Volume 24

24 Fla. L. Weekly Supp. 152a

Online Reference: FLWSUPP 2402CHERInsurance — Personal injury protection — Coverage — Medical expenses — Examination under oath — Failure to attend — Where insurer did not request EUO until more than thirty days after receipt of medical provider’s bills and did not send letter to provider required to extend time for investigation under section 627.736(4)(i), insured’s failure to attend EUO did not breach PIP policy

24 Fla. L. Weekly Supp. 169a

Online Reference: FLWSUPP 2402ZAPAInsurance — Personal injury protection — Coverage — Medical expenses — Where CPT code for drug administered in non-emergency office setting is not reimbursable under Medicare Part B fee schedule or workers’ compensation fee schedule, CPT code is not reimbursable under PIP statute and PIP policy that limits reimbursement to permissive statutory fee schedule

24 Fla. L. Weekly Supp. 768b

Online Reference: FLWSUPP 2409KELLInsurance — Coverage — Medical expenses — Plaintiff to amend complaint or, alternatively, file statement of particulars specifying exact date or dates of services and CPT codes plaintiff contends are at issue

24 Fla. L. Weekly Supp. 724b

Online Reference: FLWSUPP 2409ESPIInsurance — Personal injury protection — Complaint — Amendment — Where mid-suit demand letter requesting reimbursement for additional dates of service not covered in original complaint was procedurally invalid for having been sent to insurer that was represented by counsel without service or notice to counsel, and medical provider’s subsequent motion for leave to amend complaint was filed shortly before hearing on insurer’s motion for summary judgment on original complaint, court abates action for 30 days to allow insurer and its counsel to confer on response to new demand letter — Any additional payment on claim made by insurer within 30-day period will not constitute confession of judgment or otherwise create right to attorney’s fees — Provider has leave to file amended complaint after 30-day period

24 Fla. L. Weekly Supp. 462a

Online Reference: FLWSUPP 2406FERNInsurance — Personal injury protection — Arbitration — Where parties did not request trial de novo within deadline for such request, trial court must enter judgment in accordance with arbitrator’s decision despite insurer’s claim that its failure to timely request trial de novo was result of mistake or inadvertence

24 Fla. L. Weekly Supp. 840a

Online Reference: FLWSUPP 2410LEONInsurance — Personal injury protection — Answer — Amendment — Denial — Motion to amend answer to assert affirmative defense relating to PIP statute’s 35-day billing requirement is denied — Amendment would be futile because requirement is not applicable to plaintiff hospital

24 Fla. L. Weekly Supp. 993b

Online Reference: FLWSUPP 2411JOHNInsurance — Personal injury protection — Provider’s motion to strike insurer’s affirmative defense that insurer was not placed on notice of covered loss in accordance with statute is denied — Defense presents a bona fide question of fact as to reasonableness of charge — Assertion that facts of case do not support affirmative defense is not appropriately considered when ruling on motion to strike

24 Fla. L. Weekly Supp. 564b

Online Reference: FLWSUPP 2407MRODInsurance — Personal injury protection — Coverage — Conditions precedent — Examination under oath — Child — Where PIP statutes and policy required ten-year-old child, as omnibus insured, to submit to EUO and child failed to appear for three scheduled EUOs, material breach of policy relieves insurer of any further obligation to child or medical provider/assignee — Mother’s fears that child is shy or introverted and that participation in EUO may be detrimental to child’s mental or emotional well-being are not summary judgment evidence establishing that child is not competent to testify at EUO

24 Fla. L. Weekly Supp. 844a

Online Reference: FLWSUPP 2410CORDInsurance — Personal injury protection — Coverage — Medical expenses — Condition precedent — Examination under oath — Where both PIP statute and policy provide that EUO is condition precedent to receipt of benefits, neither insured who failed to appear at two scheduled EUOs nor medical provider/assignee is entitled to benefits — Insurer that scheduled EUOs to occur more than thirty days after receipt of provider’s bills did not thereby waive right to notice EUO — Further, where PIP policy contains “no action clause” that states that lawsuit against insurer is precluded until insured complies with all portions of policy, policy bars suit until EUO requirement is met

24 Fla. L. Weekly Supp. 15a

Online Reference: FLWSUPP 2401EICHInsurance — Personal injury protection — Affirmative defenses — Amendment — In absence of transcript of hearing on insurer’s first request to amend affirmative defenses or written order denying request, record is insufficient to establish abuse of discretion by trial court — No abuse of discretion in denying renewed request to amend where request was made near entry of final judgment