Volume 15

15 Fla. L. Weekly Supp. 671a

Insurance — Personal injury protection — Coverage — Medical expenses — Withdrawal of benefits — Insurer who denied payment of benefits altogether, rather than starting and then withdrawing payment, was not required to obtain medical report prior to denial of benefits — Error to enter summary judgment in favor of medical provider based on finding that insurer was barred from raising defense that treatment was not reasonable, related or necessary by failure to obtain report prior to withdrawing benefits

15 Fla. L. Weekly Supp. 749a

Insurance — Personal injury protection — Coverage — Denial — Failure to maintain patient logs does not permit insurer to deny responsibility to pay claims for lawfully rendered treatment

15 Fla. L. Weekly Supp. 1013a

Insurance — Personal injury protection — Coverage — Medical expenses — Failure to pay or obtain reasonable proof within 30 days — Insurer is liable for statutory interest on late-paid bill where insurer failed to pay claim or obtain reasonable proof that it was not responsible for claim within 30-day period allocated for authentication, and thereafter paid claim

15 Fla. L. Weekly Supp. 330b

Insurance — Personal injury protection — Summary judgment — Factual issues — Error to strike opposing affidavit for failure to attach referenced documents and on grounds that it was irrelevant, conclusory and contained hearsay — Medical provider’s affidavit in support of summary judgment, stating that charged amount was reasonable charge for doctor within county, was not sufficient to support summary judgment on issue — Summary judgment on issue of proper coding was not appropriate where opposing affidavits presented contrary evidence — Error to enter summary judgment in favor of provider on issue of claim for lumbar support based on determination that provider had satisfied “mailbox rule” presumption that requested invoice was mailed to insurer — Claims adjuster’s testimony that invoice was never received raises disputed issue of fact requiring evidentiary hearing

15 Fla. L. Weekly Supp. 1207c

Insurance — Personal injury protection — Coverage — Version of PIP statute in effect at time PIP policy was executed, which provided for payment of 80% of reasonable charges, rather than version of statute in effect at time of treatment after expiration of policy, which provides for payment of 80% of Medicare fee schedule, is applicable — Provision in policy stating that it is controlled by PIP statute “as amended” cannot reasonably be construed to refer to amendments occurring after policy’s expiration — At best, “as amended” language is ambiguous and construed against drafter — Amendment at issue is not remedial amendment but substantive amendment that should not be applied retroactively — No merit to argument that version of statute at time claim was actually reduced controls

15 Fla. L. Weekly Supp. 1132c

Insurance — Personal injury protection — Affirmative defenses — Amendment — Denial — Insurer does not have standing to assert plaintiff’s violations of certain statutes as basis for non-payment of PIP benefits

15 Fla. L. Weekly Supp. 1132b

Insurance — Personal injury protection — Affirmative defenses — Amendment — Denial — Insurer does not have standing to assert plaintiff’s violations of certain statutes as basis for non-payment of PIP benefits

15 Fla. L. Weekly Supp. 1132a

Insurance — Personal injury protection — Affirmative defenses — Amendment — Denial

15 Fla. L. Weekly Supp. 265b

Insurance — Personal injury protection — Coverage is extended to toddler’s head injury incurred in fall on seat belt bolt in vehicle floor while playing in parked vehicle because injury resulted from ownership and use of vehicle

15 Fla. L. Weekly Supp. 159a

Insurance — Personal injury protection — Priority of payments — Exhaustion of policy limits — Where lost wage claim was made before insured gave assignment to medical provider, and assignment only assigned benefits for treatment, not for any lost wages, insurer was correct in paying lost wage claim that exhausted policy limits even after receipt of provider’s demand letter disputing reduced medical bills and notice of assignment