Volume 7

7 Fla. L. Weekly Supp. 49a

Insurance — Personal injury protection — Insurer remains liable for medical bills from heath care provider that were received prior to first scheduled independent medical examination where insurer failed to either pay medical bills at full 80% pursuant to terms of policy and section 627.736, Florida Statutes, or establish that it had reasonable proof that it was not responsible for payment of these medical bills — Insured entitled to partial summary judgment on these bills — Court reserves jurisdiction to determine whether insurer is liable for all medical bills received prior to second IME based upon jury’s determination of whether insured reasonably refused to attend scheduled IME — Issue of whether insured unreasonably refused to attend scheduled IMEs is question of fact for jury — If jury finds that insured’s failure to attend scheduled IMEs was not unreasonable, court reserves jurisdiction to determine whether insurer is liable of any and all medical bills that it received on behalf of insured, where defendant failed to obtain report from physician in same licensing chapter as treating physician in order to establish that it was not responsible for payment of any medical or diagnostic bills — Attorney’s fees — Plaintiff entitled to prevailing party attorney’s fees and costs and court reserves jurisdiction to determine amount of reasonable fees and costs

7 Fla. L. Weekly Supp. 181b

Insurance — Personal injury protection — Collateral estoppel — Trial court erred in finding that plaintiffs were collaterally estopped from claiming PIP benefits by jury verdict in previous suit in which plaintiffs sought uninsured motorist benefits and in which jury found that accident was not legal cause of loss, injury, or damage sustained by plaintiffs — Issues and claims in UM suit were too disparate from issues and claims in PIP suit for collateral estoppel to apply — Jury in UM suit was concerned with future medical expenses, permanent injury, and any accompanying damages for pain and suffering, disability, disfigurement, and loss of consortium and was not asked to render any opinion as to whether past medical expenses were incurred as result of the accident

7 Fla. L. Weekly Supp. 775a

Insurance — Personal injury protection

7 Fla. L. Weekly Supp. 434a

Insurance — Leased vehicles — Rental car company seeking indemnity from drivers listed on rental agreement and driver to whom vehicle was loaned and who was cited for accident in which rental car and another automobile struck by rental car were damaged

7 Fla. L. Weekly Supp. 543a

Insurance — Personal injury protection — Delay in payment of benefits — Interest — Based on plain meaning and intent of Section 627.736(4), insurer is required to pay interest on all payments made more than thirty days after bills were submitted — Waiver of interest — Any waiver of interest insurer obtained from medical provider is nullity since medical provider has no legal standing to waive benefit — Only person with authority to waive payment of interest would be insured, since statute clearly states that benefits paid pursuant to statute are for benefit of insured

7 Fla. L. Weekly Supp. 289a

Insurance — Personal injury Protection — Interest — Insured not entitled to interest on payments for chiropractic services rendered after insurer discontinued chiropractic benefits, because insurer obtained timely report from appropriate physician before terminating chiropractic benefits, and therefore had reasonable proof it was not responsible for payment — Because insurer had reasonable proof as required by statute, no payments were overdue and insured could not be entitled to interest on overdue payments pursuant to no-fault statute — Even if case continued to trial and plaintiff proved services rendered by treating chiropractor were necessary, insurer still would have complied with requirements of no-fault statute before terminating chiropractic benefits — No-fault statute only provides for interest if insurer fails to comply with statute by having reasonable proof that it is not responsible for payment within 30 days of being furnished with notice of loss and amount of loss

7 Fla. L. Weekly Supp. 505b

Insurance — Personal injury protection — Denial of benefits based upon physician’s report that treatment was not reasonable, related, or necessary — Report need not be based upon actual physical examination of patient — Statute requires interest on late payments to accrue from date bill is received by insurer

7 Fla. L. Weekly Supp. 214a

Insurance — Personal injury protection — Interest — Where insurer paid certain bills for medical services rendered to insured beyond thirty-day period provided in section 627.736(4)(b), interest on overdue payments by insurer for PIP benefits commences on first day after submission of bills — Question certified: When an insurer pays PIP benefits for medical services more than thirty (30) days after submission, does interest commence on the first day after submission or the thirty-first day after submission?

7 Fla. L. Weekly Supp. 279a

Insurance — Health — Coverage — Preexisting conditions — Motion for summary judgment asserting insured had preexisting condition which precludes coverage under policy — Incontestability clause does not bar insurer from denying liability on ground that policy contains preexisting condition limitation which precludes coverage — Argument that denial of coverage is barred by incontestability clause because of insurer’s failure to initiate litigation to deny coverage based on preexisting condition is misplaced — Insurer is allowed to deny coverage for losses due to preexisting condition where evidence shows that loss occurred prior to expiration of two year incontestability period, and that preexisting condition was undisclosed — Waiver — There is no support for argument that because insurer failed to address issue of preexisting conditions in prior summary judgment motion, it waived right to file present motion — When the lower court’s grant of summary judgment to an insurer is reversed based on holding that applicant’s responses to questions on applications were not misstatements warranting rescission, on remand insurer is not prevented from litigating its other bases for denying coverage — Insurer entitled to summary judgment as there is no evidence of existence of any material fact

7 Fla. L. Weekly Supp. 357b

Insurance — Evidence — Policy language regarding insurer’s right to refuse to pay medical expenses it deems to be unreasonable or unnecessary — Plaintiff’s motion in limine granted