Volume 12

12 Fla. L. Weekly Supp. 554b

Insurance — Personal injury protection — Plaintiff is not required to submit demand letter to insurer as condition precedent to filing amended complaint

12 Fla. L. Weekly Supp. 926b

Insurance — Personal injury protection — Claims — HCFA form — Error to grant summary judgment in favor of insurer on ground that HCFA forms were insufficient due to unidentifiable signature in box 31 — Statute does not contain express requirement that box be signed, insurer does not contend that failure to sign box legibly hindered its investigation of accident in any way, and insurer’s processing of claims for two years without raising problem with signature and its payment of portions of some claims submitted on forms with allegedly deficient signature implies intentional and voluntary waiver of alleged deficiency

12 Fla. L. Weekly Supp. 163a

Insurance — Personal injury protection — Claim forms — Physician signature — HCFA forms not containing physician’s signature are not deficient — Coverage — Unregistered clinic — Charges for services provided by licensed acupuncturist at unregistered medical clinic wholly owned by person who is not licensed medical provider are unlawful and noncompensable

12 Fla. L. Weekly Supp. 115b

Insurance — Personal injury protection — Claims — Signature by medical provider — Error to enter summary judgment in favor of insurer based on medical provider’s failure to sign box 31 of HCFA form where statute does not expressly require signature and there is no evidence that lack of signature caused confusion regarding amount of claim or hindered insurer’s investigation of claim or that provider intentionally provided false, misleading, incomplete and patently deceptive HCFA form — Statute does not require that technically deficient notice constitutes no notice at all

12 Fla. L. Weekly Supp. 888b

Insurance — Personal injury protection — Claim forms — Signature of physician — Where insurer was provided all information needed to process claim despite use of stamp to affix physician’s signature and misplacement of physician’s license number in wrong box on form, claim form was substantially complete and accurate — Coverage — Medical expenses — Reasonable, related and necessary services — Where insured filed affidavit of treating orthopaedic physician stating that orthopaedic treatment rendered was reasonable, related and necessary, and insurer submitted affidavit of physician of undisclosed specialty who performed independent medical examination stating that further treatment in his specialty would not be reasonable, related or necessary, there is no competent evidence of record to dispute that any orthopaedic treatment was reasonable, related and necessary — Where insured filed affidavit of treating chiropractor stating that chiropractic treatment rendered was reasonable, related and necessary, and insurer submitted affidavit of chiropractor who performed IME stating that further treatment would not be reasonable, related and necessary, there is no evidence that chiropractic treatment rendered prior to date of IME was not reasonable, related and necessary — Insured’s motion for summary judgment is granted as to all affirmative defenses except improper CPT billing, on which issue insured offered no evidence

12 Fla. L. Weekly Supp. 637a

Insurance — Personal injury protection — Claim form — Signature and credential of medical provider — Where statute does not expressly require provider’s signature on notice of loss to insurer but does suggest credentials must be supplied, typewritten name of provider supplied in box 31 of HCFA claim forms is not fatal to provider’s claim, but failure to supply credentials in box 31 or on any other form leads to conclusion that provider failed to provide notice of covered loss — Error to enter summary judgment finding insurer improperly denied payment

12 Fla. L. Weekly Supp. 781a

Insurance — Personal injury protection — Claim form — License number — Insurer has met burden for summary judgment based on medical provider’s failure to satisfy condition precedent of submitting complete claim form where insurer submitted both incomplete claim form and affidavit of claims adjuster indicating HCFA form received from provider did not reflect provider’s professional license number — Unnotarized affidavit of provider’s billing clerk indicating that provider subsequently sent new HCFA form with license number on unspecified date did not create genuine issue of material fact — Billing clerk’s affidavit is defective for being unnotarized and not having been provided to insurer prior to hearing — Retroactive submission of complete HCFA form does not cure failure to satisfy condition precedent

12 Fla. L. Weekly Supp. 594b

Insurance — Personal injury protection — Claim form — Omission of license number — Insurer’s motion for final summary judgment asserting that it was not furnished with notice of loss due to medical provider’s failure to include license number in box 31 of HCFA forms is denied where insurer cannot reasonably assert that license number was needed to process or evaluate bills as it paid all bills submitted on identical forms prior to withdrawal of benefits based on independent medical examination, insurer never requested any information from provider regarding box 31 or suggested that it was in need of license number to be on notice of claim, and insurer cannot show any prejudice from omission of license number

12 Fla. L. Weekly Supp. 570b

Insurance — Personal injury protection — Claim forms — Medical license number — Claim form containing medical provider’s medical license number in box 33 rather than box 31 substantially met statutory requirements for claims — Insurer’s motion for summary judgment denied

12 Fla. L. Weekly Supp. 484a

Insurance — Personal injury protection — Claim forms — Motion for rehearing of order granting summary judgment in favor of insurer is denied where medical provider failed to satisfy condition precedent of submitting properly completed statement or bills, by failing to include license number of treating physician in Box 31 of HCFA forms until after suit was filed and two months after being warned by insurer of defect, and failed to obtain leave of court to abate action to allow re-submission of properly completed bill — Suggestion that compliance with statute requiring submission of completed form could be met by quick Internet search for physician’s license number is rejected where legislature did not provide for this alternative to statutory scheme