Volume 19

19 Fla. L. Weekly Supp. 432a

Online Reference: FLWSUPP 1906MIAMInsurance — Personal injury protection — Coverage — Policy issued during statutory gap period — Retroactive application of 2008 version of PIP statute to policy issued prior to enactment of statute was unconstitutional infringement on parties’ right to contract with one another where effect of application of 2008 statute was substantial reduction in coverage

19 Fla. L. Weekly Supp. 60a

Online Reference: FLWSUPP 1901TOMOInsurance — 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 opinion by district court of appeal disallowing use of OPPS cap

19 Fla. L. Weekly Supp. 928a

Online Reference: FLWSUPP 1911KEITInsurance — Personal injury protection — Coverage — Medical expenses — MRI — Where PIP policy provides that insurer will pay 80% of reasonable medical expenses, and statutory fee schedule limiting amount medical providers could charge for MRI services was automatically repealed through sunsetting after policy was issued but prior to insured’s accident, insurer was not entitled to limit reimbursement under statutory fee schedule — Insurer had no vested right or legitimate expectation in continuing statutory fee limitations beyond date of sunsetting where insurer knew of scheduled sunsetting before policy was issued

19 Fla. L. Weekly Supp. 51b

Online Reference: FLWSUPP 1901FULLInsurance — Personal injury protection — Coverage — Medical provider’s motion for partial summary judgment as to applicability of Medicare fee schedule is granted where Medicare fee schedule language was not included in policy, and prior explanation of benefits did not put medical provider on proper notice of intent to pay pursuant to that fee schedule

19 Fla. L. Weekly Supp. 854c

Online Reference: FLWSUPP 1910WALKInsurance — Personal injury protection — Coverage — Lawfully rendered treatment — Inadequacy of medical provider’s record keeping is not lawful basis for nonpayment of PIP benefits — Affirmative defense stricken

19 Fla. L. Weekly Supp. 373a

Online Reference: FLWSUPP 1905BRANCriminal law — Driving under influence — Speeding — Search and seizure — Field sobriety exercises — Neither odor of alcohol emanating from vehicle and defendant’s person, observation of “slightly” bloodshot eyes after officer removed defendant from vehicle, nor fact that defendant was driving at an estimated speed of 46 mph in a 35-mph zone provided the reasonable suspicion necessary to justify requesting that defendant perform field sobriety exercises — Motion to suppress granted

19 Fla. L. Weekly Supp. 591b

Online Reference: FLWSUPP 1907VELAInsurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered services — Medical provider that is health care clinic, not massage establishment, and holds valid health care clinic license from Agency for Health Care Administration was not required to have massage establishment license in order to lawfully render massage services

19 Fla. L. Weekly Supp. 561b

Online Reference: FLWSUPP 1907SCHLInsurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered services — Despite being issued a clinic exemption by Agency for Health Care Administration, medical provider was not wholly owned by licensed physician where management company held equitable or security interest in provider, and sham owner did not have indicia of ownership — Further, management company improperly exercised control over provider’s treatment and business decisions in violation of statute governing chiropractic medicine — Because provider’s services were not lawfully rendered, they are not compensable under PIP statute

19 Fla. L. Weekly Supp. 52a

Online Reference: FLWSUPP 1901NORTInsurance — Personal injury protection — Coverage — Exhaustion of policy limits — Post-suit exhaustion of benefits — Questions certified

19 Fla. L. Weekly Supp. 588a

Online Reference: FLWSUPP 1907MITEInsurance — Personal injury protection — Coverage — Medical expenses — Exhaustion of policy limits — Where medical provider timely filed claim for reasonable, related and medically necessary MRI covered under PIP policy, insurer failed to pay claim within 30 days, and, after paying later-received claims, insurer made partial payment to provider that exhausted policy limits, insurer deviated from statutorily mandated order of payment and is required to pay balance of provider’s bill — Where provider gave notice of assignment and claim against policy before subsequent assignees gave notice, payments to subsequent assignees are erroneous and gratuitous payments that cannot count against insured’s PIP benefits