Volume 26

26 Fla. L. Weekly Supp. 139b

Online Reference: FLWSUPP 2602FERDInsurance — Personal injury protection — Coverage — Medical expenses — Statutory fee schedules — Clear and unambiguous election by insurer — PIP policy that states that insurer will determine to be unreasonable any charges that exceed schedule of maximum charges provided pursuant to section 627.736(5)(a)2 and will limit reimbursement to 80% of schedule of maximum charges clearly and unambiguously elects to limit payment pursuant to permissive statutory fee schedules — Inclusion in policy of statement that insurer will pay 80% of all reasonable expenses does not render policy language ambiguous — Physician fee schedule published by federal Department of Health and Human Services on CMS website is not hearsay — Insurer properly reimbursed medical provider in compliance with Medicare fee schedule and is entitled to summary judgment

26 Fla. L. Weekly Supp. 766a

Online Reference: FLWSUPP 2609VILLInsurance — Personal injury protection — Summary judgment — Evidence — Hearsay — Exception — Business records — Transcript of examination under oath prepared for purpose of litigation lacks trustworthiness that business records are presumed to have and is not admissible under business records exception to hearsay rule — Further, transcript is not admissible as former testimony where EUO was taken without opportunity for cross-examination or objection, was not deposition, and was not obtained in course of judicial proceeding, and transcript was not reviewed and signed by insured — Pursuant to section 92.33, EUO transcript cannot be used as summary judgment evidence where copy was not provided to insured at time he submitted to EUO — Transcript is not admissible under party admission exception to hearsay rule where insured is not party to case, and plaintiff medical provider and insured have different interests in action — Motion to strike transcript is granted

26 Fla. L. Weekly Supp. 105a

Online Reference: FLWSUPP 2602PETZInsurance — Liability — Duty to defend — General contractor not entitled to summary judgment on its third-party complaint against subcontractor’s liability insurer, claiming that contractor was an additional insured under policy and that insurer had duty to defend it in action brought against contractor and subcontractor/named insured by bicyclist who was injured when he struck manhole cover near construction site that was substantially ajar and protruding above surface of roadway — Policy, as plainly written, provided coverage to unnamed “Additional Insureds” confronted with claim based upon the negligent acts or omissions of the named insured, and plaintiff sued contractor for, and only for, its own alleged negligence

26 Fla. L. Weekly Supp. 896b

Online Reference: FLWSUPP 2611RRAMInsurance — Voluntary dismissal — Timeliness of notice — Notice of voluntary dismissal filed ten calendar days after hearing on insurer’s motion for final summary judgment is untimely — Motion to strike is granted

26 Fla. L. Weekly Supp. 121a

Online Reference: FLWSUPP 2602METZInsurance — Dismissal of provider’s action against insurer with leave to amend

26 Fla. L. Weekly Supp. 303a

Online Reference: FLWSUPP 2604CLAIInsurance — Discovery — Documents — Insurer is not entitled to discovery of trade secret documents not reasonably calculated to lead to discoverable and relevant evidence

26 Fla. L. Weekly Supp. 508a

Online Reference: FLWSUPP 2606LESLInsurance — Personal injury protection — Discovery — Reasonableness of charges — Usual and customary charges satisfy the “reasonable expense” mandate of PIP statute — Insurer not entitled to additional discovery on issue of reasonableness where insurer limited its payment to 75% of billed amounts and in its explanation of benefits informed provider that allowable amount was calculated pursuant to statute limiting reimbursement to 75% of provider’s usual and customary charges for emergency services

26 Fla. L. Weekly Supp. 509a

Online Reference: FLWSUPP 2606FRANInsurance — Personal injury protection — Discovery — Reasonableness of charges — Geozip or community pricing report — Insurer is compelled to produce documentation indicating what other medical providers within geographic region charged for CPT codes at issue during specific time frame

26 Fla. L. Weekly Supp. 685a

Online Reference: FLWSUPP 2608MOLIInsurance — Personal injury protection — Discovery — Medical provider is ordered to provide better answers to interrogatories, requests to produce, and requests for admissions regarding insured’s medical condition, treatment provided, and insured’s status as employee of provider at time of treatment

26 Fla. L. Weekly Supp. 133b

Online Reference: FLWSUPP 2602WIGGInsurance — Personal injury protection — Discovery — Provider need not provide documents or information regarding payments received from secondary payers such as Medicaid, Medicare and private insurance