does not contain certification that medical provider has truthfully and accurately completed form, utilize correct codes, and comply with HCFA directions does not put insurer on notice of claim and is not properly payable — Medical provider who accepts assignment of benefits must provide copy of assignment to insurer as condition precedent to suit against insurer and must comply with policy terms and conditions — Countersignature — HCFA form which does not contain signature of insured, but indicates “signature on file,” does not put insurer on notice of loss — Medical provider who knows or should have known that information in HCFA form is false, misleading, incomplete or patently deceptive, or who acts in deliberate ignorance of truth, falsity or completeness of the information cannot recover direct payment from insurer — HCFA form must contain name and address of medical provider who actually rendered medical services to insured, not of billing or factoring company — Medical provider must certify on form that services were performed; “signature of file” notation is legally insufficient certification — Medical provider who has used unregistered fictitious name on HCFA form or assignment of benefits cannot recover benefits — Summary judgment granted in favor of insurer

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NEW HAMPSHIRE INDEMNITY COMPANY, Plaintiff/Petitioner, v. EQUINOX BUSINESS CREDIT CORP., a Florida Foreign For-Profit Corporation, d/b/a EQUINOX FACTORS; WELLNESS CONCEPTS, INC., a Florida Foreign For-Profit Corporation; WELLNESS CONCEPTS, INC., a dissolved Florida Corporation; JEFFREY CULLERS d/b/a ATLANTIC CHIROPRACTIC & MASSAGE; JEFFREY CULLERS and/or BRUCE MARING, D.C., d/b/a INJURY CARE OF ORMOND BEACH; and BRUCE MARING, D.C., individually, Defendants\Respondents.

10 Fla. L. Weekly Supp. 172a

Insurance — Personal injury protection — Claim forms — HCFA form which does not contain certification that medical provider has truthfully and accurately completed form, utilize correct codes, and comply with HCFA directions does not put insurer on notice of claim and is not properly payable — Medical provider who accepts assignment of benefits must provide copy of assignment to insurer as condition precedent to suit against insurer and must comply with policy terms and conditions — Countersignature — HCFA form which does not contain signature of insured, but indicates “signature on file,” does not put insurer on notice of loss — Medical provider who knows or should have known that information in HCFA form is false, misleading, incomplete or patently deceptive, or who acts in deliberate ignorance of truth, falsity or completeness of the information cannot recover direct payment from insurer — HCFA form must contain name and address of medical provider who actually rendered medical services to insured, not of billing or factoring company — Medical provider must certify on form that services were performed; “signature of file” notation is legally insufficient certification — Medical provider who has used unregistered fictitious name on HCFA form or assignment of benefits cannot recover benefits — Summary judgment granted in favor of insurer

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