Volume 27

27 Fla. L. Weekly Supp. 789a

Online Reference: FLWSUPP 2709MOREInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Trial court erred in entering summary judgment in favor of medical provider on issue of reasonableness of charges where opposing affidavit filed by insurer, which relied on reimbursement schedules and managed care guides, sufficiently raised issue of material fact

27 Fla. L. Weekly Supp. 601b

Online Reference: FLWSUPP 2707PENAInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Trial court erred in rejecting opposing affidavit filed by insurer on basis that affiant relied on Medicare fee schedules, even if insurer failed to elect fee schedule method of reimbursement in PIP policy — Where affidavit explained affiant’s experience, how experience led to his opinion, provided basis for opinion and is reasonably applied to facts; and affidavit is not conclusory in nature, affidavit is sufficient to preclude summary judgment as to reasonableness of charges

27 Fla. L. Weekly Supp. 591b

Online Reference: FLWSUPP 2707ARODInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Trial court erred in rejecting opposing affidavit filed by insurer where medical provider did not make specific objection describing alleged defects in affidavit but simply made general arguments that Daubert standard should be applied to any expert affidavit — Trial court abused discretion in rejecting affidavit where affidavit complied with rules, was not conclusory, and was not otherwise insufficient

27 Fla. L. Weekly Supp. 502a

Online Reference: FLWSUPP 2706PADRInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Trial court did not err in finding that affidavit of medical provider’s owner met summary judgment burden on issue of reasonableness of CT scan charge — Trial court abused discretion by rejecting affidavit of insurer’s expert where affiant qualified as expert under Daubert standard — References to Medicare, HMO and PPO rates do not invalidate affiant’s opinion on reasonableness of charges — Summary judgment is reversed

27 Fla. L. Weekly Supp. 501a

Online Reference: FLWSUPP 2706JRODInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Opposing affidavit filed by insurer was sufficient to preclude summary judgment in favor of medical provider on issue of reasonableness of charges — Affidavit was not conclusory and provided sufficient evidence to survive summary judgment — Trial court abused its discretion by disregarding affidavit under a Daubert analysis — Conclusion that Medicare, HMO, and PPO reimbursements are not relevant to issue of reasonableness of charges is expressly contradicted by PIP statute

27 Fla. L. Weekly Supp. 498a

Online Reference: FLWSUPP 2706DECHInsurance — Personal injury protection — Appeals — Where Florida Supreme Court receded from opinion determining that Frye standard was appropriate test to evaluate expert witness’s qualifications after issuance of circuit court’s opinion holding that trial court erred in applying Daubert standard but before time for rehearing had passed, circuit court must apply Daubert test in analysis on motion for rehearing — Trial court abused its discretion in finding that affidavit of insurer’s expert witness failed to meet Daubert standard where witness qualifies as expert on reasonableness of charges for x-ray and MRI services, witness used reliable principles and methods in making his determination of reasonableness, affidavit was based on sufficient facts and data, and affidavit applied principles and methods reliably to facts of case — Further, trial court erred in rejecting affidavit on ground that Medicare rates are not applicable to issue of reasonableness of charges — Summary judgment is reversed

27 Fla. L. Weekly Supp. 226a

Online Reference: FLWSUPP 2703DECHNOT FINAL VERSION OF OPINION
Subsequent Changes at 27 Fla. L. Weekly Supp. 498aInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Trial court erred in applying Daubert standard to determine that physician whose affidavit was filed by insurer in opposition to summary judgment did not qualify as expert witness — Where insurer objected to application of Daubert standard below, and subsequent to entry of summary judgment the Florida Supreme Court decided that Frye standard is appropriate test in Florida courts, Frye standard applies in case — Affiant is qualified as expert on issue of reasonableness of charges under Frye standard — References to Medicare, HMO, and PPO rates do not invalidate affiant’s opinion on reasonableness of charges — Summary judgment is reversed

27 Fla. L. Weekly Supp. 221a

Online Reference: FLWSUPP 2703DURAInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Trial court did not abuse discretion in entering summary judgment in favor of medical provider on issue of reasonableness of charges where opposing affidavit filed by insurer was conclusory and unsupported by facts or data, and affiant was not qualified to render opinion on reasonableness issue as expert or as lay witness — Trial court properly found that mere fact that Medicare, HMO, and PPO rates are less than amount billed by provider does not create factual issue as to reasonableness of charges

27 Fla. L. Weekly Supp. 856a

Online Reference: FLWSUPP 2710AVILInsurance — Personal injury protection — Coverage — Medical expenses — Where PIP policy does not elect statutory fee schedule method of reimbursement, medical provider moving for summary judgment as to reasonableness of charges must show by summary judgment evidence that charges are reasonable — Trial court erred in entering summary judgment on reasonableness issue based on erroneous belief that provider is always entitled, as matter of law, to be reimbursed no less than 80% of 200% of Medicare fee schedule

27 Fla. L. Weekly Supp. 646a

Online Reference: FLWSUPP 2707CONTInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Insurer’s motion for summary judgment on issue of reasonableness of charges, based on testimony that on case-by-case basis medical provider sometimes offers discounts to cash patients paying for services at time they are rendered, is denied, as there is no evidence that provider has program, custom or policy of charging cash patients less