Volume 19

19 Fla. L. Weekly Supp. 735c

Online Reference: FLWSUPP 1909VILLInsurance — Personal injury protection — Coverage — Policy language regarding method of reimbursing claims controls over permissive statutory fee schedule not referenced in policy

19 Fla. L. Weekly Supp. 925a

Online Reference: FLWSUPP 1911NEGRInsurance — Personal injury protection — Coverage — Medical expenses — Where policy provides that insurer will pay 80% of reasonable medical expenses and does not say that insurer will pay in accordance with permissive fee schedule of section 627.736(5)(a)2.f., insurer is not entitled to limit reimbursement to permissive statutory fee schedule — Even if insurer is correct that PIP statute is incorporated into policy, resulting ambiguity regarding which method insurer would use to calculate reimbursement must be resolved in favor of insured to require that insurer pay greatest amount possible under policy language

19 Fla. L. Weekly Supp. 946b

Online Reference: FLWSUPP 1911SOUZInsurance — Personal injury protection — Coverage — Permissive statutory fee schedule of section 627.736(5)(a)2 could not be applied where policy made no reference to permissive fee schedule

19 Fla. L. Weekly Supp. 894a

Online Reference: FLWSUPP 1910CURTInsurance — Personal injury protection — Coverage — Permissive statutory fee schedule of section 627.736(5)(a)2 could not be applied where policy made no reference to permissive fee schedule

19 Fla. L. Weekly Supp. 893b

Online Reference: FLWSUPP 1910DARIInsurance — Personal injury protection — Coverage — Permissive statutory fee schedule of section 627.736(5)(a)2 could not be applied where policy made no reference to permissive fee schedule

19 Fla. L. Weekly Supp. 893a

Online Reference: FLWSUPP 1910GOMEInsurance — Personal injury protection — Coverage — Permissive statutory fee schedule of section 627.736(5)(a)2 could not be applied where policy made no reference to permissive fee schedule

19 Fla. L. Weekly Supp. 376a

Online Reference: FLWSUPP 1905MIRAInsurance — Personal injury protection — Coverage — Permissive statutory fee schedule of section 627.736(5)(a)2 could not be applied where policy made no reference to permissive fee schedule

19 Fla. L. Weekly Supp. 127a

Online Reference: FLWSUPP 1902NEWBInsurance — Personal injury protection — Coverage — Where insurer elected to reimburse medical provider pursuant to permissive statutory fee schedule and applied Outpatient Prospective Payment System cap, caps insurer cannot belatedly contest reasonableness of charge submitted by provider following decision by district court of appeal disallowing use of OPPS cap

19 Fla. L. Weekly Supp. 126b

Online Reference: FLWSUPP 1902GOSHInsurance — Personal injury protection — Coverage — Where insurer elected to reimburse medical provider pursuant to permissive statutory fee schedule and applied Outpatient Prospective Payment System cap, insurer cannot belatedly contest reasonableness of charge submitted by provider following decision by district court of appeal disallowing use of OPPS cap — Once insurer elected to use permissive fee schedule, reasonableness of charge became irrelevant and only issue is whether insurer correctly reimbursed provider under fee schedule

19 Fla. L. Weekly Supp. 1091a

Online Reference: FLWSUPP 1913GUERInsurance — Personal injury protection — Coverage — Medical expenses — Conclusory affidavit filed in opposition to medical provider’s motion for summary judgment did not severely impeach or create direct conflict with provider’s evidence as to reasonableness of charges — Presuit demand letters were not insufficient for failure to attach insurer’s notices of withdrawal of authorization for any future benefits pursuant to independent medical examination where demand letters did not seek future benefits — Further, insurer waived any defect by failing to advise provider of alleged deficiencies prior to suit