Volume 6

6 Fla. L. Weekly Supp. 481a

Insurance — Personal injury protection — Coverage — Non-resident

6 Fla. L. Weekly Supp. 625b

Insurance — Personal injury protection — Coverage — Nexus between injury and use of motor vehicle — Insured who was sprayed by crop duster as he rode as passenger in motor vehicle was entitled to coverage under terms of insurance policy

6 Fla. L. Weekly Supp. 752b

Insurance — Personal injury protection — For purposes of PIP benefits, an individual is the same as his or her fictitious name/sole proprietorship — Trial court properly found individual who was sole employee/owner of towing business which he operated under fictitious name was entitled to PIP coverage under policy insuring tow truck, notwithstanding insurer’s contention that business, not individual, was owner of truck

6 Fla. L. Weekly Supp. 779a

Insurance — Personal injury protection — Insurer entitled to summary judgment on claim alleging insurer wrongfully refused to pay medical bills insured incurred for treatment rendered by health care provider — Section 627.736(5)(b) (1998) is clear and unambiguous in requiring that PIP bills be furnished only by provider directly to carrier within thirty (30) days of date of service, which date is measured by postmark on envelope in which bills are transmitted — Health care provider did not submit “Notice of Initiation” to insurer which would extend time within which insurer might be responsible for payment of bills for services rendered — Medical bills, which were not sent to insurer within 30 days of date services were rendered, were untimely pursuant to statute and insurer is relieved of its obligation to pay these bills

6 Fla. L. Weekly Supp. 236b

Insurance — Personal injury protection — Plaintiff who acknowledges that he is seeking declaration concerning his rights under insurance policy as policy relates to 30-day review and independent medical examination requirements under section 627.736(7) is not entitled to summary judgment because claim for lost wages, which is the only claim remaining, is not implicated by IME requirement

6 Fla. L. Weekly Supp. 722a

Insurance — Personal injury protection — Insurer, as condition precedent to reducing medical charges and/or defending lawsuit for benefits, must first obtain report from a physician with the same level of licensure as the treating physician, stating that the charges are excessive — Question certified: In a claim for personal injury protection benefits disputing the amount charged by the treating physician, is it a condition precedent, pursuant to F.S. 627.732(7)(a), that the insurer first obtain a report from a physician licensed under the same chapter as the treating physician, stating that the charge is excessive?

6 Fla. L. Weekly Supp. 733a

Insurance — Personal injury protection — Insurer liable for payment of bill for nerve testing, plus statutory interest and attorney’s fees, where payment was denied thirty-five days after bill was received, and insurer did not have reasonable proof establishing that it was not responsible for payment of bill within thirty days of receipt

6 Fla. L. Weekly Supp. 109a

Insurance — Personal injury protection — Error to enter summary judgment in favor of insurer based on payment of insured’s bills within 30 days — Termination letter was repudiation of contract giving rise to cause of action — Insurer’s contention that even if they exercise right to deny further benefits they should still be permitted to take 30 days to evaluate any additional bills is rejected

6 Fla. L. Weekly Supp. 354b

Insurance — Personal injury protection — Independent medical examination — Insured’s refusal to submit to two IMEs was unreasonable and without proper justification where IME was scheduled at doctor’s office that was between three and five miles from insured’s residence, insured did not provide adequate notice of intent to refuse to submit to IME, and reasons given by insured for refusal to submit to IME were arbitrary and insufficient to justify noncompliance — Because there were no qualified physicians within municipal limits of insured’s residence, insurer was entitled to schedule IME outside insured’s residence in a location reasonably accessible to insured — Insured’s untimely attempt to raise issue of doctor’s office being located in what he was told was high crime area is ineffectual — Insurer is not obligated to pay for medical bills which were received after insured’s first scheduled IME because insured unreasonably refused to appear for two properly scheduled independent medical examinations

6 Fla. L. Weekly Supp. 469b

Insurance — Personal injury protection — Action against insurer after coverage was denied for failure of injured party to attend independent medical examinations — Notice of initial and rescheduled independent medical examinations sent to plaintiff’s counsel was sufficient — No error in entering summary judgment in favor of insurer