Volume 16

16 Fla. L. Weekly Supp. 963a

Online Reference: FLWSUPP 1610KELL

Insurance — Personal injury protection — Coverage — Version of PIP policy in effect at time of execution of policy, which provided for payment of 80% of reasonable medical expenses, rather than version in effect at time of treatment, which provides for payment of 80% of Medicare fee schedule, is applicable

16 Fla. L. Weekly Supp. 962b

Online Reference: FLWSUPP 1610BURC

Insurance — Personal injury protection — Coverage — Version of PIP policy in effect at time of execution of policy, which provided for payment of 80% of reasonable medical expenses, rather than version in effect at time of treatment, which provides for payment of 80% of Medicare fee schedule, is applicable

16 Fla. L. Weekly Supp. 960c

Online Reference: FLWSUPP 1610OCAN

Insurance — Personal injury protection — Coverage — Determination of applicable PIP statute is based on date of accident and treatment, not date policy was issued

16 Fla. L. Weekly Supp. 870b

Online Reference: FLWSUPP 169VERNE

Insurance — Personal injury protection — Coverage — Version of PIP statute in effect at time PIP policy was executed, which provides 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 — Statutory amendment at issue is not remedial amendment but substantive amendment that should not be applied retroactively

16 Fla. L. Weekly Supp. 862a

Online Reference: FLWSUPP 169COFFE

Insurance — Personal injury protection — Coverage — 2007 version of PIP statute, which provides for payment of 80% of reasonable charges, rather than 2008 version of statute in effect at time of treatment, which provides for payment of 80% of Medicare fee schedule, is applicable where policy expired prior to January 1, 2008

16 Fla. L. Weekly Supp. 680a

Online Reference: FLWSUPP 167MCKEN

Insurance — Personal injury protection — Coverage — Medical expenses incurred during statutory “gap period” — No merit to medical provider’s argument that no statute applies to services rendered during “gap period” created by sunsetting of PIP statute where original policy contained PIP coverage which was revived and amended to continue in effect after “gap period” — Provisions of PIP statute in effect at time policy went into effect applies to bills accrued during “gap period”

16 Fla. L. Weekly Supp. 677a

Online Reference: FLWSUPP 167ALPER

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

16 Fla. L. Weekly Supp. 505a

Online Reference: FLWSUPP 166ORELL

Insurance — Personal injury protection — Affirmative defenses — Striking — Fraud — Error to strike affirmative defenses of fraud where insurer alleged all essential elements of fraud and defenses were not redundant, repetitive, sham or frivolous pleading — Insurer listed inconsistencies between medical bills and insured’s statements regarding treatment received, stated reason for insurer’s belief that acts or omissions in claim for benefits were misleading, and claimed that insurer’s reliance on misrepresentations caused damage in form of expense of litigating case

16 Fla. L. Weekly Supp. 315a

Online Reference: FLWSUPP 164CHIRO

Insurance — Personal injury protection — Declaratory judgment — Where medical provider has no treatment records for procedures billed to insurer, court concludes that provider did not perform procedures and improperly billed insurer in false and misleading manner — Where provider has no record of performing or interpreting x-rays on date reflected in bill, court concludes that provider did not perform x-rays for which it billed insurer — Where provider’s records do not establish that myofascial release billed under one CPT code was performed to separate region of insured’s body than chiropractic manipulation billed for same date of service under different CPT code, provider improperly billed for myofascial release and used modifier indicating that procedures were performed to different regions of body in false and misleading manner — Because bills were not properly completed, insurer is deemed not to have received notice of bills and does not owe benefits for bills

16 Fla. L. Weekly Supp. 505b

Online Reference: FLWSUPP 166BETAN

Insurance — Personal injury protection