Volume 22

22 Fla. L. Weekly Supp. 271a

Online Reference: FLWSUPP 2202PERLInsurance — Personal injury protection — Where there is no reasonable explanation for insurer’s failure to inform medical provider of exhaustion of benefits until six months after exhaustion and four months after filing of suit, trial court exercises its inherent authority to impose sanctions for bad faith conduct

22 Fla. L. Weekly Supp. 185b

Online Reference: FLWSUPP 2202CROBInsurance — Personal injury protection — Coverage — Exhaustion of policy limits — Although at time insurer exhausted benefits and medical provider filed suit over claims paid pursuant to permissive statutory fee schedule Florida Supreme Court had not yet ruled on issue of whether insurer could calculate reimbursement utilizing fee schedule without electing to do so in policy, binding precedent from district courts of appeal already required that insurer elect statutory fee schedule before reducing payment — Accordingly, post-suit exhaustion of benefits may not shield insurer from liability — Remand to trial court to determine whether $6.00 payment that exhausted benefits was gratuitous payment, and if so, to enter judgment for provider

22 Fla. L. Weekly Supp. 1167a

Online Reference: FLWSUPP 2210CHAVInsurance — Personal injury protection — Coverage — Exhaustion of policy limits — In absence of any evidence of bad faith, where benefits were exhausted in payment of other medical providers before assignee of medical provider filed suit for balance of reduced claim, insurer is entitled to summary judgment — Insurer was not required to reserve funds for claim reduced through erroneous application of statutory fee schedule and is not liable for balance of reduced claim after exhaustion of benefits

22 Fla. L. Weekly Supp. 637a

Online Reference: FLWSUPP 2205LEIVInsurance — Personal injury protection — Coverage — Exhaustion of policy limits — In absence of any evidence of bad faith, where benefits were exhausted in payment of other medical providers before assignee of medical provider filed suit for balance of reduced claim, insurer is entitled to summary judgment — Insurer was not required to reserve funds for claim reduced through erroneous application of statutory fee schedule and is not liable for balance of reduced claim after exhaustion of benefits

22 Fla. L. Weekly Supp. 630a

Online Reference: FLWSUPP 2205GUARInsurance — Personal injury protection — Coverage — Medical expenses — Exhaustion of policy limits — In absence of bad faith, post-suit exhaustion of benefits absolves insurer from responsibility to pay otherwise valid claim

22 Fla. L. Weekly Supp. 161a

Online Reference: FLWSUPP 2201CHAMInsurance — Personal injury protection — Evidence — Motion in limine is denied where mere mention of items at trial would not be prejudicial or could be cured or possibility of mention at trial is merely speculative

22 Fla. L. Weekly Supp. 943a

Online Reference: FLWSUPP 2208LORRInsurance — Personal injury protection — Coverage — Emergency medical condition — Determination by qualified medical provider that insured had broken bone in her wrist that caused extreme pain and seriously interfered with her ability to function at work satisfied requirement for determination of emergency medical condition despite provider’s failure to use phrase “emergency medical condition” — Insured is entitled to reimbursement of medical expenses up to $10,000

22 Fla. L. Weekly Supp. 1103a

Online Reference: FLWSUPP 2209YENGInsurance — Personal injury protection — Coverage — Emergency medical condition — Under amendments to PIP statute requiring PIP insurer to pay benefits up to $10,000 if qualified medical provider has determined that claimant had emergency medical condition and limiting reimbursement to $2,500 if qualified provider has determined that claimant did not have emergency medical condition, insurer properly limited benefits to $2,500 where qualified provider has not determined that insured suffered emergency medical condition — No merit to argument that insurer was required to pay benefits up to $10,000 unless there was determination of absence of emergency medical condition

22 Fla. L. Weekly Supp. 617a

Online Reference: FLWSUPP 2205BAPTInsurance — Personal injury protection — Coverage — Emergency medical condition — Physician who did not provide any services or care to claimant is not qualified medical provider for purposes of determining whether claimant had emergency medical condition — Non-treating physician’s determination that claimant did not have emergency medical condition does not limit reimbursement to $2,500 when treating physician has determined that claimant had emergency medical condition — PIP statute does not permit insurer to challenge determination of qualified provider that claimant had emergency medical condition

22 Fla. L. Weekly Supp. 448a

Online Reference: FLWSUPP 2204WEINInsurance — Personal injury protection — Coverage — Emergency medical condition — Under amendments to PIP statute requiring PIP insurer to pay benefits up to $10,000 if qualified medical provider has determined that claimant had emergency medical condition and limiting reimbursement to $2,500 if qualified provider has determined that claimant did not have emergency medical condition, insurer properly limited benefits to $2,500 where qualified provider has not determined that insured suffered emergency medical condition — No merit to argument that insurer was required to pay benefits up to $10,000 unless there was determination of absence of emergency medical condition