Volume 18

18 Fla. L. Weekly Supp. 104a

Online Reference: FLWSUPP 1801PARK

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

18 Fla. L. Weekly Supp. 663b

Online Reference: FLWSUPP 1808MRI

Insurance — Personal injury protection — Coverage — Medical expenses — Statutory provisions and policy language requiring that insurer pay 80% of reasonable amounts control over permissive statutory fee schedule

18 Fla. L. Weekly Supp. 733c

Online Reference: FLWSUPP 1809GARO

Insurance — Personal injury protection — Coverage — Policy issued during gap period between expiration and reenactment of PIP statute is not governed by reenacted statute

18 Fla. L. Weekly Supp. 213a

Online Reference: FLWSUPP 1802LEE

Insurance — Personal injury protection — Coverage — 2007 version of PIP statute in effect at time policy was issued, rather than 2008 version in effect at time of accident and treatment, controls reimbursement where 2008 statute does not clearly express intent that it apply retroactively, and reimbursement schedule in 2008 statute is substantive change that would impair vested rights — Policy provision allowing insurer to pay in accordance with “Florida Motor Vehicle No-Fault Law and any amendments” does not allow insurer to rely on 2008 fee schedule where 2008 PIP statute did not truly amend former PIP statute, and ambiguous provision must be construed against insurer

18 Fla. L. Weekly Supp. 98a

Online Reference: FLWSUPP 1801MCCL

Insurance — Personal injury protection — Notice of loss — Where insured has submitted no bills to insurer and has received no treatment from medical provider, but rather, insured seeks pre-authorization for treatment, written notice of covered loss has not been provided, and no benefits are overdue — Insurer’s motion for summary judgment is granted

18 Fla. L. Weekly Supp. 19a

Online Reference: FLWSUPP 1801FRED

Insurance — Personal injury protection — Summary judgment — Opposing affidavit — Peer review report and affidavit that contain little more than conclusory statements cannot create genuine issue of material fact in opposition to motion for summary judgment — Rehearing — No abuse of discretion in denying motion for rehearing arguing that insurer had discovered that insured did not disclose previous injury to insurer’s medical expert where trial court found that doctor knew about injury

18 Fla. L. Weekly Supp. 1195b

Online Reference: FLWSUPP 1811LAND

Insurance — Personal injury protection — Res judicata — Suit for second set of medical bills filed on same day as entry of summary judgment on first set of bills is barred by res judicata where medical provider had knowledge of second set more than thirty days prior to entry of summary judgment on first set

18 Fla. L. Weekly Supp. 774a

Online Reference: FLWSUPP 1809DIAZ

Insurance — Personal injury protection — Res judicata — Error to conclude that res judicata barred suit for second set of medical bills discovered during pendency of suit for another set of bills where medical treatment, procedures, CPT codes, dates of service and amounts charged for second set of bills were different from set of bills litigated in prior case such that facts and evidence necessary to maintain second suit and identify thing sued for are not same as in prior suit — Moreover, dismissing suit based on res judicata was not equitable or just where insured was barred from amending complaint in prior suit to include newly discovered bills by freeze order imposed when insurer failed to appear at summary judgment hearing

18 Fla. L. Weekly Supp. 102b

Online Reference: FLWSUPP 1801SEID

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — PIP policy providing for payment of 80% of reasonable expenses controls over permissive statutory language allowing limitation of reimbursement for MRI to 80% of 200% of Medicare Part B fee schedule — Policy language stating that insurer will pay in accordance with No-Fault Act and will not pay any charge that No-Fault Act does not require it to pay is insufficient to place insured on notice that payment of benefits is to be made according to Medicare fee schedule

18 Fla. L. Weekly Supp. 1059a

Online Reference: FLWSUPP 1810FREE

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Fee schedule — Statute in effect at time insurance contract was executed governs substantive issues — Reimbursement is controlled by terms of policy and not subsequently amended statute