Volume 16

16 Fla. L. Weekly Supp. 114a

Insurance — Personal injury protection — Notice of loss — Claim form contained sufficient information to put insurer on notice of loss — Notice requirements in policy do not supersede statutory notice requirements

16 Fla. L. Weekly Supp. 110b

Insurance — Personal injury protection — Notice of loss — HCFA claim forms to which outside billing agent has affixed physician’s stamped signature are substantially complete where absence of signature is not material to defeat claim, and affidavit of physician provides that he authorized billing company to affix his signature — Placement of physician’s license number in wrong box on claim form is materially compliant with statute

16 Fla. L. Weekly Supp. 193a

Online Reference: FLWSUPP 162MABRY

Insurance — Personal injury protection — Notice of loss — Claim form — Where medical provider mistakenly indicated on CMS 1500 claim forms that treatment was not related to automobile accident, claim forms were not complete as to material provisions, and insurer was not provided with notice of covered loss — No merit to argument that insurer was provided with notice of loss despite error because medical reports attached to claim forms referred to automobile accident — Later submission of corrected claim forms did not provide notice of loss where corrected claim forms were not provided within 35 days of dates of service

16 Fla. L. Weekly Supp. 341a

Online Reference: FLWSUPP 164HERRA

Insurance — Personal injury protection — Claim form — Despite misplacement of license number in box 33 instead of box 31, claim form was substantially complete and accurate — Insurer’s motion for summary judgment denied

16 Fla. L. Weekly Supp. 464b

Online Reference: FLWSUPP 165DORSA

Insurance — Personal injury protection — Claim form — Professional license number — Omission of professional license number from claim form constitutes failure to provide notice of claim — Failure to list omission of license number on explanation of benefits did not waive defense of lack of notice of claim

16 Fla. L. Weekly Supp. 575c

Online Reference: FLWSUPP 166BALDW

Insurance — Personal injury protection — Claim form — Where medical provider first submitted CMS 1500 form lacking professional license number, and more than 35 days after date of service provider resubmitted form with license number, failure to submit statutorily compliant form within 35 days of date of service is fatal to claim

16 Fla. L. Weekly Supp. 928c

Online Reference: FLWSUPP 1610GORD

Insurance — Personal injury protection — Notice of loss — HCFA form — Physician’s license number — Error to grant summary judgment in favor of insurer on ground that initial HCFA form submitted by medical provider did not include physician’s professional license number — License number was not material element of bills where insurer knew license number, there was no evidence or suspicion of fraud, and there was no indication that insurer even considered possibility that physician was not properly licensed — Even if license number was material, provider substantially complied with notice requirements when it resubmitted HCFA with license number included

16 Fla. L. Weekly Supp. 620a

Online Reference: FLWSUPP 167ALMOR

Insurance — Personal injury protection — Notice of loss — HCFA form — Medical license number — Omission of medical provider’s license number from HCFA form was not material element of notice of loss where form was filled out properly as to all provisions except license number, provider was licensed, there was no indication that insurer even considered possibility that provider was not properly licensed, and provider’s license number was easily obtained from Department of Health website

16 Fla. L. Weekly Supp. 1061c

Online Reference: FLWSUPP 1611LAGE

Insurance — Personal injury protection — Notice of loss — Claim form — Medical provider that failed to include professional license number on CMS 1500 forms failed to put insurer on notice of covered loss — Provider cannot recover for resubmitted claim forms that were corrected to include professional license number where forms were untimely submitted more than 35 days after dates of service

16 Fla. L. Weekly Supp. 666a

Online Reference: FLWSUPP 167PANDY

Insurance — Personal injury protection — Notice of loss — CMS-1500 claim forms that contain incorrect date of accident failed to provide insurer with notice of covered loss — Insurer may raise defense of lack of notice of loss at any time — Where notice of loss was not provided, bills did not become overdue, and demand letters were premature — Further, demand letters containing incorrect date of accident were invalid and failed to satisfy condition precedent to filing suit