Volume 13

13 Fla. L. Weekly Supp. 1002a

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Where affidavit of medical provider attests that MRI was requested by provider and was reasonable, related and necessary as result of accident, and insurer has not filed opposing affidavit, provider’s charges for MRI are payable at statutory fee schedule — Fact that HCFA form submitted to insurer claimed amount greater than fee schedule allows is not defense to payment — Independent medical examination — Failure to attend — Where insurer set two dates for IME and admits that insured never received notice of first date and insured’s counsel never received notice of second date, insurer failed to provide legally sufficient notice of IMEs, and failure to attend IMEs is attributable to insurer and not unreasonable

13 Fla. L. Weekly Supp. 729a

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Charges in excess of statutory fee schedule — Where charges for MRI set forth in demand letter exceeded statutory fee schedule, charges were unreasonable and not payable

13 Fla. L. Weekly Supp. 361a

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Reasonable, related and necessary treatment — Where medical provider’s affidavit attests that MRI services were reasonable, related and necessary as result of injuries incurred in accident, and insurer did not file opposing affidavit, provider is entitled to payment of charges pursuant to MRI fee schedule — Fact that HCFA form submitted to insurer sets forth amount greater than fee schedule is not defense to payment of charges — No merit to claim that insured is not entitled to coverage under PIP policy covering vehicle she occupied at time of accident because she was entitled to PIP coverage under policy covering vehicle owned by grandmother with whom she resides where grandmother filed unopposed affidavit stating that insured is not listed on her PIP policy

13 Fla. L. Weekly Supp. 347a

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Bill in excess of statutory amount — Insurer’s motion for summary judgment raising for first time defense that insurer could not respond to demand letter for MRI bill because letter failed to state correct statutory amount allowable for MRI procedures is denied where it is undisputed that insurer denied MRI claim based on peer review opining that MRI was not reasonable or medically necessary and charges appeared excessive

13 Fla. L. Weekly Supp. 329c

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — No error in granting summary judgment in favor of medical provider where ample evidence was presented to find bill for each MRI was reasonable, and order granting summary judgment was consistent with statute

13 Fla. L. Weekly Supp. 242a

Insurance — Personal injury protection — Since time trial court issued final summary judgment holding that MRI provider could recover for underpayment of PIP benefits, appellate court has issued decision determining that benefits payable for MRIs are to be based on Medicare Part B fee schedule rather than limiting charge schedule — Remand to trial court to follow now-controlling appellate decision

13 Fla. L. Weekly Supp. 499a

Insurance — Personal injury protection — Demand letter — Insurer’s motion for summary judgment as to issue of whether plaintiff complied with demand letter requirement is denied where there is disputed issue of material fact as to PIP contact person listed on Department of Insurance website — Coverage — Medical provider — Referral and billing service — Summary judgment is granted in favor of insurer as to issue of whether amount billed by plaintiff was improper where plaintiff provided only referral and billing services not compensable under PIP statute and is not physician, hospital, clinic or other person or institution lawfully rendering treatment and entitled to recover PIP benefits

13 Fla. L. Weekly Supp. 824b

Insurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered treatment — Affirmative defense of failure to comply with provision of Health Care Act concerning medical director is stricken where during all relevant times medical provider held unencumbered license pursuant to Act, and insurer cannot state cause of action for perceived violation of Act absent independent determination of violation by Agency for Health Care Administration

13 Fla. L. Weekly Supp. 824b

Insurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered treatment — Affirmative defense of failure to comply with provision of Health Care Act concerning medical director is stricken where during all relevant times medical provider held unencumbered license pursuant to Act, and insurer cannot state cause of action for perceived violation of Act absent independent determination of violation by Agency for Health Care Administration

13 Fla. L. Weekly Supp. 823b

Insurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered treatment — Affirmative defense of failure to comply with provision of Health Care Act concerning medical director is stricken where during all relevant times medical provider held unencumbered license pursuant to Act, and insurer cannot state cause of action for perceived violation of Act absent independent determination of violation by Agency for Health Care Administration