Volume 26

26 Fla. L. Weekly Supp. 134a

Online Reference: FLWSUPP 2602MAHOInsurance — 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

26 Fla. L. Weekly Supp. 239b

Online Reference: FLWSUPP 2603MILIInsurance — Personal injury protection — Coverage — Medical expenses — Summary judgment is granted in favor of medical provider as to relatedness and necessity of therapeutic exercises where insurer’s expert found exercises to be proper part of rehabilitation process, but expert had issues with provider’s record keeping that do not create disputed issue of material fact

26 Fla. L. Weekly Supp. 327a

Online Reference: FLWSUPP 2604LIBEInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness, relatedness and necessity of treatment — Summary judgment — Opposing affidavit filed by insurer does not preclude summary judgment in favor of medical provider on issues of reasonableness of charges and relatedness and medical necessity of treatment — Allegations in affidavit of insurer’s expert concerning sufficiency of provider’s medical record keeping, upcoding, and CPT coding issues do not create issues of fact where those issues were not raised as affirmative defenses — Expert’s opinion as to reasonableness of charges that is not based on anything other than his own experience and fact that Medicare and health insurance reimburse less than provider’s charges fails to create genuine issue of material fact

26 Fla. L. Weekly Supp. 469a

Online Reference: FLWSUPP 2606ULLAInsurance — Personal injury protection — Coverage — Medical expenses — X-rays and interpretation of x-rays — Reasonableness of charges — Necessity — Although affidavits submitted by provider were legally sufficient to satisfy provider’s summary judgment burden as to reasonableness of charges and medical necessity of treatment, affidavits submitted by insurer were legally sufficient to create genuine issue of material fact as to these issues — Extensive discussion of experts’ affidavits

26 Fla. L. Weekly Supp. 454a

Online Reference: FLWSUPP 2606JSEPInsurance — Personal injury protection — Coverage — Medical expenses — Reasonable, related, and necessary treatement — Trial court erred in entering summary judgment in favor of medical provider on issue of relatedness and medical necessity of reading and interpretation of x-rays where opposing affidavit opining that x-rays that were not read before insured underwent extensive physical therapy were not utilized to diagnose injuries or determine course of treatment created genuine issue of material fact as to whether reading and interpreting x-rays was related and necessary — Reasonableness of charges — Provider may submit affidavit containing his opinion about reasonableness of own bills despite offering opinion as lay witness — Although reasonableness of charges is generally question for jury, where insurer presented no evidence in opposition to motion for summary judgment on reasonableness of charges, trial court did not err in entering summary judgment for provider on issue

26 Fla. L. Weekly Supp. 664a

Online Reference: FLWSUPP 2608DSAAInsurance — Personal injury protection — Coverage — Medical expenses — Relatedness and medical necessity of charges — Opposing affidavit of insurer’s expert is insufficient to preclude entry of summary judgment on issues of relatedness and medical necessity of charges where affidavit was not filed and served in accordance with rule 1.510(c) — Reasonableness of charges — Opposing affidavit on reasonableness of charges is sufficient to preclude summary judgment on that issue — Fact that insurer did not elect statutory fee schedule method of reimbursement in policy does not mean that Medicare fee schedules are irrelevant when determining reasonableness of charges

26 Fla. L. Weekly Supp. 13a

Online Reference: FLWSUPP 2601GRACInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Trial court did not err in entering summary judgment in favor of medical provider on issue of reasonableness of charges where opposing affidavit filed by insurer, which focused on whether insurer paid reasonable amount rather than whether provider’s charges were reasonable, failed to create genuine issue of material fact — Trial court erred in entering summary judgment in favor of provider on issues of relatedness and necessity of treatment where opposing affidavit did create genuine issue of material fact as to relatedness and necessity

26 Fla. L. Weekly Supp. 33b

Online Reference: FLWSUPP 2601JSANInsurance — Personal injury protection — Coverage — Medical expenses — Related and necessary treatment — Summary judgment — Opposing affidavit and deposition filed by insurer do not preclude summary judgment in favor of medical provider on issues of relatedness and necessity of treatment where deposition was not filed with court and served on provider in accordance with rule 1.510(c), and affidavit is conclusory and attempts to improperly raise for first time issues of whether services were actually rendered and whether medical records were properly documented

26 Fla. L. Weekly Supp. 551a

Online Reference: FLWSUPP 2607LEWIInsurance — Personal injury protection — Coverage — Medical benefits — Reasonable, related, and necessary treatment — MRI — Trial court erred in finding that insurer could not dispute relatedness and medical necessity of treatment after it had already paid claim — Trial court erred in granting summary judgment on relatedness and necessity and on reasonableness of provider’s charges where affidavit submitted by insurer raised contested issues of material fact

26 Fla. L. Weekly Supp. 705a

Online Reference: FLWSUPP 2609PAULInsurance — Personal injury protection — Coverage — Medical expenses — Affidavit in opposition to motion for summary judgment was sufficient to create genuine issue of material fact as to reasonableness of charges and medical necessity and reasonableness of reading x-ray nine days after it was taken — Discussion of summary judgment burden of proof