Volume 12

Case Search

HEARTLAND REHABILITATION SERVICES, Appellant, vs. NATIONWIDE MUTUAL FIRE INSURANCE COMPANY, Appellee.

12 Fla. L. Weekly Supp. 688a

Insurance — Personal injury protection — Coverage — Exhaustion of policy limits — Subsequent claim for unpaid portion of bills — No error in granting summary judgment in favor of insurer where fact of exhaustion of policy limits was not in dispute — Reasonableness of insurer’s reduction of medical bills, while a genuine issue of material fact at time of reduction, was no longer material after benefits were exhausted — Medical provider’s suggestions that insurer should have held money in escrow until statute of limitations expired, issued joint checks, or filed interpleader action do not comport with purpose of no-fault statutory scheme to provide swift and virtually automatic payment

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TAMPA MEDICAL & REHAB CARE, LLC, On assignment from Lisandra Camjo, Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.

12 Fla. L. Weekly Supp. 1092c

Insurance — Personal injury protection — Coverage — Exhaustion of policy limits — Where PIP policy limits had been exhausted by time medical provider served complaint, there is no evidence that provider requested or instructed insurer not to pay other claims until benefits claimed by provider had been resolved or adjudicated, and there is no evidence insurer’s exhaustion of benefits was undertaken in bad faith, provider has no cause of action for recovery of benefits

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FIRST CHOICE MEDICAL CENTER, as Assignee of Carmen Martinez, Plaintiff, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, a corporation authorized and doing business in the State of Florida, Defendant.

12 Fla. L. Weekly Supp. 994a

Insurance — Personal injury protection — Coverage — Medical expenses — Exhaustion of policy limits — Medical provider’s entitlement to statutory interest and penalties for overdue PIP benefits survives exhaustion of policy limits — Insurer’s motion for summary judgment denied

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ASCLEPIUS MEDICAL, INC., a/a/o Raul Diaz-Viera, Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

12 Fla. L. Weekly Supp. 86a

Insurance — Personal injury protection — Coverage — Denial — Failure to attend examination under oath — Insurer which breached PIP policy by failing to pay medical bills within 30 days or establish that it had reasonable proof that it was not responsible for payment and which failed to timely schedule EUO within 30 days of receipt of notice of loss is barred from using insured’s failure to attend EUO as reason for non-payment

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HUMANITARY HEALTH CARE, INC. a/a/o JUAN ESQUIVEL, Appellant, v. UNITED AUTOMOBILE INSURANCE CO., Appellee.

12 Fla. L. Weekly Supp. 42a

NOT FINAL VERSION OF OPINION
Subsequent Changes at 12 Fla. L. Weekly Supp. 531b

Insurance — Personal injury protection — Coverage — Denial — Examination under oath — Failure to attend — Insurer can defend claim on basis of insured’s failure to attend EUO set outside of 30-day statutory period after submission of medical bills — Insurer’s failure to pay claim or obtain reasonable proof that it is not responsible for payment within 30-day period subjects insurer to penalties of interest and attorney’s fees but does not forever bar insurer from contesting claim — Summary judgment was properly entered in favor of insurer

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ROLANDO MATOS, Appellant, v. UNITED AUTOMOBILE INSURANCE COMPANY, Appellee.

12 Fla. L. Weekly Supp. 631b

Insurance — Personal injury protection — Declaratory judgment — Coverage — Error to weigh evidence and make credibility determination when deciding motion for directed verdict/involuntary dismissal — New trial required — Attorney’s fees — Appellate — Plaintiff’s motion for appellate fees for non-final appeal is granted contingent on plaintiff ultimately prevailing with recovery on policy

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