Volume 16

16 Fla. L. Weekly Supp. 446a

Online Reference: FLWSUPP 165AMAD2

Insurance — Personal injury protection — Withdrawal of benefits — Medical report issued by peer review physician does not raise issue of material fact to preclude summary judgment as to any bill for treatment pre-dating independent medical examination where there is no factual basis to support opinion, reporting physician did not examine insured or base report on examination of physician who performed IME, and reporting physician failed to set forth basis for opinions expressed — Report is further deficient because it conflicts with affidavit of IME physician, who concluded that further treatment was not necessary but did not opine that pre-IME bills were unnecessary, and because it was obtained in contemplation of litigation

16 Fla. L. Weekly Supp. 446a

Online Reference: FLWSUPP 165AMAD2

Insurance — Personal injury protection — Withdrawal of benefits — Medical report issued by peer review physician does not raise issue of material fact to preclude summary judgment as to any bill for treatment pre-dating independent medical examination where there is no factual basis to support opinion, reporting physician did not examine insured or base report on examination of physician who performed IME, and reporting physician failed to set forth basis for opinions expressed — Report is further deficient because it conflicts with affidavit of IME physician, who concluded that further treatment was not necessary but did not opine that pre-IME bills were unnecessary, and because it was obtained in contemplation of litigation

16 Fla. L. Weekly Supp. 446a

Online Reference: FLWSUPP 165AMAD2

Insurance — Personal injury protection — Withdrawal of benefits — Medical report issued by peer review physician does not raise issue of material fact to preclude summary judgment as to any bill for treatment pre-dating independent medical examination where there is no factual basis to support opinion, reporting physician did not examine insured or base report on examination of physician who performed IME, and reporting physician failed to set forth basis for opinions expressed — Report is further deficient because it conflicts with affidavit of IME physician, who concluded that further treatment was not necessary but did not opine that pre-IME bills were unnecessary, and because it was obtained in contemplation of litigation

16 Fla. L. Weekly Supp. 1133c

Online Reference: FLWSUPP 1612GALA

Insurance — Personal injury protection — Withdrawal of benefits — Valid report — Physician preparing report for purposes of withdrawal of benefits does not have to personally examine insured; it is sufficient that physician has reviewed treatment records — No error in considering peer review report and affidavit prepared after records review in ruling on motion for summary judgment

16 Fla. L. Weekly Supp. 1133a

Online Reference: FLWSUPP 1612ABAC

Insurance — Personal injury protection — Withdrawal of benefits — Valid report — Physician preparing report for purposes of withdrawal of benefits does not have to personally examine insured; it is sufficient that physician has reviewed treatment records — No error in considering peer review report and affidavit prepared after records review in ruling on motion for summary judgment

16 Fla. L. Weekly Supp. 1133a

Online Reference: FLWSUPP 1612ABAC

Insurance — Personal injury protection — Withdrawal of benefits — Valid report — Physician preparing report for purposes of withdrawal of benefits does not have to personally examine insured; it is sufficient that physician has reviewed treatment records — No error in considering peer review report and affidavit prepared after records review in ruling on motion for summary judgment

16 Fla. L. Weekly Supp. 392a

Online Reference: FLWSUPP 165AMADO

Insurance — Personal injury protection — Withdrawal of benefits — Reasonable proof — Trial court did not err in finding that peer review affidavit based solely on records of treating physician and not supported by independent medical examination is not legally sufficient to support withdrawal of benefits

16 Fla. L. Weekly Supp. 388b

Online Reference: FLWSUPP 165PERDO

Insurance — Personal injury protection — Withdrawal of benefits — Valid report to support withdrawal of benefits must be based on physical examination performed by reporting physician or physician who conducted independent medical examination, not physical examination by treating physician which does not factually support conclusion of report’s author that treatment was not reasonable, related or necessary

16 Fla. L. Weekly Supp. 137a

Online Reference: FLWSUPP 162PERDO

NOT FINAL VERSION OF OPINION
Subsequent Changes at 16 Fla. L. Weekly Supp. 388b

Insurance — Personal injury protection — Coverage — Medical expenses — Withdrawal — Insurer may not withdraw payment of a treating physician without consent of injured person unless the insurer first obtains a valid report signed by “the physician examining the injured person” — The physical examination underlying a “valid report” cannot be the physical examination of the injured person’s treating physician, but must be performed either by the reporting physician or by a physician who performed an independent medical examination — Valid report cannot be a “paper IME” based merely on review of treatment records

16 Fla. L. Weekly Supp. 767a

Online Reference: FLWSUPP 168LAHIT

Insurance — Personal injury protection — Withdrawal of benefits — Motion for summary judgment alleging that insurer is not entitled to dispute reasonableness, relatedness or necessity of medical bills because it failed to obtain report by physician who performed physical examination of insured is denied where there remains factual issue as to whether insurer, which failed to make any payment for dates at issue but never denied charges, had terminated or withdrawn benefits