Volume 15

15 Fla. L. Weekly Supp. 1051a

Insurance — Personal injury protection — Coverage — Medical expenses — Reasonable charges — Error to enter summary judgment in favor of medical provider on sole issue of reasonableness of charges based solely on affidavit of billing manager where billing manager’s attestation that charges were reasonable was based solely on manager’s knowledge and experience with the insurer and other insurers regarding reimbursements for the same procedures — Knowledge and experience with insurer are not addressed in statute as factors for consideration in determining reasonableness of medical charge

15 Fla. L. Weekly Supp. 581a

Insurance — Personal injury protection — Coverage — Medical expenses — Withdrawal — Valid physician’s report — Where insurer had physician’s report finding that further treatment would not be reasonable, related or necessary when it issued letter withdrawing treatment and refused payment for MRI that was performed in interim between report and issuance of cutoff letter, trial court erred in refusing to consider physician’s affidavit and report in ruling on motion for summary judgment

15 Fla. L. Weekly Supp. 618a

Insurance — Personal injury protection — Medical provider’s motion for partial summary judgment on issue of whether treatment was reasonable, related and medically necessary is denied where insurer has filed at least one opposing affidavit that raises issue of material fact

15 Fla. L. Weekly Supp. 628b

Insurance — Personal injury protection — Summary judgment — Opposing affidavit — Insurer’s affidavit opposing medical provider’s motion for partial summary judgment on reasonable, related and necessary issue was untimely where affidavit was hand-delivered less than two business days prior to hearing — Attachments to affidavit that are not sworn or certified cannot be considered by court — Where affidavit of litigation adjuster is not based on personal knowledge but on review of file, and affiant failed to attach extrinsic evidence relied upon regarding usual and customary charges, affidavit cannot be considered by court — Litigation adjuster cannot address whether treatment is reasonable, related to accident or medically necessary — In light of technical admissions and insurer’s failure to present countervailing evidence from licensed physician or to impeach provider’s medical expert, provider’s motion for partial summary judgment is granted

15 Fla. L. Weekly Supp. 563a

Insurance — Personal injury protection — Summary judgment — Factual issues — Where summary judgment motion and supporting affidavits failed to address insurer’s affirmative defenses, trial court had discretion to enter partial summary judgment as to whether medical bills were reasonable, related and necessary but not to enter summary judgment as to affirmative defenses

15 Fla. L. Weekly Supp. 433b

Insurance — Personal injury protection — Summary judgment — Opposing affidavits — In ruling on motion for summary judgment, trial court erred in rejecting peer review obtained more than 30 days after notice of loss as time barred

15 Fla. L. Weekly Supp. 432a

Insurance — Personal injury protection — Coverage — Medical expenses — Reasonable, related and necessary expenses — Evidence — Peer review — Error to refuse to consider peer review because it was obtained more than thirty days after medical bills became due

15 Fla. L. Weekly Supp. 123a

Insurance — Personal injury protection — Coverage — Medical expenses — Failure to obtain reasonable proof within 30 days — Clarification — Appellate court clarifies that in reversing summary judgment predicated on peer review having been obtained after benefits were denied and due and remanding case, question of legal and factual sufficiency of peer review affidavit remains, and trial court must determine validity

15 Fla. L. Weekly Supp. 567a

Insurance — Personal injury protection — Summary judgment — Opposing affidavit — Sufficiency — Error to strike affidavit of physician who conducted physical medical examination of insured and peer review where affidavit complied with requirements of rule 1.510(e) — Although medical records referenced in affidavit were not attached thereto, records were already filed with clerk of courts and references to records in affidavit were so explicit that there was no question as to documents identified — Requirement that insurer obtain valid medical report before withdrawing, reducing or denying payment of further benefits does not extend to instance in which insurer refuses payment of benefits — Error to grant motion for summary judgment where there exists genuine issue of material fact as to whether treatment was reasonable, related and necessary

15 Fla. L. Weekly Supp. 1193a

Insurance — Personal injury protection — Declaratory judgment — Physician’s report that is based solely on review of insured’s treatment records and is not supported by physical examination conducted by another physician at request of insurer is not valid report under section 627.736(7)(a) — Objection to admissibility of peer review report is sustained, and summary judgment is entered in favor of medical provider — Question certified