Volume 11

Case Search

FIRST CARE CHIROPRACTIC CENTER, INC., a/a/o Jean T. Joseph, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 650c

Insurance — Personal injury protection — Coverage — Exhaustion of policy limits — Where policy limits were exhausted prior to insurer’s receipt of provider/assignee’s suit, provider did not provide notice prior to exhaustion of policy limits that it disputed or protested reductions or denials, and final benefits payment made to provider exceeded benefits potentially in controversy such that insurer’s reductions and denials resulted in no net effect upon total PIP benefits paid to provider under disputed claim, insurer’s motion for summary judgment is granted

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TRAN CHIROPRACTIC & WELLNESS CENTER, INC. d/b/a WITH HANDS ONLY CHIROPRACTIC, P.A., as assignee of Ryan Hess, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 1012a

Insurance — Personal injury protection — Coverage — Summary judgment — Factual issues — Summary judgment is not appropriate on issue of whether settlement of outstanding medical bills between insured and provider/assignee precludes provider from seeking recovery of remaining balance of PIP benefits where intent of parties to settlement is issue of material fact not to be determined on motion for summary judgment — Conditions precedent — Examination under oath — Insurer is not absolved of liability to pay PIP benefits by insured’s failure to attend EUO scheduled to occur after expiration of insurer’s thirty-day deadline to authenticate claim — Motions for summary judgment denied

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DREW MEDICAL, INC., as assignee of Mayra Reyes, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 1008b

Insurance — Personal injury protection — Coverage — Affirmative defenses — Exhaustion of policy limits — Estoppel — Insurer that never raised exhaustion of policy limits in answer and affirmative defenses is estopped from raising issue in motion for summary judgment — Had insurer raised exhaustion defense, court would have denied motion for summary judgment because benefits were available at time reduced payment was made

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