Volume 16

Case Search

OROZCO MEDICAL CENTER, INC., a/a/o JULIET GARCIA, Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

16 Fla. L. Weekly Supp. 191a

Online Reference: FLWSUPP 162GARCI

Insurance — Personal injury protection — Standing — Assignment — Document that states it is assignment of benefits but not assignment of any cause of action did not confer standing to file suit on medical provider — Further, provider failed to satisfy condition precedent of submitting valid presuit demand letter

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OROZCO MEDICAL CENTER, INC. (As Assignee of Maria Valdez), Plaintiff, v. UNITED AUTOMOBILE INSURANCE COMPANY, Defendant.

16 Fla. L. Weekly Supp. 102b

Insurance — Personal injury protection — Standing — Assignment — No merit to argument that assignment assigned benefits but not cause of action — Insurer was not obligated to furnish PIP log to medical provider — Insurer’s provision of declarations page and policy to insured at inception of claim did not satisfy obligation to furnish provider with copy of policy requested in demand letter — Claim form is defective for failing to include medical license number in box 31 — Presuit demand letter is not defective for being sent to different address of insurer

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UNITED AUTOMOBILE INSURANCE COMPANY, a Florida corporation, Appellant, vs. TOTAL REHAB & MEDICAL CENTER, INC., a/a/o Arcadio Segura, Appellee.

16 Fla. L. Weekly Supp. 295b

Online Reference: FLWSUPP 164SEGUR

Insurance — Personal injury protection — Withdrawal of benefits — Valid peer review report to support withdrawal of benefits must be supported by independent medical examination, not merely review of treating physician’s records — Error to allow medical provider to argue at closing argument that if he did not recover over $2,500 he would recover no money at all due to application of deductible — Error was either waived by insurer’s failure to object or was harmless because amount of deductible was submitted to jury in another form without objection

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AFFIRMATIVE INSURANCE COMPANY, Appellant, v. ACUMAS TREATMENT CENTER, INC., a/a/o KENYATA MAJOR, Appellee.

16 Fla. L. Weekly Supp. 922a

Online Reference: FLWSUPP 1610MAJO

Insurance — Personal injury protection — Application — Misrepresentations — Where insurer did not appeal judgment in favor of medical provider/assignee finding that insured’s misrepresentation on application was not material and did not void policy as to insured, insurer’s appeals of identical judgments in favor of passengers are barred by collateral estoppel — No merit to argument that judgment as to insured does not qualify as final judgment for purposes of collateral estoppel because subsequent withdrawal of opinion on which court relied indicates that case may not have been decided correctly — Fact that insured has filed rule 1.540(b) motion for relief from judgment is of no moment because, assuming a mistake of law, such mistake cannot be remedied by this type motion

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AFFIRMATIVE INSURANCE CO., Appellant, vs. BAYVIEW MEDICAL & REHAB CENTER, INC., (as assignee of FELIPE POSAS), Appellee.

16 Fla. L. Weekly Supp. 213c

Online Reference: FLWSUPP 163POSAS

Insurance — Personal injury protection — Application — Misrepresentations — No error in entering summary judgments in favor of insureds alleged to have made material misrepresentations on applications where evidence of materiality of misrepresentations was inadmissible as offered — Although transcripts of unsworn recorded statements of insureds offered as proof of misrepresentations were inadmissible, insureds’ own affidavits do raise issue of fact as to omissions of potentially relevant household members on applications — However, insurer failed to present admissible evidence of materiality of omissions where unauthenticated letters by underwriters in support of claim that premiums would have been higher had insureds disclosed all alleged household members were properly excluded, and affidavits filed in support of underwriters’ records, which were not offered by underwriters or records custodian, were also inadmissible

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