Volume 19

19 Fla. L. Weekly Supp. 380a

Online Reference: FLWSUPP 1905MONTInsurance — Personal injury protection — Examination under oath — Failure of insured to attend EUO does not bar payment of PIP benefits

19 Fla. L. Weekly Supp. 924a

Online Reference: FLWSUPP 1911LUCIInsurance — Personal injury protection — Examination under oath — Insured’s attendance at EUO is not condition precedent to coverage under PIP policy

19 Fla. L. Weekly Supp. 536b

Online Reference: FLWSUPP 1907ABDUInsurance — Personal injury protection — Coverage — Denial of benefits — False or misleading statement relating to claim or charges — Trial court erred in ruling that insurer could not assert affirmative defense that medical provider knowingly submitted false or misleading statements relating to claim or charges without first obtaining adjudication of guilt of insurance fraud from Department of Financial Services — Explanation of benefits — Error to grant summary judgment in favor of provider on claim for failure to provide EOB and find that provider is entitled to attorney’s fees on issue, as there is no private cause of action for failing to provide EOB

19 Fla. L. Weekly Supp. 865b

Online Reference: FLWSUPP 1910GASSInsurance — Personal injury protection — Claims — Timeliness — Where medical provider timely submitted notice of initiation of treatment to insurer, time for submission of all charges, not just charges for first treatment, was extended from 35 days to 75 days — Partial summary judgment granted in favor of provider

19 Fla. L. Weekly Supp. 789d

Online Reference: FLWSUPP 1910BALDInsurance — Personal injury protection — Notice of loss — Claim form that contains correct name of medical provider but omits provider’s professional license number is substantially complete and accurate and provided insurer notice of covered loss

19 Fla. L. Weekly Supp. 1092a

Online Reference: FLWSUPP 1913LEMIInsurance — Personal injury protection — Coverage — Medical expenses — CPT coding — Medical provider’s motion for partial summary judgment is denied where there is genuine issue of material fact as to whether bills which failed to utilize correct CPT code for service rendered placed insurer on notice of covered loss and were overdue within meaning of PIP statute

19 Fla. L. Weekly Supp. 212a

Online Reference: FLWSUPP 1903JONEInsurance — Personal injury protection — Mileage to attend independent medical examination — Insured has not adequately pled cause of action for breach of PIP policy based on insurer’s inadvertent reimbursement of mileage for IME attendance from available PIP benefits where there is no proof that insured sustained any damages — Correction of oversight by insurer after action was filed does not constitute confession of judgment where insured has failed to prove necessary damages element of cause of action

19 Fla. L. Weekly Supp. 374a

Online Reference: FLWSUPP 1905ESTIInsurance — Personal injury protection — Affirmative defenses — Amendment — Motion to amend answer to add affirmative defenses of failure to timely bill for one date of service and failure to satisfy conditions precedent relating to demand letter and examination under oath is denied — Insurer has previously amended affirmative defenses twice and has admitted in discovery that all bills were timely received, that there were no errors or defenses with regard to demand letter, and that insured cooperated in investigation of claim

19 Fla. L. Weekly Supp. 617a

Online Reference: FLWSUPP 1908VALEInsurance — Personal injury protection — Affirmative defenses — Amendment — New trial is required following district court of appeal ruling that appellate division of circuit court properly found that it was within trial court’s discretion to strike insurer’s defense of fraud on morning of trial, but that circuit court’s affirmance was based on incorrect factual assumption — On remand trial court should resolve any issue involving amended pleadings though application of small claim rules or any rules of civil procedure invoked — Where final judgment is vacated, insurer’s request for offer of judgment appellate fees and medical provider’s request for prevailing party appellate fees are denied

19 Fla. L. Weekly Supp. 395a

Online Reference: FLWSUPP 1905FRIEInsurance — Personal injury protection — Affirmative defenses — Amendment — Motion to amend affirmative defenses is denied where insurer was aware of defenses over a year prior to filing original answer and medical provider would be prejudiced by allowing amendments — No merit to affirmative defense asserting that claim should have been included in prior litigation where demand letter for claim was sent after prior litigation was dismissed and, therefore, claim was not ripe at time that litigation was pending