Volume 14

14 Fla. L. Weekly Supp. 1161a

Insurance — Personal injury protection — Complaint — No merit to claim that separate counts alleging breach of contract for failure to pay amounts owed, provide explanation of benefits, provide declarations page, and provide copy of policy are repetitive and must be pled as single count — Argument that counts alleging failure to provide EOB and copy of policy do not allege causes of action permitting the injunctive relief sought by plaintiff also fails — Motion to dismiss is denied

14 Fla. L. Weekly Supp. 576a

Insurance — Personal injury protection — Claim forms — Signature of medical provider — Requirements of box 31 of HCFA form are met where provider’s name is typed or facsimile signature is stamped in box — Question certified whether statute requires actual handwritten signature of medical provider in Box 31 of HCFA form

14 Fla. L. Weekly Supp. 103b

Insurance — Personal injury protection — Claim form — Professional license number — Insurer’s failure to notify medical provider for two years after receipt of claims that claims were defective due to absence of professional license number constituted waiver of defense — Further, insurer that was able to proceed as normal with claims investigation has not demonstrated prejudice caused by alleged deficiency in claim formsREVERSED at 16 Fla. L. Weekly Supp. 37a

14 Fla. L. Weekly Supp. 1021a

Insurance — Personal injury protection — Claims — Medical bills — Statutory requirement that physician’s license number be included on medical bills does not apply retroactively to policy that predates requirement — Independent medical examination — Failure to attend — Rescheduling IME after insured failed to attend initial IME did not constitute waiver of right to terminate benefits as of date of first IME where there was no indication that insurer rescheduled IME to correct some statutory deficiency that would make scheduling of first IME unreasonable as matter of law or that first IME was, in fact, unreasonably scheduled — Remand for determination of whether insurer unreasonably set or insured unreasonably missed IME

14 Fla. L. Weekly Supp. 893b

Insurance — Personal injury protection — Notice of claim — Waiver — Partial payment of claims submitted on HCFA forms from which medical provider’s professional license number was omitted did not waive insurer’s right to assert that deficient forms failed to place insurer on notice of covered loss

14 Fla. L. Weekly Supp. 85a

Insurance — Personal injury protection — Claim form — Professional license number — MRI facility — Statutory requirement to place professional license number on CMS 1500 form does not apply to MRI facilities because facilities do not have, and are not required to have, such license

14 Fla. L. Weekly Supp. 796a

Insurance — Personal injury protection — Claim form — Professional license number — Insurer was not placed on notice of covered loss where medical provider failed to include professional license number on CMS 1500 forms

14 Fla. L. Weekly Supp. 480c

Insurance — Personal injury protection — Claims — Where bills submitted to insurer by medical provider do not contain professional license number of provider, insurer was not provided with written notice of covered loss, and bills are not payable

14 Fla. L. Weekly Supp. 479a

Insurance — Personal injury protection — Notice of loss — Where disclosure and acknowledgment form failed to list or describe treatment rendered and did not contain attestation of treating physician, and CMS 1500 claim form did not include professional license number of medical provider in box 31, insurer was not given written notice of covered loss — Summary judgment entered in favor of insurer

14 Fla. L. Weekly Supp. 226a

Insurance — Personal injury protection — Fee splitting — Patient brokering — Where medical provider paid same rent for use of MRI facility’s space and equipment every month irrespective of amount of actual use, lease provided that rental payments were consistent with fair market value without regard to volume or value of referrals between parties, provider was prohibited by lease from using MRI facility on anyone other than own patients, MRIs were performed by personnel of MRI facility but under direct supervision of provider, and additional amount charged by provider above actual MRI cost was charge for performance of MRI, not referral fee, there was no basis on which trial court could find fee splitting or patient brokering arrangement, and court did not err in denying insurer’s motion for summary judgment on issue — Notice of claim — HCFA forms — Notation of “signature on file” in box 31 of HCFA forms did not constitute misrepresentation where provider’s name was on forms, and provider actually rendered services claimed — Errors and omissions in HCFA forms did not result in lack of proper notice of claims where statute in effect at time forms were sent did not require that forms be filled out in entirety, omissions were not misrepresentations and, at most, information in forms was erroneous or incomplete — No merit to argument that contractual arrangement between provider and MRI facility violates public policy by violating Patient Brokering Act where evidence demonstrates that provider did provide MRI services and did not receive payment for only referring patients to facility