Volume 23

23 Fla. L. Weekly Supp. 1077b

Online Reference: FLWSUPP 2310NAPOInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges is appropriate issue to be determined by summary judgment — Opposing affidavit filed by insurer does not preclude summary judgment in favor of medical provider on reasonableness issue where affidavit lacks evidence of sufficient facts or data, reliable principles and methods, or scientific knowledge and is akin to pure opinion testimony

23 Fla. L. Weekly Supp. 1075a

Online Reference: FLWSUPP 2310CORPInsurance — Personal injury protection — Expert witness — Insurer’s expert witness on reasonableness of charges is stricken where insurer has not demonstrated that proffered opinion, that reimbursement rate of 80% of 200% of Medicare fee schedule is maximum reasonable charge, is based on sufficient facts or data and product of reliable principles and methods and that witness has reliably applied principles and methods to facts of case

23 Fla. L. Weekly Supp. 596a

Online Reference: FLWSUPP 2306HOOKInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Opposing affidavits filed by insurer do not preclude partial summary judgment in favor of medical provider on issue of reasonableness of charges where affiants rely on fee schedules that are irrelevant to insurer that did not elect use of fee schedules in its policy and opinions of affiants are conclusory, not based on sufficient facts or data, not product of reliable principles or methods and do not reflect reliable application of principles and methods to facts

23 Fla. L. Weekly Supp. 206b

Online Reference: FLWSUPP 2303CHERInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Error to enter summary judgment in favor of insurer where supporting affidavit and admissions submitted by insurer were insufficient to refute provider’s allegations that the amount it charged for taking and reading x-rays was reasonable

23 Fla. L. Weekly Supp. 585a

Online Reference: FLWSUPP 2306OLKOInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Where insurer never alleged that it elected to limit reimbursement in accordance with statutory fee schedule but, instead, has challenged reasonableness of medical provider’s charge, factual dispute as to reasonableness of charge precludes summary judgment — Provider cannot rely on same medical bill that was rejected by insurer as unreasonable as prima facie evidence in support of its motion for summary judgment on reasonableness of charge

23 Fla. L. Weekly Supp. 1057a

Online Reference: FLWSUPP 2310MORAInsurance — Personal injury protection — Coverage — Medical expenses — Insurer that breached PIP policy by utilizing statutory fee schedule that was not clearly and unambiguously elected in policy when processing medical provider’s bill is not entitled to challenge reasonableness of charges

23 Fla. L. Weekly Supp. 1049a

Online Reference: FLWSUPP 2310TMORInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Where insurer waived all defenses to medical provider’s action for PIP benefits, including right to challenge reasonableness of charge, and unilaterally determined reasonableness of charge by applying statutory fee schedule not elected in policy when processing provider’s bill, reasonableness of charge is not at issue — Final judgment is entered in favor of provider for balance of improperly reduced bill

23 Fla. L. Weekly Supp. 958a

Online Reference: FLWSUPP 2309MATOInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Where insurer waived all defenses to medical provider’s action for PIP benefits, including right to challenge reasonableness of charge, and unilaterally determined reasonableness of charge by applying statutory fee schedule not elected in policy when processing provider’s bill, reasonableness of charge is not at issue — Final judgment is entered in favor of provider for balance of improperly reduced bill

23 Fla. L. Weekly Supp. 957a

Online Reference: FLWSUPP 2309CHAMInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Where insurer waived all defenses to medical provider’s action for PIP benefits, including right to challenge reasonableness of charge, and unilaterally determined reasonableness of charge by applying statutory fee schedule not elected in policy when processing provider’s bill, reasonableness of charge is not at issue — Final judgment is entered in favor of provider for balance of improperly reduced bill

23 Fla. L. Weekly Supp. 954a

Online Reference: FLWSUPP 2309CMERInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Where insurer waived all defenses to medical provider’s action for PIP benefits, including right to challenge reasonableness of charge, and unilaterally determined reasonableness of charge by applying statutory fee schedule not elected in policy when processing provider’s bill, reasonableness of charge is not at issue — Final judgment is entered in favor of provider for balance of improperly reduced bill