Volume 26

26 Fla. L. Weekly Supp. 309b

Online Reference: FLWSUPP 2604DPERInsurance — Personal injury protection — Insurer properly denied payment to insured’s assignee based on insured’s failure to attend properly scheduled and noticed examinations under oath

26 Fla. L. Weekly Supp. 227a

Online Reference: FLWSUPP 2603LOPENOT FINAL VERSION OF OPINION
Subsequent Changes at 26 Fla. L. Weekly Supp. 404bInsurance — Personal injury protection — Coverage — Conditions precedent — Examination under oath — Failure to attend — Where language of PIP policy, adopted from PIP statute, requires compliance with insurer’s request for EUO as condition precedent to receiving PIP benefits and does not provide for any reasonable excuse for non-attendance, insured’s failure to attend two properly scheduled and noticed EUOs constituted failure to satisfy condition precedent, and medical provider, as assignee of insured, is not entitled to PIP benefits

26 Fla. L. Weekly Supp. 50a

Online Reference: FLWSUPP 2601MOYNInsurance — Personal injury protection — Coverage — Medical expenses — Deductible — No merit to argument that insurer that received bills from multiple medical providers on same day is required to look to dates of service and apply deductible to earliest date of service first — Exhaustion of policy limits — Insurer did not act in bad faith by making decision to use 2007 Medicare fee schedule as a baseline for reimbursement of providers — Even if insurer had ability to reimburse other providers’ claims at less than fee schedule amounts, decision to use fee schedule does not alter fact that provider exhausted benefits through payment of bills for reasonable, related and necessary services — Further, insurer’s decision to issue additional reimbursements to some providers upon receipt of pre-suit demand letters was proper and consistent with insurer’s obligations under law — Insurer’s motion for summary judgment on issue of exhaustion of benefits is granted

26 Fla. L. Weekly Supp. 144a

Online Reference: FLWSUPP 2602MHERInsurance — Personal injury protection — Allowing plaintiff to amend complaint to raise new and different theories of recovery and to completely abandon fee schedule issues over four and a half years into litigation would unfairly prejudice defendant, who was defending case on fee schedule issue alone — Motion to amend denied

26 Fla. L. Weekly Supp. 858a

Online Reference: FLWSUPP 2610POLAInsurance — Personal injury protection — Insurer’s motion to amend its answer to raise new defense of defective demand letter, a condition precedent to suit, is denied — Amendment would materially change and introduce new issues into case that involved relatively small amount of money and that had been pending for 17 months at the time motion to amend was served — Late amendment would prejudice plaintiff given parties’ stipulation that the only legal issue was whether insurer properly reimbursed plaintiff for services rendered to insured

26 Fla. L. Weekly Supp. 855a

Online Reference: FLWSUPP 2610CLARInsurance — Personal injury protection — Provider’s motion for leave to file amended reply which would interject new and inconsistent theory of recovery over five years into litigation, sought by provider after defendant had prevailed before the Florida Supreme Court on the sole issue pled and litigated in the case, is denied — Motion to strike or exclude unpled issues is granted

26 Fla. L. Weekly Supp. 854a

Online Reference: FLWSUPP 2610RUPIInsurance — Personal injury protection — Motion for leave to amend complaint, filed after Florida Supreme court decision undermined plaintiff’s position on the only issue framed for disposition, is denied

26 Fla. L. Weekly Supp. 847a

Online Reference: FLWSUPP 2610LEONInsurance — Personal injury protection — Provider’s motion for leave to file amended reply which would interject new and inconsistent theory of recovery over five years into litigation, sought by provider after defendant had prevailed before the Florida Supreme Court on the sole issue pled and litigated in the case, is denied — Motion to strike or exclude unpled issues is granted

26 Fla. L. Weekly Supp. 844a

Online Reference: FLWSUPP 2610CHAVNOT FINAL VERSION OF OPINION
Subsequent Changes at 27 Fla. L. Weekly Supp. 976aInsurance — Personal injury protection — Provider’s motion for leave to file amended reply which would interject new and inconsistent theory of recovery over five years into litigation, sought by provider after defendant had prevailed before the Florida Supreme Court on the sole issue pled and litigated in the case, is denied — Motion to strike or exclude unpled issues is granted

26 Fla. L. Weekly Supp. 432a

Online Reference: FLWSUPP 2605LUGOInsurance — Personal injury protection — Coverage — Medical expenses — Where PIP policy provides that charge submitted for amount less than 200% of allowable amount under Medicare Part B fee schedule shall be paid in amount of charge submitted, insurer was required to pay entire amount of charges that were less than 200% of allowable amount under fee schedule, not 80% of those charges