Volume 14

14 Fla. L. Weekly Supp. 1102b

Insurance — Personal injury protection — Independent medical examination — Failure to appear — Where insurer unilaterally rescheduled IME after insured failed to appear for first appointment in order to give insured benefit of doubt, and insured failed to appear for second IME, insurer did not waive right to terminate benefits as of date of first missed IME

14 Fla. L. Weekly Supp. 99c

Insurance — Personal injury protection — Explanation of benefits — Failure to provide — Insurer that failed to provide statutorily required EOB breached insurance contract with insured — Summary judgment entered in favor of medical provider as to liability and at minimum nominal damages

14 Fla. L. Weekly Supp. 99b

Insurance — Personal injury protection — Explanation of benefits — Failure to provide — Insurer that failed to comply with statutory mandate to furnish itemized specification of unpaid charges to medical provider breached insurance contract — Letter filed in opposition to summary judgment is legally deficient where letter explains reason for suspension of chiropractic benefits after suspension date, but provider’s services were orthopedic services provided prior to suspension date — No merit to insurer’s argument that it was merely required to provide explanation, but that explanation need not be correct or understandable

14 Fla. L. Weekly Supp. 584c

Insurance — Personal injury protection — Coverage — Denial — Explanation of benefits — Breach of contract action is proper against insurer that failed to furnish EOB for unpaid charges — Non-compliance letter does not meet requirements for EOB

14 Fla. L. Weekly Supp. 497b

Insurance — Personal injury protection — Coverage — Denial — Explanation of benefits — Breach of contract action is proper against insurer that failed to furnish medical provider with EOB for unpaid charges — Non-compliance letter does not meet requirements for EOB

14 Fla. L. Weekly Supp. 496a

Insurance — Personal injury protection — Coverage — Denial — Explanation of benefits — Breach of contract action is proper against insurer that failed to furnish medical provider with EOB for unpaid charges

14 Fla. L. Weekly Supp. 97a

Insurance — Personal injury protection — Explanation of benefits — Failure to provide — Insurer that failed to provide statutorily required EOB to medical provider/assignee breached insurance contract with insured — No merit to argument that insurer is only obligated to furnish EOB to insured or was relieved of obligation to provider by having furnished EOB to insured — Because statute requires that EOB be provided to claimant, where provider submitted claim, insurer was required to provide EOB to provider — Summary judgment entered in favor of provider

14 Fla. L. Weekly Supp. 94a

Insurance — Personal injury protection — Explanation of benefits — Where insurer sent letter to insured’s attorney advising that no benefits would be paid due to missed independent medical examination, and thereafter insured received treatment from medical provider, insurer was required to provide EOB to provider regarding ensuing claim — Because statute requires explanation for each item claimed and provider’s claim was not part of claim made by insured, insurer was obligated to explain denial of claim, even if it merely repeated previous denial

14 Fla. L. Weekly Supp. 179b

Insurance — Personal injury protection — Coverage — Actual occurrence of accident — Where both parties rely on insured’s examination under oath, in which insured states that he was injured as result of accident, and insurer has submitted no competent evidence to contravene insured’s statement, medical provider is entitled to summary judgment on issue of existence of accident and injury — Medical expenses — Reasonable, related and necessary expenses — Where insurer has presented no competent evidence to controvert provider’s affidavits, provider is entitled to summary judgment on issue of necessity of treatment rendered prior to independent medical examination — No merit to argument that provider’s affidavit is substantively defective due to notary’s failure to indicate how she identified affiant — Summary judgment is precluded on issue of reasonableness and relatedness of treatment prior to IME where inconsistency between provider’s affidavit and actual bills raises question as to what treatment was actually rendered — Summary judgment is also precluded on issue of deductible where no-fault payment register filed by provider does not establish without material dispute that deductible has been eliminated

14 Fla. L. Weekly Supp. 779a Insurance — Personal injury protection — Attorneys — Disqualification — Timeliness of motion MICHAEL J. DELESPARRA, D.C., P.A. (a/a/o