Volume 25

25 Fla. L. Weekly Supp. 815b

Online Reference: FLWSUPP 2509DWILInsurance — Application — Misrepresentations — Materiality — Failure to disclose household member on insurance application did not constitute material misrepresentation under circumstances — Omission of person who never drove insured vehicle was not material to risk assumed under policy

25 Fla. L. Weekly Supp. 562a

Online Reference: FLWSUPP 2506SANTInsurance — Coverage — Application — Material misrepresentation — Where insurer failed to appear at hearing setting matter for trial, pretrial conference, or trial, and insured’s unrefuted evidence showed that no material misrepresentation occurred, insurer is ordered to provide coverage to insured

25 Fla. L. Weekly Supp. 410b

Online Reference: FLWSUPP 2505SPATInsurance — Personal injury protection — Deductible — Trial court correctly determined that medical bills were compensable when received and that insurer improperly processed bills by applying PIP deductible to bills out of sequence — Trial court correctly found that plaintiff had standing to and that insurer had waived any right to contest plaintiff’s alleged failure to attach a written assignment to its pre-suit demand letter

25 Fla. L. Weekly Supp. 410a

Online Reference: FLWSUPP 2505RAINInsurance — Personal injury protection — Deductible — Trial court correctly determined that medical bills were compensable when received and that insurer improperly processed bills by applying PIP deductible to bills out of sequence — Trial court correctly found that plaintiff had standing to and that insurer had waived any right to contest plaintiff’s alleged failure to attach a written assignment to its pre-suit demand letter

25 Fla. L. Weekly Supp. 418a

Online Reference: FLWSUPP 2505WERNInsurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered services — Appeals — Issue not raised below — Provider failed to preserve for appeal issue of whether its records substantially comply with rule where, in opposition to motion for summary judgment arguing that services were not lawfully rendered due to noncompliance with administrative rule regarding record keeping, medical provider argued only that insurer did not have standing to raise noncompliance as defense to liability, that trial court did not have jurisdiction to decide matter, and that insurer waived issue by failing to raise it as affirmative defense — Where insurer’s answer stated that it would demonstrate that provider is in violation of or has failed to comply with section 627.736(5), including but not limited to improper billing, and its motion for summary judgment asserted that provider violated administrative rule, insurer provided adequate notice of its statutory defense — Where insurer conclusively proved provider’s noncompliance with record keeping rule through deposition testimony of provider’s president and sole practitioner, trial court correctly entered summary judgment in favor of insurer — Insurer’s motion for appellate attorney’s fees pursuant to proposal for settlement is granted, conditioned on trial court finding that proposal is valid, enforceable and made in good faith

25 Fla. L. Weekly Supp. 814a

Online Reference: FLWSUPP 2509LAWRInsurance — Discovery — Application — Insurer is ordered to produce application for insurance policy, including written election of deductible executed by insured

25 Fla. L. Weekly Supp. 822a

Online Reference: FLWSUPP 2509YALVInsurance — Personal injury protection — Standing — Assignment — Where medical provider assigned rights to PIP claim to collection agency, and there is no evidence that assignment was ever rescinded or modified despite fact that provider then brought action against insurer that resulted in settlement, collection agency has standing to pursue claim against insurer — Accord and satisfaction — Where insurer was provided notice that claim was assigned to collection agency, settlement of suit brought by provider was voluntary on part of insurer and did not constitute bar to agency’s claim — Neither res judicata nor collateral estoppel bar collection agency’s action where agency was not party to provider’s action against insurer

25 Fla. L. Weekly Supp. 865b

Online Reference: FLWSUPP 2510AHUMInsurance — Personal injury protection — Coverage — Medical expenses — Settlement — Trial court erred in entering summary judgment in favor of insurer on its affirmative defense of accord and satisfaction after previously finding that genuine issues of material fact were created by handwritten notations made by provider’s representative on settlement letter, beneath representative’s signature, indicating that representative understood once all payments were made, benefits would be exhausted; whereas, at time replacement settlement check had been sent to provider and deposited, insured had withdrawn his intention to pursue a lost wages claim which had figured into insurer’s pre-settlement discussion of the amount of policy benefits that would be available to pay provider

25 Fla. L. Weekly Supp. 384a

Online Reference: FLWSUPP 2504YHERInsurance — Personal injury protection — Affirmative defenses — Accord and satisfaction — Where insurer tendered funds to medical provider after application of statutory fee schedule under belief that it was paying full amount sought by provider, there was no superceding agreement to resolve existing dispute and, therefore, no common law accord and satisfaction — Summary judgment — Reasonableness of charges — Affidavit of insurer’s expert averring that provider’s charges for MRIs at issue are almost double amount expert charges for same MRIs is sufficient to preclude entry of summary judgment on issue of reasonableness of charges

25 Fla. L. Weekly Supp. 1028a

Online Reference: FLWSUPP 2512CHAVInsurance — Personal injury protection — Affirmative defenses — Accord and satisfaction — Common law accord and satisfaction was not effectuated where insurer believed it was paying full amount of its obligation when it tendered checks, and there was no mutual intent to effect settlement of preexisting dispute — Statutory accord and satisfaction was not effectuated where tender of amount calculated pursuant to statutory fee schedule that was not elected in PIP policy demonstrates absence of good faith tender; claim reimbursed under fee schedule is liquidated claim; there was no bona fide dispute at time of payment of claim; and “full and final” text in payee section of checks in same or lesser size as surrounding text and not in contrasting type, font or color is not conspicuous