Volume 22

22 Fla. L. Weekly Supp. 508a

Online Reference: FLWSUPP 2205CAMPInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Trial court did not abuse its discretion by excluding opposing affidavit filed by insurer on issue of reasonableness of MRI charge where affiant had no personal knowledge of charges in community and could not attest to truthfulness or reliability of data used to form his opinion that medical provider’s charge was not reasonable — Evidence that medical provider routinely accepted less from other vendors than it charged insurer for same services may be relevant in determining whether charges were unreasonable, but that information alone, even if uncontested, is not sufficient to prove that charges were unreasonable

22 Fla. L. Weekly Supp. 238b

Online Reference: FLWSUPP 2202PROGInsurance — Personal injury protection — Coverage — Lawfully rendered services — Where medical provider was not licensed by state and did not fall within licensing exemption for clinics that are wholly owned by licensed health care practitioners, neither insurers nor insureds are liable to provider for charges for services

22 Fla. L. Weekly Supp. 846a

Online Reference: FLWSUPP 2207MONSInsurance — Personal injury protection — Coverage — Lawfully rendered services — Where, during time of insured’s treatment, medical provider falsely identified licensed massage therapist as owner of provider in order to circumvent requirements of PIP statute and Florida Health Care Clinic Act, neither insurer nor insured are liable to provider for charges for services

22 Fla. L. Weekly Supp. 845b

Online Reference: FLWSUPP 2207SANTInsurance — Personal injury protection — Coverage — Lawfully rendered services — Where, during time of insured’s treatment, medical provider falsely identified licensed massage therapist as owner of provider in order to circumvent requirements of PIP statute and Florida Health Care Clinic Act, neither insurer nor insured are liable to provider for charges for services

22 Fla. L. Weekly Supp. 722a

Online Reference: FLWSUPP 2206SASSInsurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered treatment — Affirmative defense of failure to comply with provision of Health Care Clinic Act concerning medical director is stricken — Insurer cannot state cause of action for perceived violation of Act absent independent determination of violation by Agency for Health Care Administration, and affirmative defense is barred by insurer’s own actions in finding claim compensable and reimbursing medical provider under statutory fee schedule

22 Fla. L. Weekly Supp. 949b

Online Reference: FLWSUPP 2208IMPEInsurance — Personal injury protection — Coverage — Medical expenses — Lawful charges — Provider which was not licensed as a clinic under Health Care Clinic Act was not eligible to receive reimbursement under PIP statute where provider did not qualify for one of exceptions delineated in statute — Provider in instant case, which is wholly owned by licensed massage therapist, does not qualify for any of the statutory exceptions from licensure — Insurer is not legally obligated to pay pending claim

22 Fla. L. Weekly Supp. 39a

Online Reference: FLWSUPP 2201METEInsurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered services — Where medical provider failed to comply or substantially comply with requirements of Health Care Clinic Act concerning appointment of medical director, services rendered were not lawful and compensable — Error to grant summary judgment in favor of provider

22 Fla. L. Weekly Supp. 649b

Online Reference: FLWSUPP 2205STEPInsurance — Personal injury protection — Coverage — Medical expenses — Initial treatment within 14 days after accident — Where PIP policy contains amendatory endorsement adopting 2013 PIP statute requirement that party seeking PIP benefits must receive initial treatment within 14 days after accident, insurer has no obligation to pay claim submitted by assignee of insured who did not receive initial treatment within 14 days after accident

22 Fla. L. Weekly Supp. 117b

Online Reference: FLWSUPP 2201HUFFInsurance — Personal injury protection — Declaratory judgment — Coverage — Medical expenses — Former husband who is named driver in PIP policy issued to ex-wife is entitled to coverage under ex-wife’s policy for injuries suffered while driving vehicle that was titled solely in name of ex-wife — Where former husband was allowed to use vehicle under terms of marital settlement agreement, but there was no agreement to sell vehicle or transfer title to him, former husband was not owner or beneficial owner of vehicle

22 Fla. L. Weekly Supp. 380a

Online Reference: FLWSUPP 2203RFRAInsurance — Personal injury protection — Coverage — Medical expenses — Exhaustion of policy limits — Where benefits were exhausted in payment of other medical providers before plaintiff filed suit, insurer is entitled to summary judgment