Volume 20

20 Fla. L. Weekly Supp. 806a

Online Reference: FLWSUPP 2008JPHIInsurance — Personal injury protection — Complaint — Amendment — Medical provider’s motion to amend complaint to correct name of insurer is granted — Two insurers who have same addresses and contact person are sufficiently related, and provider moved to amend in timely manner

20 Fla. L. Weekly Supp. 1000b

Online Reference: FLWSUPP 2010SPEInsurance — Personal injury protection — Plaintiff granted leave to amend complaint to correct name of defendant — Leave to amend was sought in timely manner, and amendment will result in no prejudice to defendant

20 Fla. L. Weekly Supp. 1239b

Online Reference: FLWSUPP 2012ALCIInsurance — Personal injury protection — Fraud — False and misleading statement relating to claim or charges — Where medical provider knowingly submitted claim forms that included name and license number of physician who had stopped working for provider prior to claimed dates of service, provider’s entire claim is barred

Online Reference: FLWSUPP 2002GLOUInsurance — Personal injury protection — Standing — Assignment — Dissolved corporation — Where medical provider was administratively dissolved for failure to file annual report on date it accepted assignments from insureds and during period of treatment but was not in pursuit of winding up its affairs and was subsequently reinstated by Department of State, insurer cannot rely on dissolution as defense to paying PIP claims — Notice of covered loss — Although some claim forms submitted by provider did not contain license number of person performing treatment, where insurer did not notify provider of missing numbers and continued to process claim by sending insured to independent medical examination, forms were substantially complete

20 Fla. L. Weekly Supp. 179a

Online Reference: FLWSUPP 2002HEALInsurance — Personal injury protection — Standing — Assignment — Dissolved corporation — Where medical provider was administratively dissolved for failure to file annual report on date it accepted assignments from insureds and during period of treatment, but was not in pursuit of winding up its affairs and was subsequently reinstated by Department of State, insurer cannot rely on dissolution as defense to paying PIP claims — Notice of covered loss — Although some claim forms submitted by provider did not contain license number of person performing treatment, where insurer did not notify provider of missing numbers and continued to process claim by sending insured to independent medical examination, forms were substantially complete

20 Fla. L. Weekly Supp. 73a

Online Reference: FLWSUPP 2001ETIEInsurance — Personal injury protection — Affirmative defenses — CPT coding — Insurer was not entitled to deny payment of PIP benefits on ground that medical provider failed to submit claims coded in compliance with National Correct Coding Initiative — Demand letter was not defective where letter stated amount of demand and insurer’s response indicated it knew contents of demand

20 Fla. L. Weekly Supp. 1217a

Online Reference: FLWSUPP 2012BEARInsurance — Personal injury protection — Coverage — Medical expenses — CPT coding — Insurer correctly downcoded CPT code which had been inappropriately upcoded by medical provider

20 Fla. L. Weekly Supp. 160a

Online Reference: FLWSUPP 2002TOWLInsurance — Personal injury protection — Motion to amend answer after two years of litigation to raise new affirmative defenses disputing standing based on final judgment in class action involving same claims is denied where insurer has no reasonable explanation for why it failed to timely notify medical provider of class action in response to demand letter

20 Fla. L. Weekly Supp. 804b

Online Reference: FLWSUPP 2008MOORInsurance — Personal injury protection — Affirmative defenses — Amendment — Motion to amend affirmative defenses to assert defense that medical provider’s claim is barred by settlement agreement in class action suit since neither provider nor insured opted out of class action is denied where insurer filed motion to amend three years after provider filed suit and six years after it knew about class action settlement and provider would be substantially prejudiced by amendment

20 Fla. L. Weekly Supp. 873a

Online Reference: FLWSUPP 2009KOVANOT FINAL VERSION OF OPINION
Subsequent Changes at 20 Fla. L. Weekly Supp. 1152aInsurance — Personal injury protection — Answer — Amendment — Abuse of discretion to deny insurer’s motion to amend answer to assert potentially conclusive defense of res judicata based on class action settlement where insurer had not previously sought to amend answer, amendment would not have been futile as motion was supported by settlement documents and would constitute complete defense if proven, and medical provider would not have been prejudiced by granting motion filed before trial and summary judgment hearing to add issue that had been raised numerous times before motion was filed