Volume 16

16 Fla. L. Weekly Supp. 293b

Online Reference: FLWSUPP 164RAMAL

Insurance — Personal injury protection — Expert witness — Striking — No abuse of discretion in striking insurer’s expert witness on issue of independent medical examination where there is working relationship between insurer and expert, and expert repeatedly refused to produce subpoenaed copies of IME/peer review reports and failed to comply with order compelling production — No error in directing verdict in favor of medical provider where sole issue was whether MRI was medically necessary and insurer failed to impeach testimony of physician who ordered MRI, present countervailing expert medical testimony, or present other evidence that would have created direct conflict with provider’s evidence — Trial court did not impermissibly judge credibility of provider’s expert in entering directed verdict since there was no conflicting evidence to refute provider’s expert medical testimony

16 Fla. L. Weekly Supp. 981b

Online Reference: FLWSUPP 1610GODF

Insurance — Personal injury protection — Coverage — Medical expenses — Reasonable, related and necessary treatment — Summary judgment — Affidavits submitted by insurer which state opinions regarding adequacy of medical provider’s records do not create genuine issue of material fact as to reasonableness, relatedness or medical necessity of treatment — Inadequacy of record keeping is not lawful basis for nonpayment of PIP benefits — Partial summary judgment granted in favor of provider

16 Fla. L. Weekly Supp. 37a

Insurance — Personal injury protection — Coverage — Priority — Hospital lien — Because hospital that failed to timely file lien was unsecured creditor until lien was filed, medical provider that submitted bill to insurer before hospital filed lien established priority claim to payment — Notice of loss — Claim form — Where provider put universal provider identification number rather than professional license number in box 31 of claim form, provider failed to give notice of claim to insurer — Insurer did not waive box 31 affirmative defense by failing to provide explanation of benefits detailing reason payment was denied

16 Fla. L. Weekly Supp. 958a

Online Reference: FLWSUPP 1610MORA

Insurance — Personal injury protection — Coverage — Medical expenses — Overdue bills — Request for documentation — Where insurer made timely request for additional documentation regarding claims and received no response from medical provider, claims were not overdue at time of filing suit and lawsuit is premature

16 Fla. L. Weekly Supp. 678a

Online Reference: FLWSUPP 167TOFFA

Insurance — Personal injury protection — Coverage — Medical bills — MRI — Summary judgment is granted in favor of insurer where prior to suit insurer tendered all amounts due for MRI bill, plus interest, penalty, and postage as calculated under PIP statute in effect at time PIP policy was executed

16 Fla. L. Weekly Supp. 533a

Online Reference: FLWSUPP 166AFO

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — PIP statute does not authorize insurer to utilize Medicare’s Hospital Outpatient Prospective Payment System limitations or any other limitations not expressly described in section 627.736(5)(a)2.f, (a)3 and (a)4 when determining amounts due for MRI services provide in non-emergency, non-hospital setting

16 Fla. L. Weekly Supp. 964d

Online Reference: FLWSUPP 1610CABA

Insurance — Personal injury protection — Coverage — PIP statute provides for payment of 80% of applicable amount reimbursable under workers’ compensation fee schedule

16 Fla. L. Weekly Supp. 108a

Insurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered treatment — Treatment is not rendered unlawful by failure to obtain county occupational license

16 Fla. L. Weekly Supp. 473a

Online Reference: FLWSUPP 165BELVI

Insurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered treatment — No merit to claim that medical provider rendered unlawful treatment because it did not have active massage establishment license at time massage therapy was rendered where rule defines massage establishment as site where therapy is rendered by massage therapist, and insured’s therapy was rendered by chiropractor

16 Fla. L. Weekly Supp. 687a

Online Reference: FLWSUPP 167DOR

Insurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered services — Patient Self Referral Act — Medical provider who referred insured to pain management clinic of which provider is sole shareholder violated Patient Self Referral Act, and pain clinic is barred from claiming entitlement to PIP benefits — No merit to argument that only insured has standing to assert that services are not payable due to fact that they were not lawfully rendered