Volume 27

27 Fla. L. Weekly Supp. 679a

Online Reference: FLWSUPP 2708DUGAInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Trial court erred in holding that testimony of insurer’s expert on issue of reasonableness of charges must be genuinely scientific to meet Daubert standard of admissibility — Witness’s testimony regarding pricing, based on his knowledge and experience, was sufficient to preclude entry of summary judgment in favor of medical provider

27 Fla. L. Weekly Supp. 506b

Online Reference: FLWSUPP 2706FIGUInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Summary judgment — Trial court improperly granted summary judgment in favor of provider on issue of reasonableness of charges — Expert affidavit submitted by insurer in opposition to provider’s motion for summary judgment contained sufficient facts and data to support the opinions expressed, and opinions expressed by expert did not constitute impermissible “pure opinion” — Whether applying Daubert or Frye standard to expert’s affidavit, exclusion of affidavit was an abuse of discretion — Affidavit was sufficient to create genuine issue of disputed fact — Trial court’s conclusion that a jury trial was not needed to determine whether charge was reasonable because reasonableness would encompass a range of pricing supplanted a jury trial on the true issue, which was whether amount billed was reasonable and, if not, what amount was reasonable — Expert was permitted to base her opinion in part on Medicare Part B fee schedules, even if insurer failed to elect fee schedule limitation in its policy

27 Fla. L. Weekly Supp. 349a

Online Reference: FLWSUPP 2704POLLInsurance — Personal injury protection — Coverage — Medical expenses — Error to enter summary judgment in favor of provider where there remain genuine issues of material fact as to reasonable reimbursement amounts for charges in dispute

27 Fla. L. Weekly Supp. 1008a

Online Reference: FLWSUPP 2712YAGMInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness, relatedness and necessity of charges — Summary judgment — Opposing affidavit filed by insurer precluded summary judgment in favor of medical provider on issues of reasonableness, relatedness and necessity of charges where affidavit created genuine issue of material fact on all issues raised — Further support for reversal is found in trial court’s expressed confusion over what issues and evidence were before court, which was not clarified

27 Fla. L. Weekly Supp. 649a

Online Reference: FLWSUPP 2707MJOSInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness, relatedness and necessity of treatment — Summary judgment — Opposing affidavit filed by insurer is sufficient to preclude summary judgment as to relatedness and medical necessity of treatments specifically discussed therein — However, affiant’s opinion that “all other CPT codes were not reasonable, related or medically necessary” does not preclude summary judgment as to those other treatments where affidavit fails to show that this conclusion is product of reliable principles or methods — Insurer that failed to specify in PIP policy that it was electing statutory fee schedule method of reimbursement is not entitled to use that method — Affidavit of insurer’s expert that is conclusory and parrots exact charges allowed by insurer under Medicare fee schedule does not preclude summary judgment in favor of medical provider on issue of reasonableness of charges

Online Reference: FLWSUPP 2710GARAInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness and relatedness of treatment — Summary judgment — Opposing affidavits filed by insurer preclude summary judgment in favor of medical provider on issues of reasonableness of charges and relatedness of treatment where affidavits create genuine issues of material fact — Contradiction between expert’s affidavit and interrogatory responses filed by corporate representative who is not medical expert does not warrant striking affidavit

27 Fla. L. Weekly Supp. 534a

Online Reference: FLWSUPP 2706BASSInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness, relatedness and necessity of treatment — Summary judgment — Deposition and affidavit filed by insurer preclude summary judgment in favor of medical provider on issues of reasonableness, relatedness and necessity of treatment where affiant opined that treatment was not reasonable, medically necessary, or related to motor vehicle accident that occurred eleven months prior to initiation of treatment — Opinion that treatment was not medically necessary inherently creates issue of fact as to reasonableness of charges for that treatment

27 Fla. L. Weekly Supp. 423a

Online Reference: FLWSUPP 2704LUCIInsurance — Personal injury protection — Coverage — Medical expenses — Summary judgment — Unrefuted opinions of physician employed by medical provider are sufficient to establish provider’s prima facie case on issues of relatedness and necessity of treatment and reasonableness of charges — Partial summary judgment is entered in favor of provider

27 Fla. L. Weekly Supp. 96a

Online Reference: FLWSUPP 2701MORAInsurance — Personal injury protection — Coverage — Medical expenses — Related and medically necessary treatment — Summary judgment is entered in favor of medical provider on issues of relatedness and medical necessity of treatment where provider’s affidavit establishes prima facie case, insurer failed to file timely notice of intent to rely on filed summary judgment evidence in opposing motion for summary judgment, and insurer’s motion for continuance to allow for late-filed notice was not supported by affidavit and merely asserted “clerical oversight” as reason for delay

27 Fla. L. Weekly Supp. 901a

Online Reference: FLWSUPP 2710CARBInsurance — Personal injury protection — Coverage — Medical expenses — Relatedness and medical necessity of treatment — Opposing affidavit filed by insurer stating that it is impossible for affiant to determine if insured’s symptoms are result of accident due to passage of time between accident and treatment and that affiant cannot causally relate condition to accident, but not opining that any treatment was unrelated to accident or unnecessary, does not preclude summary judgment in favor of medical provider on issues of relatedness and medical necessity of treatment