Volume 17

17 Fla. L. Weekly Supp. 383a

Online Reference: FLWSUPP 1705CRUMInsurance — Personal injury protection — Coverage — Medical expenses — CPT codes — Neuromuscular reeducation — Massage therapy — Unbundling — Insurer cannot deny payment for CPT codes for neuromuscular reeducation and massage therapy recognizable under Medicare Part B fee schedule on grounds that Medicare’s National Correct Coding Initiative provides that neuromuscular reeducation and massage therapy codes cannot be billed on same day as another code billed by medical provider where insurer did not assert affirmative defense of unbundling, and PIP statute forbids insurer from applying utilization limits — No merit to argument that NCCI is payment limitation rather than utilization limitation

17 Fla. L. Weekly Supp. 465a

Online Reference: FLWSUPP 1706AYERInsurance — Personal injury protection — Coverage — Medical expenses — CPT coding — Insurer erred in denying payment for claimed CPT code that appears on Medicare Part B durable medical equipment fee schedule

17 Fla. L. Weekly Supp. 693a

Online Reference: FLWSUPP 1708MORAInsurance — Personal injury protection — Where PIP insurer’s notice that policy had been canceled prior to accident and would not cover any medical expenses related to accident constituted anticipatory breach of policy, insured and medical provider were not required to submit medical bills to insurer before filing suit

17 Fla. L. Weekly Supp. 731a Online Reference: FLWSUPP 1709RAMOInsurance — Personal injury protection — Coverage — Medical expenses — MRI — Standing — Trial

17 Fla. L. Weekly Supp. 199a

Online Reference: FLWSUPP 1703QUI2Insurance — Personal injury protection — Demand letter sent to wrong carrier — Where insurer responded to demand letter sent to wrong carrier three times without any mention of defect and insurer is related to wrong carrier, insurer had actual and imputed notice of medical provider’s intent to initiate litigation and cannot avail itself of invalid demand letter defense — Where insurer and wrong carrier named as defendant are sufficiently related, insurer knew that provider made clerical error in suing wrong carrier, and provider has moved to amend complaint to substitute insurer as defendant, defense that provider sued wrong carrier is moot

17 Fla. L. Weekly Supp. 121a

Online Reference: FLWSUPP 1702GABRInsurance — Personal injury protection — Affirmative defenses — Motion to amend affirmative defenses by asserting 6 new defenses 36 months after initiation of PIP suit is denied where proposed amendment is untimely, and medical provider who has prepared for trial several times, attended mediation and numerous hearings and rejected several proposals for settlement would be prejudiced by amendment

17 Fla. L. Weekly Supp. 684a

Online Reference: FLWSUPP 1708DELGInsurance — Personal injury protection — Affirmative defenses — Accord and satisfaction — Where medical provider has submitted affidavit attesting that provider’s acceptance of insurer’s check for reduced payment was not intended as full and final settlement of provider’s entire claim, factual issue exists as to intent to effectuate accord and satisfaction, and summary judgment is precluded — Moreover, where tendered offer was less than amount that insurer represented as being payable pursuant to provider’s usual and customary rates, tendered amount was not tendered in good faith

17 Fla. L. Weekly Supp. 703a

Online Reference: FLWSUPP 1708MIL3Insurance — Personal injury protection — Accord and satisfaction — Motion for summary judgment on insurer’s accord and satisfaction defense is denied where there exists factual issue as to whether bona fide dispute existed as to amounts owed or whether the parties even understood what amounts each claimed to be at issue

17 Fla. L. Weekly Supp. 1116a

Online Reference: FLWSUPP 1711RODEInsurance — Personal injury protection — Motion to dismiss or abate PIP suit refiled after voluntary dismissal, on ground that medical provider has not paid sanctions entered against its prior counsel in prior case — Itemization of insurer’s claim and payments made required

17 Fla. L. Weekly Supp. 10a Online Reference: FLWSUPP 1701GARR Insurance — Personal injury protection UNITED AUTOMOBILE INSURANCE COMPANY, Appellant, vs. EDUARDO J.GARRIDO, D.C., P.A.,