Volume 23

23 Fla. L. Weekly Supp. 584b

Online Reference: FLWSUPP 2306CARRInsurance — Personal injury protection — Demand letter — Pre-suit demand letter does not satisfy statutory condition precedent to suit where neither letter nor attached ledger reflect partial payments made by insurer — No merit to medical provider’s argument that letter substantially complied with notice requirements since insurer should be able to discern exact amount claimed to be due — Strict compliance with notice requirements is required

23 Fla. L. Weekly Supp. 769a

Online Reference: FLWSUPP 2307COYLInsurance — Personal injury protection — Demand letter — Abatement of PIP action is not proper remedy for filing demand letter that is defective for failing to account for prior payments made by insurer

23 Fla. L. Weekly Supp. 277a

Online Reference: FLWSUPP 2303WADEInsurance — Personal injury protection — Demand letter was defective where letter did not state exact amount due, or any amount due, and did not attach itemized statement from providers — Fact that the only issue in dispute was whether insurer improperly limited benefits to $2500 does not change result — Motion for summary judgment based on defective demand letter is granted

23 Fla. L. Weekly Supp. 549b

Online Reference: FLWSUPP 2306MWHAInsurance — Personal injury protection — Demand letter — Sufficiency — PIP statute does not require that demand letter calculate exact amount owed by insurer — By attaching ledger to demand letter, medical provider satisfied section 627.736(10)

23 Fla. L. Weekly Supp. 281a

Online Reference: FLWSUPP 2303PRODInsurance — Personal injury protection — Demand letter — Amended complaint — Medical provider was required to send new demand letter prior to filing amended complaint seeking payment for additional dates of service that were not included in initial demand letter — Amended complaint is stricken without prejudice

23 Fla. L. Weekly Supp. 389b

Online Reference: FLWSUPP 2305LGREInsurance — Personal injury protection — Wage loss — Summary judgment — Small claims — Trial court did not err in proceeding under rule 1.510 regarding summary judgment in wage loss claim that had been transferred from circuit court to county court where parties continued to litigate case in county court under rules of civil procedure without objection — Error to grant summary judgment in favor of insurer on basis that insured had not filed affidavit or other hard evidence in opposition to motion for summary judgment where complaint that included insured’s ledger showing loss of income from his mobile barbeque business and admissions in which insured denied that he had not suffered any wage loss as result of accident were already filed with court when it heard motion — Further, trial court erred in granting summary judgment when good faith discovery was still in progress

23 Fla. L. Weekly Supp. 653a

Online Reference: FLWSUPP 2306DOWAInsurance — Personal injury protection — Coverage — Medical expenses — MRI — Usual and customary charges — Where policy required reimbursement of 80% of reasonable expenses, insurer erred in reducing claim based on usual and customary charges “in the community” and subsequently paying 80% of the reduced amount — Language referencing usual and customary charges in the community is only located within statutory fee schedule, and policy did not unambiguously give notice of insurer’s election to use statutory fee schedules — Under circumstances, reasonableness of charges is no longer at issue, and provider’s bill represents prima facie evidence of reasonable expense

23Fla. L. Weekly Supp. 260a

Online Reference: FLWSUPP 2303PATTInsurance — Personal injury protection — Coverage — Medical expenses — Insurer’s motion for summary judgment is procedurally deficient for failure to attach complete copy of policy — Motion for summary judgment is denied due to ambiguity in policy that allows insurer to choose to reimburse according to permissive statutory fee schedule or reasonableness method

23 Fla. L. Weekly Supp. 683a

Online Reference: FLWSUPP 2307BLAKInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy providing that any amounts payable “shall be subject to any and all limitations” authorized by PIP statute “including, but not limited to, all fee schedules” does not provide clear and unambiguous notice of intent to limit reimbursement to Medicare Part B fee schedule

23 Fla. L. Weekly Supp. 751b

Online Reference: FLWSUPP 2307HSMIInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy that advises that medical benefits means 80% of all reasonable and medically necessary expenses at 200% of amount allowed under physician schedule of Medicare Part B clearly and unambiguously elects to limit reimbursement to permissive statutory fee schedule