Volume 13

Case Search

WILLIAM V. TEJEIRO, M.D., P.A., a/a/o FRANCISCA MARTINEZ, Appellant, vs. UNITED AUTOMOBILE INSURANCE CO., Appellee.

13 Fla. L. Weekly Supp. 686a

Insurance — Personal injury protection — Standing — Assignment — Error to dismiss medical provider’s PIP suit for lack of standing where insured, who had previously executed revocation of assignment providing that any assignment executed by insured after date of affidavit would be void unless also signed by insured’s attorney, executed assignment of benefits in favor of provider without signature of attorney — Lack of attorney’s signature did not deprive provider of standing — Further, regardless of whether assignment is valid, where provider rendered medical care to insured and insurer received benefit from care, provider is entitled to recover in quantum meruit for reasonable value of medical services

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CICERO ORTHO-MED CENTER, INC. a/a/o Caridad Quintana, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

13 Fla. L. Weekly Supp. 365a

Insurance — Personal injury protection — Standing — Assignment — Where unambiguous language of purported assignment indicates that only benefit that has been assigned to provider is right to collect payment directly from insurer, document is merely direction to pay and does not assign to provider rights necessary to proceed in litigation against insurer

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AFO IMAGING, INC., (as assignee of Maritza Donoso), Plaintiff, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

13 Fla. L. Weekly Supp. 1212a

Insurance — Personal injury protection — Claims — HCFA form — Provision of signature in box 31 of HCFA form is not requirement under Florida law and, therefore, failure to provide signature is not valid defense — Standing — Assignment — No merit to defense that medical provider lacks standing because insured executed assignments to more than one provider

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PHYSICIAN MANAGEMENT ASSOCIATES, LLC, (as assignee of James Wiggins), Plaintiff/Appellant, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, a foreign corporation, Defendant/Appellee.

13 Fla. L. Weekly Supp. 864a

Insurance — Personal injury protection — Standing — Assignment — Validity — Assignment to administratively dissolved corporation — Where at time clinic accepted assignments of benefits from insureds it was a corporation which had been administratively dissolved by state for failing to file annual report, and there was no evidence that acceptance of assignments was related to winding up affairs of clinic, acceptance of assignments violated section 607.1405, and assignments were nullity from beginning — Plaintiff which is active corporation that became successor in interest to dissolved clinic lacks standing to maintain PIP suits

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PROSPER DIAGNOSTIC CENTER, A/A/O OSCAR CENTENO, Plaintiff, vs. UNITED AUTOMOBILE INSURANCE CO., Defendant.

13 Fla. L. Weekly Supp. 168b

Insurance — Personal injury protection — Standing — Assignment — Where document stated that insured irrevocably assigned to medical provider his rights to any/all benefits and overdue interest on benefits covered by any insurance policy and indicated that consideration for assignment was services rendered, and there was no evidence that assignment was revoked or cancelled, provider has legally sufficient assignment

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HEATHER BISSETT, Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

13 Fla. L. Weekly Supp. 349a

Insurance — Personal injury protection — Standing — Assignment — Revocation — Effective date — Parol evidence — Where written revocation of assignment signed by medical provider and insured after date insured served pre-trial demand letter is silent as to effective date of revocation, affidavits of insured and provider stating insured and provider orally agreed to revoke assignment prior to date of demand letter should be considered by court since affidavits supply omitted fact

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CARLA D. MORGAN, Appellant, v. WARNER INSURANCE COMPANY, Appellee.

13 Fla. L. Weekly Supp. 533b

Insurance — Personal injury protection — Standing — Assignment — Dispute between insured and insurer — Where insured assigned benefits to medical provider prior to insured’s initiation of suit against insurer and did not obtain reassignment of benefits from provider until after suit was commenced, insured lacked standing at time suit was brought — Where there is nothing in record to indicate that insured requested or attempted to amend complaint to cure standing defect prior to dismissal for lack of standing, dismissal was proper — Issue of whether trial court abused discretion in dismissing case without explicitly granting leave to amend is not preserved for appellate review where insured did not raise argument in lower court or seek to amend complaint below — Where insurer filed motion to amend affirmative defenses, amended defenses to raise lack of standing, filed motion for summary judgment on standing issue and waited 15 months for hearing, and insured did not move to amend complaint or file affidavit in opposition to motion for summary judgment, trial court did not elevate form over substance or permit use of “gotcha” tactics in dismissing case for lack of standing — Attorney’s fees — Appellate — Justiciable issues — Because case raised justiciable issue of law as to whether lack of standing at initiation of claim can be cured by acquiring standing later, insurer’s motion for appellate attorney’s fees is denied

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OHN NICHOLAS, Appellant/Cross-Appellee, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, Appellee/Cross-Appellant.

13 Fla. L. Weekly Supp. 1033a

Insurance — Personal injury protection — Dispute between insured and insurer — Error to dismiss insured’s complaint as insufficiently pled where it is undisputed that valid contract of insurance existed, insured alleged in complaint that insurer that issued check payable only to medical provider after receipt of revocation of assignment of benefits failed to pay correct amount of money to correct claimant, in violation of contract and PIP statute, and insured alleged that he suffered damages as result of insurer’s breach — No merit to argument that revocation which revokes assignment of benefits but does not apply to any prior authorization for direct payment is confusing — There is clear distinction between assignment of benefits and direct payment authorization, and no such authorization appears on record — Error to dismiss complaint for failure to state cause of action while at same time granting partial relief under complaint by ordering insurer to reissue check in insured’s name — Attorney’s fees — Appellate — Insured is entitled to attorney’s fees for work done on initial and reply brief, but not for work done on unsuccessful cross-appeal seeking striking of order to re-issue check

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FLORIDA EMERGENCY PHYSICIANS KANG & ASSOCIATES, MD, PA, as assignee of Ronald Cefarelli, Plaintiff, vs. DAIRYLAND INSURANCE COMPANY, Defendant.

13 Fla. L. Weekly Supp. 1112a

Insurance — Personal injury protection — Standing — Assignment — Consent to treatment and authorizations and guarantee agreement given to hospital which references “my physicians” is assignment of benefits to emergency room doctors — Even if emergency room doctors were not included in written assignment, equitable assignment exists where insured intended to give and doctors intended to receive assignment, and insurer would be justified in paying doctors who rendered treatment to insured — Insurer had notice of medical bill where insurer’s corporate representative testified that nothing further was needed for insurer to consider bill, and insurer paid 80% of approved amount

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