Volume 11

11 Fla. L. Weekly Supp. 565a

Insurance — Personal injury protection — Submission of demand letter is not condition precedent to filing amended complaint to include additional charges for unpaid PIP benefits — Motion to amend complaint granted

11 Fla. L. Weekly Supp. 237b

Insurance — Personal injury protection — Claimant who filed suit against insurer for unpaid benefits and who submitted to insurer a “demand letter” was not required to submit a new demand letter before filing amended complaint seeking additional unpaid benefits arising from same accident but not originally specified in the demand letter

11 Fla. L. Weekly Supp. 128b

Insurance — Personal injury protection — Claims — Timeliness — Where medical provider timely submitted notice of initiation of treatment to insurer, time for submission of all charges, not just charges for first treatment, was extended from 30 days to 60 days — Summary judgment granted in favor of provider

11 Fla. L. Weekly Supp. 161a

Insurance — Personal injury protection — Coverage — Late-submitted bills — Amendments to statute allowing for bills erroneously submitted to incorrect carrier to be resubmitted to correct carrier do not apply retroactively — Medical provider failed to submit bills for services within 30days of treatment and failed to include with bills evidence demonstrating that provider reasonably relied on erroneous information — Partial summary judgment is granted in favor of insurer as to those bills — Summary judgment is also granted in favor of insurer for those bills that were never denied or reduced by insurer, as medical provider failed to provide insurer with demand letter for the bills

11 Fla. L. Weekly Supp. 748d

Insurance — Personal injury protection — HCFA form submitted by provider was improperly signed by referring physician instead of physician or supplier who furnished treatment and, accordingly, insurer was not notified of a covered loss

11 Fla. L. Weekly Supp. 246a

Insurance — Personal injury protection — Claim forms — Physician’s signature — Submission of properly completed HCFA 1500 form including signature of physician or supplier is condition precedent when making claim for PIP benefits — Summary judgment granted in favor of insurer

11 Fla. L. Weekly Supp. 452a

Insurance — Personal injury protection — Claim forms — Physician’s signature — Law does not require original signature of physician on each claim form — Form that contains name of physician and his qualifications is sufficient

11 Fla. L. Weekly Supp. 290a

Insurance — Personal injury protection — Coverage — Conditions precedent — Notice of loss — No error in entry of summary judgment in favor of insured where it was not disputed that benefits were owed or that notice of amount due was provided to insurer, but rather, whether letter from insured’s counsel to insurer was legally sufficient notice — Letter sent prior to suit stating sums for treatment rendered by medical provider which were outstanding met statutory notice requirement and created affirmative duty on part of insurer to verify and satisfy outstanding medical bills within 30 days — Attorney’s fees and costs awarded to insured

11 Fla. L. Weekly Supp. 274a

Insurance — Personal injury protection — Coverage — Conditions precedent — Notice of loss — HCFA form — Because statute requires that all statements and bills for medical services be submitted to insurer on HCFA form, insured’s submission of itemized statement of charges not on HCFA form did not provide notice of medical charges — No merit to argument that submission of itemized statement tolled time for payment of bills until subsequent submission of HCFA form — Legislative history and case law do not support exception to HCFA requirement for statements in substantial compliance with statutory requirements — Summary judgment in favor of insurer affirmed

11 Fla. L. Weekly Supp. 251c

Insurance — Personal injury protection — Claim for magnetic resonance imaging services by plaintiff which provided MRI images of insured’s spine to independent contractor to interpret films and render a report, compensated contractor on a per read basis, and submitted bill to insurer which included a 500% markup on professional component of MRI — Fee-splitting — Patient brokering — Plaintiff’s activities constitute violation of statute prohibiting patient brokering and split-fee arrangements since bill for amount in excess of amount paid to contractor is in effect a referral fee for brokering insured to contractor — Arrangement violates prohibition on fee-splitting regardless of fact that plaintiff is billing insurer for kickback rather than receiving kickback from contractor — Notice of claim — Insurer was not put on notice of loss and amount of loss is not properly payable where HCFA form submitted by plaintiff which merely indicated “signature on file” in box 31 failed to certify that services were rendered and was patently deceptive in leaving box 32 blank as to name and address of entity where services were rendered, failing to identify purchased service of independent contractor in box 20, and identifying physician’s supplier’s billing name and EIN as that of plaintiff — Medical services lawfully rendered — Insurer is not responsible to pay for treatment billed by plaintiff which hired contractor to perform medical services on its behalf and, therefore, did not render services — Summary judgment granted in favor of insurer