Volume 12

12 Fla. L. Weekly Supp. 403b

Insurance — Personal injury protection — Coverage — Denial — Explanation of benefits — Where medical provider had not provided documentation requested via EOB prior to filing suit, amount at issue had not become overdue, and suit was premature — Test results, including raw data, wave forms, and physician’s interpretation are within meaning of statutory discovery provision for records regarding history, condition, and treatment that provider was legally required to provide pursuant to EOB request — Insurer can request documentation or information from provider without also requesting sworn statement that treatment rendered was reasonable and necessary — Motion for continuance to allow time to perfect service of affidavit in opposition to insurer’s motion for summary judgment is denied and affidavit is stricken where affidavit faxed without cover sheet or exhibits does not comply with timeliness requirements or formal rule requirements — Summary judgment granted in favor of insurer

12 Fla. L. Weekly Supp. 403a

Insurance — Personal injury protection — Coverage — Passenger in rental vehicle driven by unauthorized driver — Where driver’s PIP policy defines covered persons broadly as persons occupying “your insured car” and defines “insured car” broadly as “any car you use,” passenger was not required to be resident or relative of driver to avail self of PIP coverage under driver’s policy and driver’s actual ownership of vehicle or being listed as additional driver on rental agreement is not prerequisite to coverage

12 Fla. L. Weekly Supp. 39b

Insurance — Personal injury protection — Coverage — Claimant who failed to maintain insurance on own vehicle — Inoperable vehicle — Trial court prematurely shifted burden from insurer, who sought summary judgment on grounds that claimant injured as passenger failed to maintain PIP insurance on own vehicle, to medical provider/assignee without first determining that insurer met burden of proving nonexistence of material issues of fact — Moreover, trial court erred in granting summary judgment where record reveals plain disputes of material fact as to inoperability of claimant’s vehicle

12 Fla. L. Weekly Supp. 716a

Insurance — Personal injury protection — Coverage — Foreseeable consequence of operating vehicle — Injuries suffered while fleeing attack in vehicle — Where insured who had been involved earlier in evening in bar fight was later attacked again at friend’s residence and dragged out of allegedly running vehicle while attempting to flee, insured’s injuries arose out of relationship with attackers, not operation of vehicle, and there is no PIP coverage for injuries — Error to enter summary judgment for insured

12 Fla. L. Weekly Supp. 681b

Insurance — Personal injury protection — Coverage — Insured person — Passenger in leased vehicle — Definition of “owner” in section 627.732(5) is definition to be used when determining whether driver’s insurance affords PIP coverage to passenger of rental vehicle, not more restrictive definition in driver’s insurance policy — Where there is genuine issue of material fact as to whether rental agreement between driver and car rental company is security agreement that allows leasing driver to have “right of possession” of vehicle so as to allow driver to be owner of vehicle, and thereby qualify vehicle as “covered vehicle” and passenger as “insured person,” insurer’s motion for summary judgment is denied

12 Fla. L. Weekly Supp. 1171b

Insurance — Personal injury protection — Coverage — Medical expenses — Usual and customary charges — Fact that policy gives insurer the choice of independent sources to determine usual and customary charges does not preclude medical provider from disputing that source’s finding of what is usual and customary charge for services in geographic area — Insurer’s motion for summary judgment is denied where there is disputed issue of material fact as to reasonableness of provider’s charge, and it cannot be determined on summary disposition whether database accurately assesses reasonableness of charges

12 Fla. L. Weekly Supp. 379a

Insurance — Personal injury protection — Coverage — Medical expenses — Medical provider — Where medical provider was not at time of treatment and is not presently properly registered fictitious name, provider is not able to sue any entity — Where provider was not and is not properly licensed to engage in or manage any business or profession in county or licensed with any governmental entity to perform medical treatment, any treatment was rendered unlawfully, and neither insurer nor insured are required to pay any charges

12 Fla. L. Weekly Supp. 216a

Insurance — Personal injury protection — Coverage — Transportation expenses — PIP statute does not provide for automobile transportation expenses incurred while driving to and from medical appointments

12 Fla. L. Weekly Supp. 873a

Insurance — Personal injury protection — Claims — Medical bills — Timeliness — Where insurer filed affidavit stating bills were received over 75 days from date of service and letter of claims representative purporting to seek medical bills from claimant, claimant filed opposing affidavit of medical provider’s billing clerk that failed to identify what bills were submitted or whether they were bills for particular claimant among four claimants involved under insured’s policy, clerk’s affidavit does not state facts upon which clerk’s personal knowledge of transactions is based except that she reviewed mail receipts and records, and no copies of medical records were presented to satisfy hearsay exceptions, insurer’s motion for summary judgment is granted

12 Fla. L. Weekly Supp. 890b

Insurance — Personal injury protection — Standing — Where named plaintiff did not provide any services to insured or submit bills to insurer, but rather services were provided and bills submitted by similarly named medical provider that is separate and distinct corporate entity, and neither plaintiff nor provider produced assignment of benefits, plaintiff lacks standing — Where plaintiff has not submitted any bills to insurer, motion for summary judgment finding plaintiff has not sustained any damages is granted — Motion for summary judgment finding plaintiff failed to satisfy condition precedent of furnishing demand letter is granted — Plaintiff whose bills had not been reduced or denied was required to submit demand letter under former version of statute then in effect and did not do so — Final summary judgment granted in favor of insurer