Volume 10

10 Fla. L. Weekly Supp. 731a

Insurance — Personal injury protection — Medical bills — Medical provider’s motion for summary judgment is denied where defense of whether medical bill was necessary and related to accident in question remains

10 Fla. L. Weekly Supp. 203a

Insurance — Personal injury protection — Independent medical examination — Because IME may be videotaped by insured’s representative, decision of IME physician to not proceed with IME was not legally correct although physician has right to choose not to proceed — Where insurer unilaterally scheduled second IME without coordinating with insured’s attorney, insured filed a motion for protective order which insurer never called up for hearing, and insurer terminated coverage when insured failed to attend IME, insurer breached contract by terminating coverage without any basis to find that insured acted “unreasonably” in failing to attend IME

10 Fla. L. Weekly Supp. 731c

Insurance — Personal injury protection — Examination under oath — Affirmative defense that insured violated condition precedent to suit by unreasonably refusing to submit to examination under oath is barred where policy language is ambiguous as to duties of insured or conditions precedent to filing suit

10 Fla. L. Weekly Supp. 729a

Insurance — Personal injury protection — Coverage — Denial — Failure to attend examination under oath — Policy language requiring written claim “and/or” EUO is ambiguous and must be construed in favor of coverage — Even if provision was not ambiguous, defense of failure to attend EUO would fail because insurer sent request for EUO directly to insured represented by counsel and made no effort to put counsel on notice of EUO — Summary judgment granted in favor of insured on bills denied solely on basis of failure to attend EUO — Insurer’s motion for summary judgment as to bills contested as not reasonable or necessary is denied because defense raises question of fact

10 Fla. L. Weekly Supp. 971c

Insurance — Personal injury protection — Coverage — Conditions precedent — Examination under oath — Where insurer scheduled EUO within thirty days of notice of claim but EUO was not scheduled to take place until over thirty days after notice of claim, insurer breached contract by failing to pay PIP claim within thirty days after notice without reasonable proof that it was not liable for claim and was properly barred from using insured’s failure to attend EUO as defense in suit to recover PIP benefits

10 Fla. L. Weekly Supp. 1044d

Insurance — Personal injury protection — Explanation of benefits constituted denial for purposes of section 627.736(11) — Plaintiff not obligated to file seven-day demand prior to filing suit

10 Fla. L. Weekly Supp. 537b

Insurance — Personal injury protection — Dispute between medical provider and insurer — Examination under oath — Although insured and claimant did not appear for EUO requested by insurer, insurer had obligation to conduct diligent search to obtain information it was seeking from insured and claimant — Where record is devoid of any evidence to show diligent effort to locate and serve subpoena on insured or claimant during two years of litigation, defendant failed in obligation to obtain reasonable proof to deny claim and bring forth facts to support its coverage defense, and medical provider is entitled to payment of bills timely submitted prior to 30 days after first request for EUO, statutory interest, and attorney’s fees

10 Fla. L. Weekly Supp. 865a

Insurance — Personal injury protection — Coverage — Conditions precedent — Independent medical examination — Trial court erred in granting summary judgment in favor of insurer where, although insured did not dispute allegation that her absence from all IMEs was unreasonable, insured was entitled to payment of medical bills incurred by insured and received by insurer prior to notice of suspension of benefits

10 Fla. L. Weekly Supp. 16a

Insurance — Personal injury protection — Where medical provider filed suit the day before insured attended examination under oath required by PIP policy, condition precedent to filing suit had not been met — EUO scheduled to occur after statutory 30-day period for insurer to obtain reasonable proof is timely where EUO was scheduled to occur within period and rescheduled at insured’s request — Insurer’s request to medical provider for complete medical records on insured before 30-day period began to run was permissible — Summary judgment for insurer affirmed

10 Fla. L. Weekly Supp. 656a

Insurance — Personal injury protection — Coverage — Plaintiff injured as driver of insured vehicle who is owner of uninsured vehicle — Where lapse in insurance on plaintiff’s vehicle occurred prior to date vehicle became inoperable, vehicle was not in storage and was not permanently inoperable but simply needed brake repair, and plaintiff drove vehicle after lapse in insurance up to right before accident, plaintiff may not recover PIP benefits