Volume 21

21 Fla. L. Weekly Supp. 879d

Online Reference: FLWSUPP 2109HJOHInsurance — Personal injury protection — Coverage — Medical expenses — Deductible — Amendment to PIP statute that altered manner in which deductible is calculated and decreased maximum deductible allowable is substantive change that cannot be applied retroactively to calculation of deductible under policy that was executed prior to amendment — Where it is impossible to determine whether jury, having heard evidence of deductible, did or did not apply deductible to expenses before rendering verdict, new trial is required — Trial court erred in concluding that jury’s verdict was not supported by evidence where jury did not find all medical bills necessary and reasonable

21 Fla. L. Weekly Supp. 868b

Online Reference: FLWSUPP 2109COTOInsurance — Personal injury protection — Coverage — Medical expenses — Deductible — Where it is impossible to determine whether jury, having heard evidence of deductible, did or did not apply deductible to expenses before rendering verdict, new trial is required — Expert witnesses — Where prior appellate court erred in incorporating provisions of 2008 PIP statute into 2001-2002 policy to determine scope of expert’s testimony, current appellate court is not bound to adhere to law of case — Error to admit expert’s deposition testimony on managed care fee schedules for purposes of evaluating reasonableness of medical charges — Statutory changes creating new reimbursement criteria cannot be applied retroactively to policy and transactions that predate enactment of those changes

21 Fla. L. Weekly Supp. 840a

Online Reference: FLWSUPP 2108FLORInsurance — Personal injury protection — Coverage — Emergency services — Deductible — Because insurer is mandated by statute to reserve $5,000 for emergency medical service providers, insurer should not have applied claim filed by plaintiff provider within that classification to deductible — Exhaustion of benefits is not defense to claim for emergency medical service provider’s bill applied to deductible

21 Fla. L. Weekly Supp. 798a

Online Reference: FLWSUPP 2108TASTInsurance — Personal injury protection — Coverage — Emergency services — Deductible — Because insurer is mandated by statute to reserve $5,000 for emergency medical service providers, insurer should not have applied claim filed by plaintiff provider within that classification to deductible — No merit to claim that provider has not met burden to prove that charge is reasonable where insurer’s motion for summary judgment was based solely on application of deductible, insurer did not challenge reasonableness of charge in explanation of benefits, and insurer’s utilization of permissive statutory fee schedule to pay charge establishes reasonableness of charge

21 Fla. L. Weekly Supp. 794b

Online Reference: FLWSUPP 2108ROMAInsurance — Personal injury protection — Coverage — Emergency services — Deductible — Because insurer is mandated by statute to reserve $5,000 for emergency medical service providers, insurer should not have applied claim filed by plaintiff provider within that classification to deductible — Exhaustion of benefits is not defense to claim for portion of emergency medical service provider’s bill applied to deductible

21 Fla. L. Weekly Supp. 436b

Online Reference: FLWSUPP 2105DUSSInsurance — Personal injury protection — Coverage — Medical expenses — Deductible — PIP statute and policy require that deductible be subtracted from total expenses and losses before statutory percentage limitations are applied

21 Fla. L. Weekly Supp. 40b

Online Reference: FLWSUPP 2101RHERInsurance — Personal injury protection — Coverage — Conditions precedent — Examination under oath may not serve as condition precedent for PIP coverage for policies issued prior to 2012

21 Fla. L. Weekly Supp. 881a

Online Reference: FLWSUPP 2109BENJInsurance — Personal injury protection — Coverage — Cancelled policy — Collateral estoppel — Trial court correctly barred insurer from pursuing affirmative defense that insured did not have coverage at time of accident due to cancellation of policy where issue had previously been litigated in action against insurer brought by different assignee of insured

21 Fla. L. Weekly Supp. 357a

Online Reference: FLWSUPP 2104TIMOInsurance — Personal injury protection — Demand letter — Medical provider may only sue for amount billed and specified in demand letter

21 Fla. L. Weekly Supp. 442c

Online Reference: FLWSUPP 2105CASTInsurance — Personal injury protection — Coverage — Medical expenses — Affirmative defenses — No merit to insurer’s claim that it timely tendered full payment requested in demand letter to medical provider where letter accompanying payment added condition reserving right to recover payment if any court determined that 2008 fee schedule could be applied retroactively to policies issued in 2007