Volume 15

15 Fla. L. Weekly Supp. 430a

Insurance — Personal injury protection — Notice of loss — Disclosure and acknowledgment form — Trial court erred in applying section 627.736(5)(e)(5) to incorporate section 627.736(4)(b) in toto and find D&A form deficient — Reference to section 627.736(4)(b) only applies to manner of furnishing form, and D&A form furnished by U.S. mail in properly addressed, postpaid envelope was sufficient to meet threshold requirements of statute — Error to fail to consider bills for subsequent treatment based on alleged deficiency in D&A form — Requirement of D&A form applies only to initial date of treatment — Final summary judgment reversed

15 Fla. L. Weekly Supp. 160a

Insurance — Personal injury protection — Notice of loss — Disclosure and acknowledgment form — Medical provider’s affidavit stating that he would have attempted to cure defect had insurer cited failure to provide disclosure and acknowledgment form as reason for denial of claim in explanation of benefits is improper where affidavit was not signed in presence of notary — Even if affidavit were proper, it is not legally sufficient to raise disputed issue of material fact as to whether insurer waived disclosure and acknowledgment defense because failure to provide required form failed to put insurer on notice of covered loss, and insurer is not required to list every reason for denial of claim in EOB

15 Fla. L. Weekly Supp. 738a

Insurance — Personal injury protection — Notice of loss — Disclosure and acknowledgment form that does not list services rendered on form but to which medical records and bills were attached substantially complied with statute — Defense of noncompliant D&A form was waived where insurer did not provide medical provider with response or explanation of benefits indicating form was noncompliant

15 Fla. L. Weekly Supp. 750b

Insurance — Personal injury protection — Notice of loss — Disclosure and acknowledgment form — Where medical provider failed to list services provided on D&A form, insurer did not have notice of covered loss — Summary final judgment entered for insurer

15 Fla. L. Weekly Supp. 502a

Insurance — Personal injury protection — Notice of loss — Disclosure and acknowledgment form — Failure to detail services rendered on D&A form or write “see attached” on form does not render form deficient where there is no allegation of fraud and PIP patient log that contains insured’s signature and attests that services were actually rendered and explained to insured, physician’s notes and CMS 1500 billing statements were attached to D&A form

15 Fla. L. Weekly Supp. 1008a

Insurance — Personal injury protection — Notice of loss — Disclosure and acknowledgment form that listed “medical treatment” on line where services rendered should have been specified was insufficient to put insurer on notice of covered loss — Defense of defective D&A form can be raised at any time, even after payment of claim — Defect in D&A form cannot be cured

15 Fla. L. Weekly Supp. 91b

Insurance — Personal injury protection — Notice of loss — Disclosure and acknowledgment form — Description of services rendered on D&A form as “Notas del Doctor” and “Therapy,” in combination with attached HCFA forms that D&A form referred to, substantially complied with requirements of section 627.736(5)(e) — D&A form signed by medical provider and insured 50 days apart does not comply with statutory requirement that insured countersign form — Waiver — Where insurer’s conduct of continuing to investigate claim, scheduling independent medical examinations and peer review and ultimately denying claim on ground other than defective D&A form evinces intent to accept notice of loss, insurer waived right to assert defective form as bar to payment

15 Fla. L. Weekly Supp. 1227a

Insurance — Personal injury protection — Notice of loss — Disclosure and acknowledgment form that has not been properly authenticated, sworn to or certified is not admissible for purposes of summary judgment — Insurer that did not send explanation of benefits explaining that it was denying claim due to incomplete/defective D&A form and denied payment of bill in full on other grounds is estopped from asserting defect — D&A form requirement applies only to first date of service

15 Fla. L. Weekly Supp. 923b

Insurance — Personal injury protection — Notice of loss — Disclosure and acknowledgment form — Where medical provider failed to submit proper D&A form, summary judgment is granted in favor of insurer as to first date of service only — Argument that insurer waived D&A form defense by failing to furnish proper explanation of benefits complaining of defect is inapplicable

15 Fla. L. Weekly Supp. 372a

Insurance — Personal injury protection — Notice of loss — Disclosure and acknowledgment form — Sufficiency — D&A form that does not list services allegedly rendered failed to place insurer on notice of covered loss — Deficient D&A form is fatal to provider’s entire claim, not just claim for initial date of service, and deprives provider of standing to bring action for declaratory relief