Volume 11

Case Search

PROGRESSIVE CONSUMER INS CO., Appellant, vs. MARIO DELVA, Appellee.

11 Fla. L. Weekly Supp. 302a

Insurance — Personal injury protection — Coverage — Passenger injured in rental vehicle — Where coverage under driver’s PIP policy extends only to insured or any relative injured while occupying motor vehicle or any other person injured while occupying a covered vehicle owned by insured, non-relative passenger injured while occupying rental vehicle is not entitled to PIP benefits under policy — Error to enter summary judgment in favor of self-insured car rental company on basis that PIP insurer, not rental company, is responsible to provide PIP benefits to passenger

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REBECCA MILAM, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 568b

Insurance — Personal injury protection — Coverage — Non-owner of vehicle — Action by injured child/passenger covered under father’s PIP policy against vehicle owner’s PIP carrier for medical expenses not paid by father’s PIP carrier due to deductible on father’s policy — Vehicle owner’s carrier is not liable to child for deductible — Summary judgment granted in favor of owner’s carrier

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PHYSICIANS REFERRAL & MEDICAL SERVICES, INC. (a/a/f Manuel Louro), Plaintiff, v. ALLSTATE INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 152c

Insurance — Personal injury protection — Coverage — Referral and billing service — Where plaintiff picked up films of x-rays and CT scan from clinic and paid independent contractors to interpret films and transcribe interpretations, plaintiff’s activities constitute referral and billing services only, not medical services and/or treatment contemplated by Florida PIP statute, and plaintiff is not entitled to payment of PIP benefits — Summary judgment granted in favor of insurer

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MANLEY W. KILGORE, II, M.D., P.A., as Assignee for TERESA A. FISCHER, Plaintiff, vs. AMERICAN INTERNATIONAL SOUTH INSURANCE COMPANY, a Foreign Insurance Company, Defendant.

11 Fla. L. Weekly Supp. 646a

Insurance — Personal injury protection — Medical bills — Reduction — Provider/assignee’s claim for needle electromyography procedures and nerve conduction velocity testing — Statutory limitation of charges to 200% of allowable amount under Medicare Part B reimbursement schedule applies only to NCV testing, not EMG procedure done in conjunction with NCV

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WINTER PARK CHIROPRACTIC PHYSICIANS, P.A., a/a/o JOSEPH TURNER, Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 1071a

Insurance — Personal injury protection — Coverage — Medical expenses — Reduction — Reduced amounts applied to deductible — Partial summary judgment granted in favor of insurer where insurer would not have been responsible for bills at issue even if no reductions had been taken as deductible would not have been met even if full amount of bills had been applied

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PHYSICIANS INJURY CARE CENTER, as assignee of GAIL SCOTT, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 1070d

NOT FINAL VERSION OF OPINION
Subsequent Changes at 12 Fla. L. Weekly Supp. 506a

Insurance — Personal injury protection — Coverage — Medical expenses — Reduction — Reduced amounts applied to deductible — Summary judgment granted in favor of insurer where insurer would not have been responsible for bills at issue even if no reductions had been taken, as deductible would not have been met even if full amount of bills had been applied

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DR. DAVID W. SHAW, D.C., (Charles Urso), Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 677a

Insurance — Personal injury protection — Medical expenses — Reduction — Preferred provider rates — Where insurer did not require use of preferred providers, but merely allowed that if insured elected to use provider who was under contract insured would benefit by obtaining lower co-payment and higher payment percentage and gaining more medical services for same policy limits, section 627.736(10) requirement that preferred provider list be provided to insured electing PPO coverage is inapplicable and provider cannot use statute to abrogate its Beech Street contract — Statute does not create civil cause of action, but is part of regulatory scheme under authority of Department of Insurance — Insurer’s motion for summary judgment granted

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NATIONWIDE GENERAL INSURANCE COMPANY, Appellant, v. FAMILY CHIROPRACTIC HEALTH CENTER, INC. (a/a/o Ruth Morningred), Appellee.

11 Fla. L. Weekly Supp. 203b

Insurance — Personal injury protection — Preferred providers — Section 627.736(10) does not prohibit insurer from making payment for healthcare services covered by PIP benefits at reduced preferred provider organization rates to healthcare provider who has entered into valid and enforceable contract to accept payment at PPO rates

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