Volume 6

6 Fla. L. Weekly Supp. 720e

Insurance — Personal injury protection — Independent medical examination should have been scheduled in municipality in which insured resides under circumstances

6 Fla. L. Weekly Supp. 573c

Insurance — Error to terminate no fault insurance benefits based on insured’s refusal to submit to independent medical examination — With regard to first scheduled examination, insured was never notified by insurer of its decision to utilize a particular entity to perform an independent medical examination and did not inform insured that she was required to comply with the request made by that entity for an IME — First IME was not scheduled in municipality where insured resided or where insured was receiving treatment — With regard to second scheduled examination, it was not unreasonable for insured to become confused as to where and when she was to submit to IME in view of conflicting communications — Medical bills, penalties, and interest awarded to assignee

6 Fla. L. Weekly Supp. 396c

Insurance — Homeowners — Subrogation — Insurer seeking to recover from manufacturer of air conditioning unit and local servicing and maintenance company the amounts it paid to its insured as result of damage caused by leaking unit — Trial court properly entered summary judgment in favor of manufacturer where there was no evidence that manufacturer was negligent, and insurer’s investigation resulted in specific determination that responsibilities for the occurrence lay solely with installer

6 Fla. L. Weekly Supp. 48b

Insurance — Health — Health maintenance organizations — Provider of medical services seeking payment of unpaid medical bills from defendant who is member of HMO — Section 641.315(3), which provides that no provider of services may maintain an action at law against a subscriber of HMO to collect money owed to such provider by HMO, does not provide a jurisdictional threshold — Because statute is not a jurisdictional requirement, motion to dismiss is denied, without prejudice to asserting statute as affirmative defense

6 Fla. L. Weekly Supp. 553a

State attorneys — Subpoenas — Privacy — Motion to quash subpoena duces tecum issued at request of investigator for Department of Insurance, Division of Insurance Fraud and requiring production of financial institution records — State’s interest in conducting an effective criminal investigation into allegations of theft on part of movant is compelling state interest, issuance of subpoena duces tecum was least intrusive means employed to achieve that interest, and subpoena was reasonably calculated to obtain information relevant to ongoing criminal investigation — Prior judicial approval of such a subpoena is not required — Motion to quash subpoena and motion for permanent injunction is denied

6 Fla. L. Weekly Supp. 522a

Insurance — Personal injury protection — Plaintiff, who referred and scheduled appointment for insured at magnetic resonance imaging facility that actually performed MRI services, is not entitled to recover PIP benefits under section 627.736 for two MRI scans provided to insured — Plaintiff is not a “physician, hospital, clinic, or other person or institution lawfully rendering treatment” to insured, and plaintiff provided no treatment or meaningful service to insured that would qualify it as a health care provider entitled to payment of PIP benefits under section 627.736 — Charge of $2,200 by plaintiff above $800 charged by MRI facility for MRI services, or $1,100 charged by plaintiff over and above MRI facility’s usual, customary and standard charge for MRI services constitutes a kickback, rebate or split-fee arrangement within meaning of section 817.505 which prohibits patient brokering — Plaintiff’s activities constitute clear violation of statute which prohibits patient brokering and split-fee arrangements — Split fee arrangement that exists between plaintiff and MRI facility is contrary to public policy of state and expressly prohibited by patient brokering statute — Payment of insured’s PIP benefits to plaintiff under section 627.736 would be contrary to public policy of state — Questions certified to Fourth District Court of Appeal: Whether an entity that refers and coordinates the scheduling of a patient’s MRI (or other diagnostic testing) to and with a facility that actually performs and provides all the MRI (or other diagnostic testing) services is entitled to payment of PIP benefits under section 627.736 for the MRI services provided to the patient/insured by the third-party facility — Whether an entity that refers and coordinates the scheduling of a patient’s MRI (or other diagnostic testing) to and with a facility that actually performs and provides all the MRI (or other diagnostic testing) services, and then bills the patient’s insurer for those MRI (or other diagnostic testing) services at a markup of between 150-375% of the charges of that actual provider of the services, is engaged in activity that constitutes patient brokering and a split-fee arrangement contrary to the public policy of this state and in violation of section 817.505

6 Fla. L. Weekly Supp. 500a

Criminal law — Solicitation of false and fraudulent insurance claim — Statute making it unlawful to solicit business in or about hospitals, sanatoriums, or any private institutions, upon private property, in public institutions, in any public place, upon public streets, for the purpose of making motor vehicle tort claims or claims for personal injury protection benefits does not apply to telephone solicitation — Motion to dismiss is granted on all counts except the single count in which it was alleged that defendant physically presented themselves at private residence to solicit business

6 Fla. L. Weekly Supp. 489a

Jurisdiction — Nonresidents — Contracts — Marine insurance — Foreign association which provided policies of insurance with respect to vessel owned by plaintiff, a foreign shipping company, lacks requisite minimum contacts to justify exercise of personal jurisdiction and is not engaged in “substantial and not isolated” business activity which would provide basis for exercise of general jurisdiction — Section 626.906, Florida Statutes, which is part of Florida’s Unauthorized Insurers Process Law, cannot provide basis for jurisdiction because it only applies to policies issued for delivery to Florida residents, a circumstance not present in instant case — Defendant’s use of correspondents in several of Florida’s ports and act of sending surveyors to examine damage after vessel was brought into Florida port following casualty not sufficient to establish specific jurisdiction over defendant — Contacts by insurer resulting from issuing of letters of undertaking when casualty may have arisen in Florida or elsewhere in the United States to stand in place of vessel on behalf of owner not sufficient to establish minimum contacts — Venue — Even if jurisdiction existed, action would be dismissed for lack of proper venue given venue provision in foreign maritime code which was incorporated into hull and machinery policy and which mandates that venue for resolution of dispute is in Sweden, the country where defendant is located and where insurance was issued

6 Fla. L. Weekly Supp. 16a

NOT FINAL VERSION OF OPINION
Subsequent Changes at 6 Fla. L. Weekly Supp. 155c

Insurance — Automobile — Exclusions — Rental vehicles — Where parties had stipulated that rental by insured was for three day period and that insured was on vacation, additional facts concerning whether three day rental constituted rental for regular use, which would have constituted exception to stipulation, are speculations not affecting court’s ability to grant summary judgment — Summary judgment determining insurance coverage in favor of insured affirmed — Attorney’s fees — No error in awarding attorney’s fees to insured, because there was an acquiescence when insured continued to prosecute his claim for fees — Although claim for attorney’s fees under “applicable Florida statute” does not appear to be adequate pleading, insurer had notice that attorney’s fees were sought, and it took no steps to further inquire or move for more definite pleading

6 Fla. L. Weekly Supp. 185a

Insurance — Personal injury protection — Insurer does not breach contract with insured by failing to pay for medical expenses deemed to be unreasonable, unnecessary, or unrelated to accident — Insurer’s contractual obligation to defend and indemnify the insured if the provider sues for outstanding bills is enforceable