Volume 15

15 Fla. L. Weekly Supp. 939b

Insurance — Personal injury protection — Explanation of benefits — Insurer breached contract by failing to provide EOB to medical provider

15 Fla. L. Weekly Supp. 188a

Insurance — Personal injury protection

15 Fla. L. Weekly Supp. 482a

Insurance — Personal injury protection — Answer — Amendment — Motion to amend answer to assert defense of failure to attend examination under oath is denied as untimely where insurer did not list failure to attend EUO as basis for denial of claim in explanation of benefits or response to demand letter and did not move to amend until notice of trial was served, and medical provider would be prejudiced by amendment

15 Fla. L. Weekly Supp. 736a

Insurance — Personal injury protection — Mediation — Statute providing for mediation of personal injury claims arising from ownership or negligent use of motor vehicles does not apply to first-party claims for PIP benefits — Affirmative defense alleging that medical provider filed PIP suit prematurely before participating in mediation is stricken

15 Fla. L. Weekly Supp. 388a

Insurance — Personal injury protection — Coverage — Affirmative defenses — Accord and satisfaction — Insurer cannot assert accord and satisfaction based on medical provider’s acceptance of check for reduced amount for MRI where insurer failed to pay statutorily mandated schedule for MRI, provider did not agree to accept lesser amount tendered as payment in full, and there was no correspondence attached to check tendered

15 Fla. L. Weekly Supp. 996a

NOT FINAL VERSION OF OPINION
Subsequent Changes at 16 Fla. L. Weekly Supp. 92b

Insurance — Personal injury protection — Med Pay — Notice of loss — Disclosure and acknowledgment form — Submission of D&A form is not prerequisite to payment of PIP benefits — Accordingly, submission of D&A form is not billing requirement under Med Pay policy which provides that bills and statements for Med Pay coverage must be submitted in accordance with billing requirements applicable under PIP coverage

15 Fla. L. Weekly Supp. 1102a

Insurance — Personal injury protection — Coverage — Medical expenses — Overdue bills — Request for documentation/information — Tolling of period to pay or reject claim — Where insurer made timely request for additional documentation and information regarding claim, and provider failed to provide all documents and information requested until after suit was filed, time for payment of claim was tolled, and claim was not overdue and collectible at time of filing suit — No merit to argument that substantial compliance with request for documentation and information is sufficient — Med Pay — Since PIP coverage is primary under terms of policy and PIP statutes, provider is not entitled to recover under Med Pay coverage for claims not payable under PIP coverage

15 Fla. L. Weekly Supp. 1107b

Insurance — Personal injury protection — Complaint — Premature — Demand for mediation — Statute which provides that filing demand for mediation tolls requirements for filing suit for 60 days does not apply to PIP cases

15 Fla. L. Weekly Supp. 946a

Insurance — Personal injury protection — Complaint — Premature — Request for mediation — Statute which provides that filing demand for mediation tolls requirements for filing suit for 60 days does not apply to action for PIP benefits

15 Fla. L. Weekly Supp. 920b

Insurance — Personal injury protection — Complaint — Premature — Demand for mediation — Statute which provides that filing of demand for mediation tolls requirements for filing suit for 60 days does not apply to PIP cases