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Volume 11

Case Search

ROBERT MARTINEZ, M.D., P.A. (As assignee of GERARDO PIMIENTA), Plaintiff, v. PROGRESSIVE EXPRESS INSURANCE COMPANY

11 Fla. L. Weekly Supp. 455b

Attorney’s fees — Insurance — Personal injury protection — Discovery — Depositions — Where insurer has not honored order preliminary to fees hearing that directed it to respond to disputed items of fees and costs within ten days of receipt of provider/assignee’s affidavit of time and costs, requested deposition of provider’s counsel may be had only by paying counsel his hourly rate

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W.P. BOORAS, M.D., P.A., as assignee of Brett Hale, Plaintiff, vs. NATIONWIDE MUTUAL FIRE INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 566a

Insurance — Personal injury protection — Supplemental medical insurance — Requirement to pay 10% penalty when claim for which demand was made is paid by insurer does not apply to payment of claim for optional supplemental medical insurance benefits — Provider is not required to send demand letter before filing suit for unpaid or overdue benefits under optional policy

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GLENICE COATES, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE CO., Defendant.

11 Fla. L. Weekly Supp. 645b

Insurance — Personal injury protection — Demand letter — Sufficiency — Court cannot grant summary judgment for plaintiff on claim for statutory 10% interest following insurer’s payment of overdue bills after receipt of demand letter or for insurer on claim that interest is not due because demand letter failed to satisfy statutory requirements where disputed issues of material fact exist concerning whether confusing letter could be understood by someone in insurance and billing industry as giving information required by statute

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DR. ROBERT D. SIMON, MD, PA (Napoleon Pham-Vo), Plaintiff, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 347a

Insurance — Personal injury protection — Where provider/assignee sent noncompliant pre-suit demand letter which did not contain assignment of benefits, provider/assignee sent complaint demand letter after suit was filed, and assignment provided to insurer during claims process was not sent to recipient designated for purposes of receiving pre-suit demand letters, summary judgment is granted in favor of insurer — Case closed without prejudice

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UNIVERSAL HEALTH CARE CENTER, INC., (a/a/o Leslie Cross), Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 1095b

Insurance — Personal injury protection — Demand letter — Sufficiency — Merely attaching HCFA forms to document identified as demand letter fails to comply with statutory requirement to provide insurer with exact amount due as it does not account for amounts applied to deductible, amounts reduced to reasonable charges or partial payments made — Final summary judgment granted in favor of insurer

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UNIVERSAL HEALTH CARE CENTER, INC., (a/a/o Texsenia Cross), Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 932b

Insurance — Personal injury protection — Demand letter — Sufficiency — Merely attaching HCFA forms to document identified as demand letter fails to comply with statutory requirement to provide insurer with exact amount due as it does not account for amounts applied to deductible, amounts reduced to reasonable charges or partial payments made — Final summary judgment granted in favor of insurer

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JACOB FEIGENBAUM, Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.

11 Fla. L. Weekly Supp. 737a

Insurance — Personal injury protection — Demand letter — Sufficiency — Letter does not comply with requirements for pre-suit demand letter as it does not state it is demand letter; does not state name of insured, claim or policy number upon which claim was originally submitted, or name of medical provider who rendered treatment; does not include itemized statement specifying exact amount, date of treatment, and type of benefit claimed to be due; was not sent to person designated by insurer to receive demand letters; and was not sent by certified or registered mail, return receipt requested — Even if letter were intended as demand letter, provider did not allow insurer 15 days after receipt before filing suit — Summary judgment in favor of insurer is appropriate despite ongoing discovery as no further discovery will reflect upon sufficiency of purported pre-suit demand letter

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