Volume 24

24 Fla. L. Weekly Supp. 449b

Online Reference: FLWSUPP 2406MACHInsurance — Personal injury protection — Demand letter — Otherwise valid demand letter is not invalidated by $5.00 miscalculation in total of medical bills

24 Fla. L. Weekly Supp. 555c

Online Reference: FLWSUPP 2407VOLCInsurance — Personal injury protection — Demand letter in which medical provider failed to reduce unpaid charges to allowable amount under permissive statutory fee schedule elected in policy does not satisfy condition precedent to PIP suit — Insurer did not waive affirmative defense of defective demand letter by explaining reasons for adjustments or denials of claim in response to demand letter without mentioning letter’s deficiencies where insurer raised affirmative defense of defective demand letter in answer

24 Fla. L. Weekly Supp. 308b

Online Reference: FLWSUPP 2404WROBInsurance — Personal injury protection — Coverage — Medical expenses — Timeliness of claim — Where medical provider was apprised at time of service that there was PIP coverage for claimant who was injured as passenger in insured’s vehicle and given means to ascertain insurance information from claimant’s personal injury attorney, provider elected instead to send CMS claim form to claimant’s attorney, attorney provided insurance information four months later, and provider submitted claim to insurer within 35 days of receipt of information, provider is not entitled to reimbursement for untimely submitted claim in absence of any evidence that either claimant or attorney provided erroneous information to provider

24 Fla. L. Weekly Supp. 828b

Online Reference: FLWSUPP 2410ROBIInsurance — Personal injury protection — Coverage — Medical expenses — Timeliness of claim — Where insured submitted bills to workers’ compensation carrier but did not submit bills to PIP insurer, bills were not overdue, and demand letter to PIP insurer was premature — Because bills were not submitted to PIP insurer within 35 days, summary judgment is granted in favor of insurer

24 Fla. L. Weekly Supp. 236a

Online Reference: FLWSUPP 2403MMADInsurance — Personal injury protection — Coverage — Medical expenses — In calculating amount of PIP benefits to reimburse under permissive statutory fee schedule, insurer erred in failing to consider 2.2% update to 2010 Medicare Part B Physician fee schedule mandated by Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which is applicable to dates of service commencing on June 1, 2010

24 Fla. L. Weekly Supp. 100a

Online Reference: FLWSUPP 2402MORAInsurance — 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 “all fee schedules” does not provide clear and unambiguous notice of intent to limit reimbursement to Medicare Part B fee schedule — Mandate is withheld pending Florida Supreme Court’s decision resolving conflict in district court of appeal opinions

24 Fla. L. Weekly Supp. 342a

Online Reference: FLWSUPP 2405OWENInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy that provides that insurer will pay 80% of all reasonable medical expenses, considering any and all limitations authorized by PIP statute, and further provides 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

24 Fla. L. Weekly Supp. 823b

Online Reference: FLWSUPP 2410POHLInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy that provides that insurer will pay 80% of all reasonable medical expenses, considering any and all limitations authorized by section 627.736, and further states that applicable fee schedule or payment limitation shall be under the permissive payment methodology clearly and unambiguously elects to limit reimbursement to permissive statutory fee schedule

24 Fla. L. Weekly Supp. 823a

Online Reference: FLWSUPP 2410FOSTInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy that provides that insurer will pay 80% of all reasonable medical expenses, considering any and all limitations authorized by section 627.736, and further states that applicable fee schedule or payment limitation shall be under the permissive payment methodology clearly and unambiguously elects to limit reimbursement to permissive statutory fee schedule

24 Fla. L. Weekly Supp. 822a

Online Reference: FLWSUPP 2410TOXIInsurance — Personal injury protection — Coverage — Medical expenses — PIP policy that provides that insurer will pay 80% of all reasonable medical expenses, considering any and all limitations authorized by section 627.736, and further states that applicable fee schedule or payment limitation shall be under the permissive payment methodology clearly and unambiguously elects to limit reimbursement to permissive statutory fee schedule