Volume 10

10 Fla. L. Weekly Supp. 675c

Insurance — Personal injury protection — Medical bills — Reduction — Exhaustion of benefits — Action by medical provider for balance of bill partially paid by insurer claiming charged amount exceeded usual and customary charges — Insurer must pay overdue claims unlawfully withheld even if policy limits have been exhausted — Abuse of discretion in granting summary judgment where there was genuine issue of material fact as to reasonableness of amount charged

10 Fla. L. Weekly Supp. 546c

Insurance — Personal injury protection — Summary judgment granted in favor of insurer on claim of medical provider to whom insured assigned benefits for unpaid portion of medical bill where prior to filing of suit insurer exhausted benefits with payment to medical provider other than plaintiff

10 Fla. L. Weekly Supp. 199a

Insurance — Personal injury protection — Action for balance of partially paid bills where policy limits have been exhausted by payment of subsequent claims — Issue of whether insurer paid medical provider reasonable and proper amount for services it provided prior to exhaustion of policy limits is question of fact that precludes summary judgment — Court recedes from prior ruling that exhaustion of benefits relieved insurer of any further liability due to fact that insurer has fulfilled its obligations under policy

10 Fla. L. Weekly Supp. 831a

Insurance — Personal injury protection — Coverage — Exhaustion of benefits — Escrow language in assignment was not sufficient for insurer to set aside funds prior to exhaustion of benefits

10 Fla. L. Weekly Supp. 827a

Insurance — Personal injury protection — Coverage — Exhaustion of benefits — Where benefits under policy were exhausted after payment of reduced amount for medical bill, no notice of assignment was provided to insurer prior to suit, no request to escrow benefits for disputed portion of bill was made to insurer prior to suit, and suit was not filed until two and a half years after exhaustion of benefits, medical provider is not entitled to any additional benefits under policy

10 Fla. L. Weekly Supp. 530b

Insurance — Personal injury protection — Coverage — Denial — Exhaustion of benefits — Insurer who denied coverage based on alleged preferred provider contract cannot wait until all benefits are exhausted, two years after filing of complaint, and move for summary judgment against assignee who timely demanded payment of PIP claim — Partial summary judgment granted in favor of assignee on inapplicability of PPO contract to which it was not a party

10 Fla. L. Weekly Supp. 826c

Insurance — Personal injury protection — Coverage — Exhaustion of benefits — Provider has no cause of action for recovery of benefits where medical provider failed to instruct insurer not to pay other medical benefits until benefits claimed by provider had been recovered or adjudicated, there is no evidence that exhaustion of benefits by insurer during pendency of provider’s suit for balance of reduced bills was undertaken in bad faith, assignment does not constitute appropriate notice to gain priority in distribution of benefits because it fails to reference specific bills in dispute, and fact that provider accepted reduced amounts paid by insurer contradicts claim that provider was disputing reasonableness of payment and requesting that benefits be set aside for future resolution

10 Fla. L. Weekly Supp. 1020b

Insurance — Personal injury protection — Exhaustion of benefits — Insurer not entitled to summary judgment based on exhaustion of benefits where evidence indicated that adequate benefits were available to pay medical bills at issue at time lawsuit was filed — There is no requirement in No-Fault statute that assignee request that benefits be placed in escrow in order to protect right to proceed against insurer following exhaustion of benefits — Filing of lawsuit provided insurer with notice of disputed bills — Insurer provided no legal basis to find that payment to separate corporate entity should be deemed equivalent of payment to plaintiff — Case shall proceed to trial on merits

10 Fla. L. Weekly Supp. 1019a

Insurance — Personal injury protection — Exhaustion of benefits — Where action was filed by assignee after payment was denied as not reasonable, related, or necessary and, at the time, there were sufficient funds available under the policy to pay the claim, and where assignee filed action against insurer prior to exhaustion of benefits, insurer was not entitled to summary judgment based on the subsequent exhaustion of benefits

10 Fla. L. Weekly Supp. 1018b

Insurance — Personal injury protection — Coverage — Medical expenses — Exhaustion of policy limits — Where insured’s PIP benefits were exhausted after medical provider filed suit against insurer, medical provider did not instruct insurer not to pay other PIP benefits until benefits claimed by provider had been adjudicated or amend complaint to specify any particular bills at issue and that any particular amount was to be retained, and there is no evidence that insurer’s exhaustion of benefits was taken in bad faith, medical provider has no cause of action against insurer for recovery of benefits