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Volume 23

Case Search

NEUROLOGY PARTNERS, P.A. d/b/a EMAS SPINE & BRAIN a/a/f JUDI FULCO, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant

24 Fla. L. Weekly Supp. 52b

Online Reference: FLWSUPP 2401FULCInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy providing that insurer will pay 80% of reasonable expenses and also stating that to determine whether a charge is reasonable insurer may consider any and all limitations authorized by PIP statute and will not pay more than 80% of 200% of Medicare Part B fee schedule provides clear and unambiguous notice of intent to limit reimbursement to permissive statutory fee schedule

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NEUROLOGY PARTNERS, P.A. d/b/a EMAS SPINE & BRAIN SPECIALISTS, a/a/o KELLY BAGGETT, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

24 Fla. L. Weekly Supp. 52a

Online Reference: FLWSUPP 2401BAGGInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy providing that insurer will pay 80% of reasonable expenses but also providing that amount payable “shall be subject to any and all limitations” authorized by PIP statute, including all fee schedules, clearly and unambiguously elects to limit reimbursement to permissive statutory fee schedule

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NEUROLOGY PARTNERS, P.A., D/B/A EMAS SPINE & BRAIN SPECIALISTS, as assignee for ROSALIE DUNN, Plaintiff, v. PROGRESSIVE SELECT INSURANCE COMPANY, Defendant.

24 Fla. L. Weekly Supp. 624a

Online Reference: FLWSUPP 2408DUNNInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy that states that insurer will pay 80% of all reasonable medical expenses considering all limitations authorized by PIP statute and that applicable fee schedule or payment limitation shall be under permissive payment methodology clearly and unambiguously elects to limit reimbursement to permissive statutory fee schedule

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CRESPO & ASSOCIATES, P.A., as assignee of HERBERT VILLANUEVA, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant

24 Fla. L. Weekly Supp. 714b

Online Reference: FLWSUPP 2409VILLInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy that states that insurer will only pay reasonable medical expenses but in no event will pay more than 80% of No-Fault Act schedule of maximum charges provides legally sufficient notice of intent to limit reimbursement to permissive statutory fee schedule

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ROY GOODMAN, D.C., P.A. d/b/a FLORIDA SPINE & WELLNESS GROUP as assignee of Paul McDermott, Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

24 Fla. L. Weekly Supp. 368a

Online Reference: FLWSUPP 2405MCDEInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy providing that insurer will pay 80% of reasonable expense but also providing that in no event will insurer pay more than 80% of No-Fault Act schedule of maximum charges does not provide clear and unambiguous notice of intent to limit reimbursement to permissive statutory fee schedule

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CEDA HEALTH OF DOWNTOWN, a/a/o, Elio Serra, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant.

24 Fla. L. Weekly Supp. 81a

Online Reference: FLWSUPP 2401SERRInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy providing that insurer will pay 80% of reasonable expenses but also providing that in no event will insurer pay more than 80% of schedule of maximum charges does not provide clear and unambiguous notice of election to limit reimbursement to permissive statutory fee schedule

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NEUROLOGY PARTNERS, P.A. D/B/A EMAS SPINE & BRAIN SPECIALISTS as assignee for Daniel Irvin, Plaintiff, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant.

24 Fla. L. Weekly Supp. 689a

Online Reference: FLWSUPP 2409IRVIInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy that defines “unreasonable and unnecessary benefit” to be anything in excess of maximum charges set forth in No-Fault Law and states that it will limit reimbursement of unreasonable and unnecessary benefits to no more than 80% of listed maximum charges, clearly and unambiguously elects to limit reimbursement to permissive statutory fee schedule

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CENTRAL FLORIDA MEDICAL & CHIROPRACTIC CENTER, INC., d/b/a FLORIDA MRI CENTER, a/a/o NEL JOFFE, Plaintiff, vs. PERMANENT GENERAL ASSURANCE CORPORATION, Defendant.

24 Fla. L. Weekly Supp. 694b

Online Reference: FLWSUPP 2409JOFFInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy that states that insurer will pay 80% of medical expenses subject to applicable fee schedule and defines “medical expenses” as properly billed and lawfully rendered reasonable charges limited to the medical expense limitations schedule set forth in section 627.736(5)(a) clearly and unambiguously elects to limit reimbursement to permissive statutory fee schedule

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NEUROLOGY PARTNERS, P.A. D/B/A EMAS SPINE & BRAIN SPECIALISTS as assignee for KAREN HAMILTON, Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant.

24 Fla. L. Weekly Supp. 535a

Online Reference: FLWSUPP 2407HAMIInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy that defines “unreasonable or unnecessary medical benefits” to be anything in excess of maximum charges set forth in No-Fault Law and affirmatively states that insurer will limit reimbursement to no more than 80% of schedule of maximum charges clearly and unambiguously elects to limit reimbursement to permissive statutory fee schedule

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