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Volume 22

Case Search

DIRECT GENERAL INSURANCE COMPANY, Appellant, vs. EMERGENCY PHYSICIANS OF CENTRAL FLORIDA, LLC a/a/o Oriol Saintilma, Appellee.

22 Fla. L. Weekly Supp. 209b

Online Reference: FLWSUPP 2202SAINInsurance — 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 medical provider within that classification to deductible

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EMERGENCY PHYSICIANS OF CENTRAL FLORIDA, LLP, as assignee of Abigail Pelletier, Plaintiff, v. METROPOLITAN CASUALTY INSURANCE COMPANY, Defendant.

22 Fla. L. Weekly Supp. 164a

Online Reference: FLWSUPP 2201PELLInsurance — Personal injury protection — Coverage — Emergency services — Deductible — Because insurer is mandated by statute to reserve $5,000 for emergency service providers, insurer should not have applied claim by plaintiff provider within that classification to deductible

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SUNSET MEDICAL GROUP, INC. a/a/o SONIA M. PIMENTEL, Plaintiff, v. PROGRESSIVE SELECT INSURANCE COMPANY, Defendant.

22 Fla. L. Weekly Supp. 129c

Online Reference: FLWSUPP 2201PIMEInsurance — Personal injury protection — Declaratory actions — Complaint seeking declaration as to scope of coverage under policy and PIP statute when medical record contains conflicting opinions as to whether insured had emergency medical condition meets requirements for declaratory action — Motion to dismiss is denied

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ADVANTAGE HEALTH & WELLNESS CENTER, LLC, a Florida Corporation assignee of Slone, Cassandra, Plaintiff, v. PROGRESSIVE SELECT INSURANCE COMPANY, Defendant.

22 Fla. L. Weekly Supp. 749b

Online Reference: FLWSUPP 2206SLONInsurance — Personal injury protection — Coverage — Emergency medical condition — Declaratory action — Question as to whether, under PIP statute, reimbursement limit of $10,000 or $2,500 is applicable when record is silent as to existence of emergency medical condition is appropriate matter for declaratory relief — Motion to dismiss denied

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RAYMOND D. CLITES, DC, PA a/a/o McKenzie Klemkosky, Plaintiff, v. USAA GENERAL IND. CO., Defendant.

22 Fla. L. Weekly Supp. 967b

Online Reference: FLWSUPP 2208MKLEInsurance — Personal injury protection — Declaratory actions — Motion to dismiss declaratory action on ground that PIP policy was not attached to complaint is denied where action was filed by medical provider not typically in possession of policy, and insurer denied provider’s pre-suit request for policy — Motion to dismiss on ground that insured is minor who lacks capacity to assign benefits is denied — Provider’s motion to amend complaint to more specifically allege equitable assignment is granted

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MARTINEZ CHIROPRACTIC CENTER, INC. A/A/O MARCELLA DUQUE, Plaintiff, vs. MERCURY INDEMNITY COMPANY OF AMERICA, Defendant.

22 Fla. L. Weekly Supp. 447c

Online Reference: FLWSUPP 2204DUQUInsurance — Personal injury protection — Coverage — Medical expenses — Emergency medical condition — Amended complaint seeking declaratory relief regarding emergency medical condition provision in PIP statute denied, as complaint fails to make any allegations about plaintiff’s doubts concerning its rights or privileges and fails to allege plaintiff’s entitlement to have such doubts removed

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TURNER ORTHOPEDICS, PA A/A/O ESTELLE FUTRELL, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

22 Fla. L. Weekly Supp. 1082c

Online Reference: FLWSUPP 2209FUTRInsurance — Personal injury protection — Standing — Assignment — No merit to insurer’s contention that, because insured assigned benefits to both physician individually and professional association owned by physician, association lacks standing to bring suit for PIP benefits — Summary judgment is precluded by disputed issues of material fact as to whether physician or association maintains standing to bring action and whether insured intended to assign benefits to physician or to association — Complaint — Amendment — Leave is granted to amend complaint to name physician as plaintiff

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