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Volume 13

Case Search

PROGRESSIVE EXPRESS INS. CO., Appellant, vs. APEX PAIN MANAGEMENT CENTER, INC., (a/a/o Sorraya Lamanati), Appellee.

13 Fla. L. Weekly Supp. 437a

Insurance — Personal injury protection — Error to present medical charges to jury where medical provider waived charges as to services provided by one physical therapist and the only other therapist working for provider testified that he did not provide any services to insured — Verdict form — Defects — Issue of defect on verdict form was preserved for appeal where insurer raised issue prior to discharge of jury — Where issue for jury was reasonableness of charges compared to reduced amount allowed by insurer, verdict form that directed jury to add up reasonable amounts to determine damages, rather than adding up differences between reasonable amounts and amounts paid, would not yield correct damages and would result in double payment to provider — Provider’s argument that there was no evidence that allowed amounts had ever been paid is unpersuasive under circumstances — Trial court had authority to correct verdict at hearing on final judgment

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MOBILE DIAGNOSTIC CENTERS, INC., (captioned in this action as MOBILE DIAGNOSTICS, INC.), a/a/o Susan Shepard, Appellant, vs. GEICO INDEMNITY COMPANY, Appellee.

13 Fla. L. Weekly Supp. 797a

Insurance — Personal injury protection — Complaint — Amendment — Medical provider’s name — Abuse of discretion to deny medical provider’s motion to amend complaint to correct omission of word “Centers” from provider’s name and to enter summary judgment in favor of insurer based on named plaintiff, which is real corporation, not being real party in interest and not suffering any damages — Fact that insurer correctly named provider in caption to its response to request for admissions established that insurer had no illusions as to identity of proper plaintiff

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ALLSTATE INSURANCE COMPANY, Appellant, vs. DIGITAL MEDICAL DIAGNOSTIC, (a/a/o Rosario Alvarez), Appellee.

13 Fla. L. Weekly Supp. 960a

Insurance — Personal injury protection — Affirmative defenses — Striking — Abuse of discretion to sua sponte strike affirmative defense during pre-jury conference — Pleadings — Amendment — Abuse of discretion to not allow insurer to amend defenses to include other insurance where motion to amend was insurer’s first attempt to amend pleadings and amendment would not be unduly prejudicial, was significantly related to original claims and would not radically alter nature and scope of litigation — Summary judgment — Factual issue — Abuse of discretion to grant medical provider’s motion for summary judgment on issue of whether treatment was reasonable, related and necessary and deny insurer’s motion for summary judgment based on provider’s alleged improper use of portable x-ray machine where insurer’s motion presented material issue of disputed fact as to whether x-ray services were reasonable, related and necessary — Trial court erred in denying motion for rehearing of orders striking fraud defense and orders granting and denying motions for summary judgment where insurer presented sufficient circumstantial evidence in affidavit regarding material factual issue to grant motion for rehearing

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FRANCISCO M. GOMEZ, M.D., P.A., (As assignee of Berta Flores), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

13 Fla. L. Weekly Supp. 374a

Insurance — Personal injury protection — Coverage — Medical expenses — Medical provider is entitled to recover 80% of amount of bill and statutory interest for bill which insurer’s litigation adjuster admits insurer should have paid — Provider entitled to statutory interest, penalty and postage on bill that insurer paid late without paying statutory interest

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HOWARD J. GELB, M.D., P.A., F.A.A.O.S. (a/a/o Sonila Fuentes), Plaintiff, vs. PROGRESSIVE CONSUMERS INSURANCE COMPANY, Defendant.

13 Fla. L. Weekly Supp. 380a

Insurance — Personal injury protection — Coverage — Exhaustion of policy limits — Evidence — Affidavit in support of insurer’s motion for summary judgment claiming exhaustion of benefits is deficient where affidavit provides no information demonstrating that affiant is competent to testify to matters stated therein — Where only remaining materials filed in support of motion for summary judgment are hearsay, motion is denied

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SPACE COAST CHIROPRACTIC HEALTH SERVICES & DR. BRADLEY CLOW CHIROPRACTIC, as assignee of Ruthlyn Gomes, Plaintiff, vs. NATIONWIDE MUTUAL INSURANCE COMPANY, Defendant.

13 Fla. L. Weekly Supp. 393a

Insurance — Personal injury protection — Coverage — Exhaustion of policy limits — Subsequent claim for unpaid portion of bills — Where medical provider never put insurer on notice that it was contesting partial payment of bill until after benefits were exhausted, summary judgment is granted in favor of insurer

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FIRST CARE CHIROPRACTIC CENTER, INC., Appellant, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, Appellee.

13 Fla. L. Weekly Supp. 1149a

Insurance — Personal injury protection — Coverage — Exhaustion of policy limits — Subsequent claim for unpaid portions of bill — No error in finding that medical provider was required to provide notice of intent to contest partial payments and that provider’s notice was not received by insurer until complaint was served, after benefits were exhausted — No error in granting insurer’s motion for summary judgment — Appeals — Argument that provider may be entitled to attorney’s fees and interest if benefits should have been paid was not raised below and, accordingly, cannot be considered on appeal

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ROBERT C. NUCCI, M.D., P.A., on behalf of Carl Kalinsky, Appellant, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Appellee.

13 Fla. L. Weekly Supp. 766a

Insurance — Personal injury protection — Exhaustion of Benefits — English Rule for establishing priorities of assignees — An insured cannot maintain a cause of action against the insurer once benefits are exhausted unless certain criteria are met — Where bad faith is not alleged, insured must promptly notify insurer that an amended claim will be forthcoming when insurer tenders partial payment of claim — Insured must also refuse partial payment or escrow such funds until claim has been fully adjudicated — Summary judgment in favor of insurer affirmed

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ABACOA PHYSICAL MEDICINE (Patient: Pilar Alvarez), Plaintiff, vs. PROGRESSIVE AUTO PRO INSURANCE COMPANY, Defendant.

13 Fla. L. Weekly Supp. 1223a

Insurance — Personal injury protection — Coverage — Exhaustion of policy limits — Medical provider’s claim that, despite fact that no benefits can or would be paid because policy limits have been exhausted, insurer can and should be required to pay interest on benefits provider sought is contrary to PIP statute which provides that interest is due at time payment of overdue claim is made — Provider cannot be entitled to attorney’s fees where claim for benefits and interest must be denied

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