Volume 22

22 Fla. L. Weekly Supp. 835c

Online Reference: FLWSUPP 2207MUSEInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Affidavits filed by medical provider are sufficient to meet provider’s burden on summary judgment regarding reasonableness of x-ray charges where affidavits set forth factual basis for opinions — Opposing affidavit and independent medical examination report filed by insurer do not preclude summary judgment in favor of provider on issue of reasonableness of charges where IME report concludes that charges were reasonable and affidavit is conclusory and lacks foundation

22 Fla. L. Weekly Supp. 1100a

Online Reference: FLWSUPP 2209DIAZInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Opposing affidavit filed by insurer does not preclude summary judgment in favor of medical provider on issue of reasonableness of MRI charge where affidavit lacks evidence that opinion is based on sufficient facts or data or is product of reliable principles and methods or scientific knowledge — Fact that provider routinely accepts less than charged amount for services provided under HMO and PPO contracts does not create factual issue as to reasonableness of charge

22 Fla. L. Weekly Supp. 167a

Online Reference: FLWSUPP 2201RAMIInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Provider made prima facie showing of reasonableness of its charges by presenting medical bill for service at issue and affidavit of fact witness explaining how price was set — Affidavit presented by insurer did not preclude summary judgment in favor of provider on issue of reasonableness where affidavit was not based on sufficient facts or data and was not product of reliable principles and method

22 Fla. L. Weekly Supp. 285b

Online Reference: FLWSUPP 2202FAVEInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Opposing affidavit filed by insurer does not preclude summary judgment in favor of medical provider on issue of reasonableness of MRI charge where affidavit presents inadmissible lay opinion testimony and is conclusory — Fact that Medicare, workers’ compensation and other government payors pay less than amount billed by provider does not, by itself, create factual issue as to reasonableness of charge

22 Fla. L. Weekly Supp. 1174a

Online Reference: FLWSUPP 2210ROBIInsurance — Personal injury protection — Coverage — Medical expenses — Evidence — Insurer that did not amend its policy to elect payment under permissive statutory fee schedule is precluded from mentioning section 627.736(5)(a)(2)2 or payments made by insurers who have used permissive statutory fee schedule

22 Fla. L. Weekly Supp. 135b

Online Reference: FLWSUPP 2201BLANInsurance — Personal injury protection — Coverage — Medical expenses — Evidence — Insurer is precluded from mentioning or asking witnesses about section 627.736(5)(a)2

22 Fla. L. Weekly Supp. 833b

Online Reference: FLWSUPP 2207CLAVInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Opposing affidavits filed by insurer do not preclude summary judgment in favor of medical provider on issue of reasonableness of x-ray charges where affidavits are conclusory, lack foundation, and are contrary to insurer’s previous position, and affiants are not qualified to render opinion on reasonableness of charges — Insurer is precluded from relying on Medicare fee schedule to determine reimbursement level when it did not adopt fee schedule in its policy

22 Fla. L. Weekly Supp. 271b

Online Reference: FLWSUPP 2202MEJIInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Where it is undisputed that insurer did not adopt permissive statutory fee schedule in PIP policy, it is precluded from relying on Medicare Part B fee schedule in reimbursement of claim — Opposing affidavit filed by insurer does not preclude summary judgment in favor of medical provider on issue of reasonableness of charges where affiant’s opinions are not based on sufficient facts or data and are not product of reliable principles and methods

22 Fla. L. Weekly Supp. 142a

Online Reference: FLWSUPP 2201BAPTInsurance — Personal injury protection — Evidence — Motion in limine to exclude reference to rates contracted with health insurance companies and Medicare and workers’ compensation fee schedules is granted — Health insurance rates and fee schedules are irrelevant to PIP case, and any probative value is substantially outweighed by danger of unfair prejudice, confusing issues, and misleading jury

22 Fla. L. Weekly Supp. 837a

Online Reference: FLWSUPP 2207FERRInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Medicare and TriCare fee schedules filed by insurer do not preclude summary judgment in favor of medical provider on issue of reasonableness of charges — Medical provider is not required to provide expert testimony regarding reasonableness of medical bills; prima facie showing of reasonableness can be established by presenting bills along with testimony that services were provided to insured