Volume 6

6 Fla. L. Weekly Supp. 55a

Insurance — Personal injury protection — Third-party beneficiaries — Language in policy stating that insurer would pay benefits to “or on behalf of” injured person did not make medical service provider an intended third party beneficiary of insurance contract — Medical services provider who did not receive assignment of benefits from insured did not have standing to sue insurer for payment

6 Fla. L. Weekly Supp. 328c

Insurance — Personal injury protection — Error to grant summary judgment based on finding that it was reasonable to require wage verification form before payments commenced under section 627.736(4)

6 Fla. L. Weekly Supp. 443b

Insurance — Personal injury protection — Statute allows for 10% interest per year on overdue benefits — Insured entitled to additional 12% interest on settlement proceeds where insurer did not tender settlement amounts within 20 days of written settlement

6 Fla. L. Weekly Supp. 793a

NOT FINAL VERSION OF OPINION
Subsequent Changes at 7 Fla. L. Weekly Supp. 63a

Insurance — Personal injury protection — Insurer may not reduce bills submitted on behalf of insured on ground that treatment was not medically necessary unless it obtains reasonable proof that it does not owe benefits within thirty days of receipt of bills

6 Fla. L. Weekly Supp. 780a

Insurance — Personal injury protection — Insurer not entitled to reduce amount of PIP benefits without an independent medical examination or showing that insured failed to perform a condition precedent — Insurer will not be permitted to escape or reduce liability by alleging that a purported fee review, which was conducted to determine reasonable amount for specified treatment given geographical locale, allows insurer to unilaterally reduce amount of required PIP benefits — Unless it can be shown that insured has failed to perform some condition precedent, insurer must obtain an independent medical examination before PIP benefits are withdrawn, reduced or denied

6 Fla. L. Weekly Supp. 471a

Insurance — Personal injury protection — Insurer may defend a PIP claim on the merits even when it does not have reasonable proof in its possession, within thirty days of receiving a claim, that it is not responsible for payment of the claim — Such claim is, however, overdue, and insured will be entitled to statutory interest and attorney’s fees as provided by law

6 Fla. L. Weekly Supp. 470a

Insurance — Personal injury protection — Error to enter summary judgment awarding disputed medical benefits to insured on ground that insurer failed to make payment or furnish reasonable proof supporting denial within thirty days of receipt of bill — Whether treatment was medically necessary is element for insurer to prove at trial — Although failure to pay benefits or furnish reasonable proof to support denial within thirty days may subject insurer to attorney’s fees and interest, statute does not create any greater penalty — Remand with instructions that case be set for trial

6 Fla. L. Weekly Supp. 234b

Insurance — Personal injury protection — Confession of judgment — Motion for summary judgment claiming that insurer confessed judgment by paying disputed medical bill after lawsuit was filed denied, where insurer may have paid the claim within 30-day review period — An insurer does not confess a judgment upon payment of PIP claim within statutory 30-day period, even if theory of anticipatory repudiation permits premature filing of lawsuit — Issue of whether insurer paid the medical bill before or after expiration of statutory 30-day review period remains unresolved

6 Fla. L. Weekly Supp. 289a

Insurance — Personal injury protection — Plaintiff who owned no motor vehicle which provided No-Fault benefits, resided with no relatives that owned a motor vehicle, and was not, according to jury verdict, a resident of Florida on date of accident was not an insured or omnibus insured under contract in question

6 Fla. L. Weekly Supp. 564a

Insurance — Personal injury protection — Coverage — Pedestrian who did not come into contact with motor vehicle which struck and fatally injured her companion and who was not physically injured not entitled to coverage for psychological counseling