Volume 12

Case Search

UNITED SERVICES AUTOMOBILE ASSOCIATION, Appellant, vs. AFFILIATED HEALTH CARE, INC., a/o/a SARAH SHOEMAKER, Appellee.

12 Fla. L. Weekly Supp. 327a

Attorney’s fees — Insurance — Personal injury protection — Prevailing party — Confession of judgment — No error in finding that medical provider was prevailing party entitled to award of attorney’s fees where insurer confessed judgment by paying bills within 8 days after PIP suit was filed, but still defended suit based on lack of notice of intent to initiate litigation — Demand letter — Error to enter final judgment in favor of medical provider despite lack of notice of intent to initiate litigation where insured received medical treatment after October 1, 2001, and her policy was renewed after effective date of section 627.736(11) and, therefore, statute was applicable and notice of intent to initiate litigation was required — Issue of notice of intent is moot, however, due to insurer’s full payment of medical bills prior to entry of final judgment — Contingency risk multiplier — Abuse of discretion to award multiplier where Quanstrom requirements were not met

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RICHARD MAZLIN, D.C., P.A, a/a/o Julio Andrade, Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

12 Fla. L. Weekly Supp. 495b

Insurance — Personal injury protection — Default — Vacation — Denial — Excusable neglect — Motion to set aside default is denied where, although insurer claims it was unaware motion for enlargement of time to respond to complaint had been denied, it offered no good faith explanation as to why mail would not reach insurer’s counsel at address provided by counsel or explanation for its failure to respond to court clerk’s telephone inquiry regarding failure to include return envelopes with motion for enlargement of time — Neglect due to understaffing, although perhaps excusable if an isolated circumstance, is no longer excusable where it has persisted over past two years

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CHRISTOPHER P. MACMILLAN, Plaintiff, vs. HARBOR SPECIALTY INSURANCE COMPANY, Defendant.

12 Fla. L. Weekly Supp. 665b

Insurance — Personal injury protection — Workers’ compensation lien — Action by insured injured in automobile accident while in course and scope of his employment against PIP carrier that seeks to apply deductible and then pay 80% of balance due for satisfaction of workers’ compensation lien — Insurer is precluded from applying deductible in satisfaction of workers’ compensation lien because to do so would not assure complete coverage to insured for work-related injuries — To avoid duplication of coverage, PIP check should be made payable directly to workers’ compensation carrier — Insured need not pay workers’ compensation lien before seeking reimbursement from PIP insurer — Attorney’s fees — Insured is entitled to pro-rata share of attorney’s fees and costs — Contingency risk multiplier of 2.0 is awarded where likelihood of success was even at outset and amount involved, results obtained and fee arrangement in light of relevant market would require multiplier to obtain competent counsel — Costs, expert witness fee and prejudgment interest awarded

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NEILL URBAN, Plaintiff, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

12 Fla. L. Weekly Supp. 957c

Insurance — Personal injury protection — Coverage — Out-of-state policy without PIP coverage — Where insured with non-PIP policy issued in Iowa was employed in Florida for at least five months prior to accident, but insured failed to register vehicle in Florida and maintain security on vehicle, insurer’s motion for summary judgment is granted

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OSAMA YOUSSEF, Appellant/Cross Appellee, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Appellee/Cross-Appellant.

12 Fla. L. Weekly Supp. 607a

Insurance — Personal injury protection — Res judicata — Appeal of dismissal of subsequent suit involving same accident and injuries involved in prior suit — Where order enforcing settlement of first suit clearly does not provide that resolution of matter was without right to further proceedings by medical provider, and trial court determined that settlement covered only those bills incurred through certain date and second suit could proceed as to bills incurred after that date, doctrine of res judicata does not bar second suit — Error to dismiss suit

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PROFESSIONAL MEDICAL GROUP, INC., a/a/o JESSICA MACHIN, Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

12 Fla. L. Weekly Supp. 240a

Insurance — Personal injury protection — Coverage — Resident relative of owner of another vehicle — Evidence — Accident report privilege — Regardless of whether plaintiff’s address as recorded on police accident report was taken from her driver’s license or verbally given to investigating officer by plaintiff, portion of report containing address is admissible in proceeding on plaintiff’s motion for partial summary judgment as to residency — No merit to argument that report, which is self-authenticating, is inadmissible as unverified document that was not authenticated — Questions certified

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MED PLUS OF BRADENTON, INC. A/A/O ROMAN RAMOS, Plaintiff, v. PEACHTREE CASUALTY INSURANCE COMPANY, Defendant.

12 Fla. L. Weekly Supp. 1087a

Insurance — Personal injury protection — Coverage — Son of insured who does not own a motor vehicle and resides in insured’s home is entitled to PIP benefits under insured’s policy — Where insurer failed to conduct reasonable investigation or set claimant for examination under oath within 30 days of receipt of claim, insurer has failed to establish any proof that it was not responsible for payment of claim — Where insurer breached policy and failed to timely schedule EUO, insurer is barred from using claimant’s failure to attend post-suit EUO as reason for nonpayment — Insurer has agreed to allow medical provider to amend pleading to correct name of assignor

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MARTINEZ HEALTH INC., A Florida Corporation a/a/o Hector and Salvador Ramirez, Appellant, vs. UNITED AUTOMOBILE INSURANCE COMPANY Appellee.

12 Fla. L. Weekly Supp. 311b

Insurance — Personal injury protection — Coverage — Evidence — Hearsay — Error to enter involuntary dismissal based on ruling that hearsay evidence of medical provider was insufficient to prove prima facie case of coverage — Deposition testimony of treating physician establishing that patients’ injuries were related to accident for which coverage was available fell within exception to hearsay rule and was sufficient to survive motion for directed verdict

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