Volume 24

24 Fla. L. Weekly Supp. 975b

Online Reference: FLWSUPP 2411KISSInsurance — Personal injury protection — Coverage — Medical expenses — Emergency medical condition — Where at time of payment insured had not been diagnosed with EMC, insurer did not wrongfully withhold benefits by limiting benefits to $2,500 and explaining that benefits were exhausted in absence of EMC determination — Payment of additional benefits up to $10,000 limit after EMC diagnosis was provided three months after suit was filed did not amount to confession of judgment

24 Fla. L. Weekly Supp. 922a

Online Reference: FLWSUPP 2411KEITInsurance — Personal injury protection — Coverage — Medical expenses — Emergency medical condition — Insurer was not required to pay benefits in excess of $2500 until qualified medical provider made determination that claimant had an emergency medical condition — Demand letter seeking amounts in excess of $2500 was premature, as insurer’s obligation to pay disputed PIP benefits had not yet been triggered — Insurer’s post-suit payment of disputed benefits after it was presented with documentation indicating that claimant was treated for EMC did not amount to confession of judgment entitling provider to attorney’s fees — Insurer is entitled to final judgment in its favor on remand

24 Fla. L. Weekly Supp. 746b

Online Reference: FLWSUPP 2409HIMMInsurance — Personal injury protection — Attorney’s fees — Insurer’s post-suit payment of claim operates as confession of judgment that entitles medical provider to attorney’s fees under section 627.428(1) — No merit to insurer’s argument that payment does not operate as confession of judgment because provider did not comply presuit with insurer’s demand that it provide signed affidavit attesting as to when provider, which initially sent claim to wrong insurance carrier based on misinformation supplied by insured, first obtained information to submit bill to correct insurer — Insurer has waived right to claim lack of cooperation by provider where insurer did not demand additional information under section 627.736(6)(b), did not allege affirmative defenses of lack of cooperation or unclean hands and did not request affidavit after suit was filed

24 Fla. L. Weekly Supp. 869b

Online Reference: FLWSUPP 2410LEEInsurance — Personal injury protection — Med Pay — Declaratory actions — Motion to dismiss action seeking declaration as to whether insurer paid claims pursuant to hybrid method rather than reasonable amount method or statutory fee schedule, whether insurer was entitled to do so or was required to use either fee schedule or reasonable amount method, and whether insurer was entitled to rely on Multiple Procedure Payment Reduction is denied where complaint properly sets out matter for determination within contemplation of declaratory judgment statutes — Declaratory judgment is not precluded merely because another adequate remedy is available — Motion to strike medical provider’s claim for attorney’s fees and costs is denied where motion is premature when court has not yet entered judgment or decree that might entitle provider to fee award — No merit to argument that recovery of attorney’s fees and costs under section 627.428 is limited to cases in which plaintiff recovers benefits

24 Fla. L. Weekly Supp. 843a

Online Reference: FLWSUPP 2410CHANInsurance — Personal injury protection — Med Pay — Declaratory actions — Motion to dismiss action seeking declaration as to whether insurer paid claims pursuant to hybrid method rather than reasonable amount method or statutory fee schedule, whether insurer was entitled to do so or was required to use either fee schedule or reasonable amount method, and whether insurer was entitled to rely on Multiple Procedure Payment Reduction is denied — Complaint properly sets out matter for determination within contemplation of declaratory judgment statutes — Declaratory judgment is not precluded merely because another adequate remedy is available — Motion to strike medical provider’s claim for attorney’s fees and costs is denied as premature where court has not yet entered judgment or decree that might entitle provider to fee award — No merit to argument that recovery of attorney’s fees and costs under section 627.428 is limited to cases in which plaintiff recovers benefits

24 Fla. L. Weekly Supp. 235a

Online Reference: FLWSUPP 2403SCANInsurance — Personal injury protection — Attorney’s fees — Award of fees to provider/assignee who prevailed in action against insurer — Award of taxable costs, prejudgment interest, and fee for expert witness on issue of attorneys’ fees

24 Fla. L. Weekly Supp. 975a

Online Reference: FLWSUPP 2411COMPInsurance — Attorney’s fees awarded to provider who prevailed in action against personal injury protection insurer

24 Fla. L. Weekly Supp. 724a

Online Reference: FLWSUPP 2409LANEInsurance — Personal injury protection — Attorney’s fees — Claim or defense not supported by material facts or applicable law — Where medical provider lacked standing at outset of case due to expiration of registration of fictitious name to which insured assigned PIP benefits, insurer is entitled to award of attorney’s fees and costs

24 Fla. L. Weekly Supp. 712a

Online Reference: FLWSUPP 2409EUCEInsurance — Personal injury protection — Attorney’s fees — Claim or defense not supported by material facts or applicable law — Motion for sanctions pursuant to section 57.105 is granted where insurer knew or should have known that affirmative defense asserting that medical provider failed to furnish demand letter compliant with PIP statute was not supported by material facts or applicable law, yet insurer did not withdraw defense within 21 days of letter advising of provider’s intent to file motion for section 57.105 sanctions

24 Fla. L. Weekly Supp. 193a

Online Reference: FLWSUPP 2402SDAVInsurance — Personal injury protection — Attorney’s fees — Claim or defense not supported by material facts or applicable law — Where there were conflicting cases supporting both parties’ positions on issue of validity of assignment prior to circuit court decision on issue, medical provider’s position cannot be said to have not been supported by then-existing law — Attorney’s fees and costs are awarded to insurer where provider should have known that action was premature because ledger attached to demand letter, which was ambiguous and stated that nothing was due, lacked specificity required to satisfy condition precedent