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Volume 20

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ALHAMBRA HEALTH & REHAB, INC. a/a/o HENRY WANECER, Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

20 Fla. L. Weekly Supp. 268a

Online Reference: FLWSUPP 2003WANEInsurance — Personal injury protection — Counterclaims — Insurer cannot file counterclaim against medical provider in individual capacity where provider brought original action solely as assignee of patient — Because medical provider is not opposing party in individual capacity, and physician and other individuals named as counter-defendants are not parties to original action, entire counterclaim must be dismissed

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UNITED AUTOMOBILE INSURANCE COMPANY, Appellant, v. D. ABECKJERR, D.C., P.A., d/b/a CLOVERLEAF CHIROPRACTIC CLINIC, a/a/o Brunet Gedeon, Appellee.

20 Fla. L. Weekly Supp. 21a

Online Reference: FLWSUPP 2001GEDEInsurance — Personal injury protection — Expert witnesses — Abuse of discretion to exclude expert witness not disclosed in accordance with pretrial order where medical provider cannot claim surprise because insurer provided provider with expert’s peer review report and disclosed intent to rely on expert’s opinion, and there is no evidence that insurer’s failure to comply with pretrial order was willful or motivated by bad faith

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T&M DIAGNOSTIC SERVICE INC., a/a/o RIGOBERTO GUTIERREZ Appellant, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Appellee.

20 Fla. L. Weekly Supp. 373a

Online Reference: FLWSUPP 2004GUTIInsurance — Personal injury protection — Coverage — Medical expenses — Examination under oath — Trial court erred in entering summary judgment in favor of insurer on ground that failure of an insured to provide answers for certain questions asked during examination under oath conducted by the insurer was tantamount to a failure to submit to a contractually mandated EUO and constituted a failure to fulfill a condition precedent to lawsuit for PIP benefits — Because insurer asserted in its affirmative defense that insured refused to answer “material” questions, insurer was obligated to establish materiality of unanswered questions — Whether an insured’s refusal to answer certain questions at an EUO amounts to a failure to cooperate is a question which requires an evaluation of the degree of cooperation and, accordingly, a question for factfinder rather than an issue for judicial determination on a motion for summary judgment — Condition subsequent — Under statute in effect at time policy was issued, submitting to EUO was condition subsequent, not a condition precedent to coverage

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STAND-UP MRI & DIAGNOSTIC CENTER, P.A., as assignee of Lekisha Burke, Plaintiff, v. LIBERTY MUTUAL INSURANCE COMPANY, Defendant.

20 Fla. L. Weekly Supp. 732b

Online Reference: FLWSUPP 2007BURKInsurance — Personal injury protection — Evidence — Judicial notice — Policy endorsementSTAND-UP MRI & DIAGNOSTIC CENTER, P.A., as assignee of Lekisha Burke, Plaintiff, v. LIBERTY MUTUAL INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 2012-SC-360. December 10, 2012. Jerri L. Collins, Judge. Counsel: David B. Alexander, Bradford Cederberg, Orlando, for Plaintiff. Maddge B. Penton, Orlando, for Defendant.

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PERSONAL CHIROPRACTIC CARE CENTER, INC. (A/A/O MARTINE BRUNY), Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

20 Fla. L. Weekly Supp. 1002b

Online Reference: FLWSUPP 2010BRUNInsurance — Personal injury protection — Discovery — Reasons why individual bills were not paid at 80% or 100%, name and address of person employed by insurer who has most knowledge of why each individual bill was not paid at 80%or 100%, and name and address of each person who will testify at trial as to why each individual was not paid at 80% or 100% — Range of charges submitted by all providers in particular zip for certain CPT codes — Motion to compel better answers granted

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XTREME CHIROPRACTIC & REHAB, INC., a Florida Corporation (assignee of Park, Jeena), Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

20 Fla. L. Weekly Supp. 620a

Online Reference: FLWSUPP 2006XTREInsurance — Personal injury protection — Demand letter that contained itemized statement in form of billing ledger and stated amount claimed to be due satisfied statutory condition precedent to suit — Statute does not require that demand letter state amount ultimately determined to be due or itemized statement of amount claimed by CPT code

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AMERICAN MOBILE HEALTH SERVICES (a/a/o Jose Sevillano), I & J REHABILITATION CENTER INC. (a/a/o Jose Sevillano), AMERICAN MOBILE HEALTH SERVICES (a/a/o Andy Rodriguez), AMERICAN MOBILE HEALTH SERVICES (a/a/o Juan Rosario), Appellants, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE CO., Appellee.

20 Fla. L. Weekly Supp. 123a

Online Reference: FLWSUPP 2002SEVIInsurance — Personal injury protection — Demand letter — Demand letters which contained incorrect claim numbers and either failed to reference policy number or referenced incorrect policy number were legally insufficient — Trial court did not err in granting summary judgment in favor of insurer due to insufficiency of demand letters

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FOUNDATION CHIROPRACTIC CLINIC, INC. a/a/o DIEGO SOLORZANO, Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

20 Fla. L. Weekly Supp. 694c

Online Reference: FLWSUPP 2007SOLOInsurance — Personal injury protection — Demand letter — Where billing ledger attached to demand letter contained incorrect double charge for one date of service, demand letter was defective and failed to satisfy condition precedent to suit — Final summary judgment is entered for insurer

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