Volume 17

17 Fla. L. Weekly Supp. 43b

Online Reference: FLWSUPP 1701GOLD

Insurance — Personal injury protection — Coverage — Policy issued during statutory gap period — Where PIP policy was executed during statutory gap period when there was no PIP statute, policy language requiring that medical expenses be paid at 80% of reasonable charges controls reimbursement

17 Fla. L. Weekly Supp. 329b

Online Reference: FLWSUPP 1705GON2

Insurance — Personal injury protection — Coverage — Reasonable, related and necessary treatment — Summary judgment — Peer review — Error to enter summary judgment in favor of insured after striking peer review report because it was not supported by physical examination conducted by physician signing peer review

17 Fla. L. Weekly Supp. 990a

Online Reference: FLWSUPP 1710CARU

Insurance — Personal injury protection — Summary judgment — Peer review report — No merit to claim that medical records referenced in peer review affidavit were not authenticated where insured provided records to insurer during discovery and relied on same records to present her claim — Where affidavit that corrected all technical deficiencies in original stricken affidavit was attached to insurer’s motion for reconsideration of order granting summary judgment, judgment in favor of insured is reversed and case is remanded for consideration on merits — Motion for entry of mandate or order directing clerk to return file to lower court denied

17 Fla. L. Weekly Supp. 991a

Online Reference: FLWSUPP 1710LOPE

Insurance — Personal injury protection — Valid peer review report is required as prerequisite only to withdraw benefits that were previously provided, not to deny them from the inception — Trial court erred in striking peer review and granting summary judgment in favor of provider

17 Fla. L. Weekly Supp. 927a

Online Reference: FLWSUPP 1710BEAD

Insurance — Personal injury protection — Denial of benefits — Valid medical report — Trial court erred in striking affidavit and peer review report offered in opposition to medical provider’s motion for summary judgment on ground that peer review must be supported by physical examination of insured — Discovery — Depositions — Expert witness fees — No error in determining that treating physician was entitled to expert witness fees for his deposition testimony

17 Fla. L. Weekly Supp. 1078b

Online Reference: FLWSUPP 1711OSOR

Insurance — Personal injury protection — Coverage — Medical benefits — Reasonable, related, and medically necessary treatment — Summary judgment — Opposing affidavit — Error to grant summary judgment in favor of provider without considering insurer’s peer review affidavit — Peer review was not invalid because it was based on review of treating physician’s records rather than on independent medical examination

17 Fla. L. Weekly Supp. 892b

Online Reference: FLWSUPP 1710VEGA

Insurance — Personal injury protection — Coverage — Medical benefits — Reasonable, related, and necessary treatment — Summary judgment — Opposing affidavit — Error to refuse to consider peer review report on ground that it was not based on independent medical examination

17 Fla. L. Weekly Supp. 1058a

Online Reference: FLWSUPP 1711JULI

Insurance — Personal injury protection — Coverage — Medical expenses — Denial of benefits — Valid medical report — Error not to consider peer review affidavit submitted by insurer’s expert on grounds that expert did not personally examine insured or that affidavit was not obtained prior to denial of claim — No merit to argument that affidavit was properly not considered because documents it referenced were not attached to it where documents were clearly enumerated in affidavit and were already on file in case — If trial court found affidavit to be conclusory, it should have given insurer opportunity to correct that technical deficiency

17 Fla. L. Weekly Supp. 520a

Online Reference: FLWSUPP 1707MONT

NOT FINAL VERSION OF OPINION
Subsequent Changes at 18 Fla. L. Weekly Supp. 501aInsurance — Personal injury protection — Summary judgment — Opposing affidavit — Although trial court erred in refusing to consider peer review affidavit because it was not obtained prior to denial of medical bills, grant of summary judgment in favor of medical provider is affirmed under tipsy coachman doctrine because affidavit is conclusory, is based on unauthenticated and unattached documents, and conflicts with report of independent medical examination performed by same physician VACATED. Revised Opinion at FLWSUPP 1806MONT.]

17 Fla. L. Weekly Supp. 745a

Online Reference: FLWSUPP 1709REGI

Insurance — Personal injury protection — Denial of benefits — Valid medical report — Error to hold that peer review was not valid report supporting denial of claim for PIP benefits because insurer did not also conduct independent medical examination — Demand letter was premature where amount demanded for two MRIs on HCFA claim form exceeded allowable amount under PIP statute, insurer never received notice of exact amount owed, and amount owed was not overdue when medical provider subsequently sent demand letter — Even if demand letter were not premature, letter was invalid where amounts listed in letter still did not accurately reflect allowable amounts under statute