Volume 13

13 Fla. L. Weekly Supp. 364b

Insurance — Personal injury protection — Reconsideration — Where no final judgment has issued, trial court has authority to reconsider and modify or vacate order denying motion for summary judgment — Coverage — Medical provider — Unregistered clinic — Where medical provider operated from single structure or facility on date services were rendered to insured, provider was clinic which was required to register with state to recover claimed PIP benefits — Summary final judgment entered in favor of insurer

13 Fla. L. Weekly Supp. 87a

Insurance — Personal injury protection — Coverage — Medical expenses — Reduction — Where insured provided evidence that therapeutic pillow was reasonable, related and medically necessary and that amount charged for pillow was reasonable, insurer’s decision to reduce charge to 20% over invoiced cost of pillow failed to meet requirements of no-fault statute

13 Fla. L. Weekly Supp. 641b

Insurance — Personal injury protection — Coverage — Where insurer failed to identify to medical provider’s responses to interrogatories that insurer relied on to oppose summary judgment, court will not consider responses — Where provider attached uncertified copies of bills to affidavit in support of summary judgment and did not attest in affidavit that attachments were true and correct copies, court will not consider copies — Partial summary judgment is entered as to uncontroverted matters on which provider’s affidavit is not conclusory, including fact that insured was injured in accident, total amount of treatment rendered, assignment of benefits to provider, and proper licensure of provider

13 Fla. L. Weekly Supp. 343b

Insurance — Personal injury protection — Coverage — Medical expenses — Where insured was involved in two motor vehicle accidents occurring one month apart, and medical records and reports indicate that insured sustained no new injuries and received no additional treatment as result of second accident, insured is not entitled to PIP benefits with respect to second accident

13 Fla. L. Weekly Supp. 203a

Insurance — Personal injury protection — Coverage — Medical expenses — Second opinion — Physician who examined insured and provided second opinion on request of treating physician provided medical service compensable under PIP statutes

13 Fla. L. Weekly Supp. 359b

Insurance — Personal injury protection — Coverage — Medical expenses — Reasonable, related and necessary treatment — New trial — Where insurer presented no medical testimony to refute testimony of medical provider’s medical expert that treatment was reasonable, related and necessary, and cross-examination in no way severely impeached expert’s testimony, zero verdict is unjust and against manifest weight of evidence — Motion for new trial granted

13 Fla. L. Weekly Supp. 126a

Insurance — Personal injury protection — Ruling that provider had burden to prove reasonableness of treatment, but not reasonableness of price, was error — Appeals — Insurer did not invite error and waive right to appeal where record shows that insurer argued that unreasonableness of medical provider’s charges need not be pled as affirmative defense, and not until judge upheld own ruling that insurer was estopped from arguing unreasonableness of amount of charge did insurer ultimately acquiesce to entry of final judgment

13 Fla. L. Weekly Supp. 394b

Insurance — Personal injury protection — Coverage — Medical expenses — Determination of reasonable charge for disputed bills is question of fact for jury that precludes summary judgment

13 Fla. L. Weekly Supp. 101a

Insurance — Personal injury protection — Notice of loss — Insured’s motions for directed verdict and judgment notwithstanding verdict, following verdict determining that insurer did not receive reasonable notice of loss, are granted — Correspondence from insured to insurer requesting that hospital bill for gastric bleed occurring one year after automobile accident be processed for payment with enclosed hospital bill stating that physician charges will be billed separately and later letter specifically requesting payment for physicians in certain amount satisfied requirement for notice of loss and amount of loss for services provided by physicians — No merit to argument that insured was required to provide insurer with medical bill for physicians’ services or medical records to establish reasonable proof of covered loss where bill would not assist insurer in determining whether hospitalization for gastric bleed was related to accident, PIP statute did not require insured to furnish insurer with bill or records, and insured fulfilled any obligation to provide medical records by signing authorization allowing insurer to obtain records — No merit to argument that insured’s cause of action on claim based on second more specific letter sent after complaint was filed was premature since 30-day period to pay claim had not expired at time complaint was filed where premature element of cause of action was cured by passage of time as claim matured and benefits subsequently became overdue 30 days after insurer’s receipt of letter — Insurer’s recourse for premature claim was to either seek dismissal without prejudice or to seek stay or abatement of action until claim ripened, which it did not do — Coverage — Medical expenses — Reasonable, related and necessary treatment — Where insured’s experts testified credibly that insured’s use of aspirin and other non-steroidal and anti-inflammatory medicines was likely cause of gastric bleed resulting in hospitalization, insured testified credibly that she consumed medicines on almost daily basis following accident, and insurer failed to present own expert in rebuttal or to substantially discredit or severely impeach testimony of insured’s experts, insured is entitled to summary judgment on issue of relatedness of treatment to accident — Further, insured is entitled to summary judgment on relatedness issue due to insurer’s failure to comply with statutory requirement to obtain report from physician licensed under same statute as treating physicians before it could challenge reasonableness, relatedness or necessity of treatment rendered

13 Fla. L. Weekly Supp. 380b

Insurance — Personal injury protection — Coverage — Medical expenses — Reasonable, related and necessary treatment — Summary judgment is granted in part where there is no disputed issue of material fact as to relatedness and medical necessity of treatment, but there remains dispute as to reasonableness of amount charged