Volume 26

26 Fla. L. Weekly Supp. 709a

Online Reference: FLWSUPP 2609AISPInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Affidavit in opposition to summary judgment, coupled with statutory fee schedules, was sufficient to raise genuine issue of material fact on issue of reasonableness of charge

26 Fla. L. Weekly Supp. 617a

Online Reference: FLWSUPP 2608ARANInsurance — Personal injury protection — Medical expenses — Reasonableness of charges — Summary judgment was improper where parties provided competing, legally sufficient affidavits establishing a genuine issue of material fact — Insurer’s affidavit did not impermissibly rely on Medicare Part B schedule of fees — Consideration of Medicare Part B schedule of fees is a permissible factor to be considered under section 627.736(5)(a)(1), and insurer was not seeking to limit reimbursement under 627.736(5)(a)2

26 Fla. L. Weekly Supp. 616a

Online Reference: FLWSUPP 2608LOPEInsurance — Personal injury protection — Medical expenses — Reasonableness of charges — Trial court erred in concluding that insurer’s affidavit concerning reasonableness of fees was legally incompetent to create genuine issue of material fact where affiant qualified as expert, attested to his experience regarding the treatment of automobile accidents and the associated costs and reimbursements, and did not improperly rely on Medicare Part B schedule of fees

26 Fla. L. Weekly Supp. 326a

Online Reference: FLWSUPP 2604ANICInsurance — Personal injury protection — Coverage — Medical expenses — Reasonable charges — Summary judgment — Insurer’s corporate representative’s deposition testimony that other MRI facilities in provider’s zip code charge same amount as provider and that insurer has approved payment of that amount constitutes admission that provider’s charges are within reasonable range and satisfies provider’s prima facie burden to prove reasonableness of charges — Affidavit of insurer’s expert does not preclude summary judgment in favor of provider on reasonableness issue where affidavit is insufficient to create triable issue

26 Fla. L. Weekly Supp. 706a

Online Reference: FLWSUPP 2609TORRInsurance — Personal injury protection — Medical expenses — Reasonableness of charges — Affidavit of provider’s corporate officer was not conclusory where it was based on facts personally known to the officer and properly averred that the medical charges do not exceed what is customarily charged in the community with similar providers — Insurer was not precluded from having the opportunity to challenge medical provider’s charges under section 627.736(5)(a)1 despite its failure to elect to use the fee schedule limitation under section 627.736(5)(a)2 in its policy — Error to reject insurer’s opposing expert affidavits at summary judgment stage where affiants possessed the necessary background, knowledge, and skill in their disciplines to qualify as experts

26 Fla. L. Weekly Supp. 164a

Online Reference: FLWSUPP 2603JROSInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Trial court erred in entering summary judgment in favor of medical provider on reasonableness of medical bills where there were genuine issues of material fact as to reasonableness of charges

26 Fla. L. Weekly Supp. 761a

Online Reference: FLWSUPP 2609ALEXInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Medical provider set forth prima facie showing on issue of reasonableness of MRI charge where undisputed evidence shows that multiple insurance carriers, including insurer, have paid provider’s charge at 80% of submitted amount — Opposing affidavit and deposition testimony of radiologist filed by insurer does not preclude summary judgment in favor of provider — Radiologist is not qualified as expert on reasonableness of diagnostic facility charges, his opinion is not admissible as lay opinion testimony, and he failed and refused to consider factors set forth in section 627.736(5)(a)

26 Fla. L. Weekly Supp. 909b

Online Reference: FLWSUPP 2611COMInsurance — Personal injury protection — Coverage — Medical expenses — Where evidence indicates that PIP policy failed to elect to limit reimbursement to statutory fee schedules and that insurer utilized Medicare Part B fee schedule as exclusive basis for reimbursement of medical provider’s claim, provider has met prima facie burden to establish that its charges are reasonable, and insurer has not filed opposing affidavit regarding reasonableness of charges, summary judgment is entered in favor of provider

26 Fla. L. Weekly Supp. 674b

Online Reference: FLWSUPP 2608YAPInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment entered in favor of insurer

26 Fla. L. Weekly Supp. 150a

Online Reference: FLWSUPP 2602MAZOInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Provider met its burden to set forth prima facie showing that its charges were reasonable through the affidavit of individual who owned the clinic and also provided care and treatment to insured — Insurer failed to present competent, admissible evidence rebutting this prima facie showing