Volume 28

28 Fla. L. Weekly Supp. 82a

Online Reference: FLWSUPP 2801MCCUInsurance — Personal injury protection — Coverage — Medical expenses — Nurse practitioners — PIP insurer is not entitled to rely upon Medicare’s 15% reduction to calculate amount of PIP benefits payable for non-hospital non-emergency health care services provided by nurse practitioner — 2012 amendment to statute did not in any way alter or amend substantive requirements of first and second sentences of section 627.736(5)(a)(3) — Question certified whether a PIP insurer is authorized to rely upon Medicare’s “Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS) Services Payment Methodology” to calculate amount of PIP benefits payable for health care services provided by a nurse practitioner to a PIP insured

28 Fla. L. Weekly Supp. 215a

Online Reference: FLWSUPP 2803KILGInsurance — Attorney’s fees — Insurer should not be joined as party defendant on motion to enter final judgment for attorney’s fees and costs in negligence action where insurer asserted denial of coverage and reservation of rights defenses and claimed attorney’s fees award arose out of proposal for settlement that exceeded policy limits

28 Fla. L. Weekly Supp. 5b

Online Reference: FLWSUPP 2801FROMInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Cconfession of error — Trial court erred in finding that insurer was not entitled to contest reasonableness of provider’s bills after it initially erroneously used fee schedule not elected in policy to reduce and pay billed amounts

28 Fla. L. Weekly Supp. 29d

Online Reference: FLWSUPP 2801TORRInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Medical provider confesses that trial court erred in finding that insurer was not entitled to contest reasonableness of provider’s bills after it initially erroneously used fee schedule not elected in policy to reduce and pay billed amounts

28 Fla. L. Weekly Supp. 234c

Online Reference: FLWSUPP 2803BELTInsurance — Personal injury protection — Affirmative defenses — Fraud — Staged accident — Medical provider’s motion for summary judgment as to affirmative defense of fraud is granted where insurer failed to file or identify any counter-evidence that would reveal existence of factual issue, and there is no evidence of any sworn statement by insured admitting to fraud or any court records establishing that insured committed fraud, but only the alleged fact that the driver of the other vehicle involved in the accident pled guilty to fraud

28 Fla. L. Weekly Supp. 185a

Online Reference: FLWSUPP 2803IRIZInsurance — Personal injury protection — Where district court of appeal held that circuit court in its appellate capacity departed from essential requirements of law by holding that PIP statute mandates that insurer must reimburse full amount billed when amount billed is less than maximum allowed under statutory fee schedule, circuit court remands matter to trial court with instructions to enter judgment consistent with DCA decision

28 Fla. L. Weekly Supp. 167a

Online Reference: FLWSUPP 2802COMPInsurance — Personal injury protection — Coverage — Medical expenses — Chiropractic services — Medicare fee schedule — PIP insurer is not entitled to 2% reduction in payment for chiropractic treatment implemented by Medicare where 2% reduction is specifically reserved only for claims that Medicare is required to reimburse

28 Fla. L. Weekly Supp. 5a

Online Reference: FLWSUPP 2801KWILInsurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Medical provider confesses that trial court erred in finding that insurer was not entitled to contest reasonableness of provider’s bills after it initially erroneously used fee schedule not elected in policy to reduce and pay billed amounts

28 Fla. L. Weekly Supp. 87a

Online Reference: FLWSUPP 2801PEREInsurance — Personal injury protection — Coverage — Emergency medical condition — Summary disposition is entered in favor of insurer where medical provider’s proposed witness on sole remaining issue of whether insurer received emergency medical condition determination from provider has been stricken

28 Fla. L. Weekly Supp. 56a

Online Reference: FLWSUPP 2801TAERInsurance — Personal injury protection — Affirmative defenses — Setoff — Insurer’s motion to amend affirmative defenses to add setoff defense claiming entitlement to setoff for money paid to insured in settlement of action against tortfeasor is denied — Insurer is not entitled to setoff as matter of law where there is no possibility of double recovery by insured because, pursuant to section 627.736(3), insured could not have recovered any medical expenses from tortfeasor — Further, under PIP statute, only tortfeasor is entitled to setoff for PIP benefits paid or payable — Subrogation provision in policy does not give rise to setoff defense