Volume 9

9 Fla. L. Weekly Supp. 626b

Insurance — Personal injury protection — Application — Misrepresentation — Insurer is estopped from asserting affirmative defense that policy was void ab initio based upon alleged material misrepresentation by insured failing to list other household members on application where insurer continued to collect and retained insurance premiums from insured — Further, there is no evidence that any misrepresentation was material where there is no evidence that had insurer known the alleged true facts it would not have issued policy at same rate or in as large an amount, or would not have covered the hazard that resulted in the loss — Affirmative defense stricken with prejudice

9 Fla. L. Weekly Supp. 853a

Insurance — Personal injury protection — Pleadings — Affirmative defenses that include allegation that diagnostic tests performed were not medically necessary; demand for attorney’s fees under statute which forbids medical providers from ordering, procuring, providing or administering unnecessary diagnostic tests; and allegation that insurer determined from independent medical examination that insured had reached maximum medical improvement and no further chiropractic treatment was required are stricken because they are not avoidances of an otherwise valid claim but denials of medical provider’s claim

9 Fla. L. Weekly Supp. 410b

Insurance — Personal injury protection — Medical expenses — Despite absence of insured’s countersignature on medical bills attached to HCFA Form 1500, insurer was required to pay bills for reasonable and necessary services related to automobile accident

Affirmed at 12 Fla. L. Weekly Supp. 218b
Jurisdiction declined by District Court of Appeal at 28 Fla. L. Weekly D2274a

9 Fla. L. Weekly Supp. 397b

Insurance — Personal injury protection — Medical expenses — Section 627.736(5)(a) and (d) do not require the HCFA form to be countersigned by the insured if the medical provider has accepted an assignment of benefits

9 Fla. L. Weekly Supp. 397a

Insurance — Personal injury protection — Medical expenses — Where there was a valid assignment of benefits, insured was required to pay benefits directly to medical provider despite fact that bills were not countersigned by insured but, rather, were marked “signature on file” Defendant.

9 Fla. L. Weekly Supp. 111b

Insurance — Personal injury protection — Medical benefits — Transportation costs — Class action alleging that payment for transportation costs at rate of 34.5 cents per mile violated Florida’s PIP statute and breached contract, and seeking declaratory relief determining that section 627.736 does not permit insurer to pay for automobile usage mileage at its set rate — Reimbursement of 34.5 cents per mile for the cost of transportation associated with medical treatment under section 627.736(1)(a) is reasonable as a matter of law — Court does not have primary jurisdiction as matter is better determined by Department of Insurance — Claim is inappropriate for class action treatment where adjudication would require court to consider individual facts surrounding PIP claims of thousands of policyholders, as well as insurer’s defenses to each of those claims — Complaint dismissed with prejudice

District Court affirmed at 28 Fla. L. Weekly D1239a. HOWEVER,
District court opinion was QUASHED at 30 Fla. L. Weekly S145a and 30 Fla. L. Weekly S172d

9 Fla. L. Weekly Supp. 867a

Insurance — Personal injury protection — Independent medical examination — Insurer which has knowledge that insured is represented by counsel has an obligation to notify counsel of scheduling of IME

9 Fla. L. Weekly Supp. 817b

Insurance — Personal injury protection — Summary judgment — Due process — No error in granting insured’s renewed motion for summary judgment at hearing on set trial date which was continuance of properly noticed pretrial conference — Independent medical examination — Location — MRI is treatment within meaning of section 627.736(7)(a), which allows IMEs to be conducted where insured resides or receives treatment — Trial court erred in finding that IMEs could not be conducted in locale where insured had previously received MRI — No error in denying summary judgment on insurer’s affirmative defense that insured unreasonably refused to submit to two properly scheduled IMEs where insured’s claim that she was not notified of IMEs by her counsel and evidence that insured’s counsel did not have her correct address or telephone number raised issues of material fact

9 Fla. L. Weekly Supp. 721a

Insurance — Personal injury protection — Motion in limine is partially granted, prohibiting insurer from making any mention or question regarding fault related to the accident, whether type of impact would produce injury claimed, anything suspicious about the accident, any comment made by anyone at accident scene during accident investigation, whether insured is dishonest and committing insurance fraud, motivation for insured seeking treatment, insured’s financial status, other claims insured has made, effect of suit on insurance rates, opinion as to validity of claim, observations of insured after the accident suggesting a lack of injury, suggestion that physician hired by insurer is “court-appointed” or independent, possibility of insured obtaining settlements against others, whether this type of case is cause for court backlog, or attorney’s fees and statutory entitlement to fees

9 Fla. L. Weekly Supp. 415a

Insurance — Personal injury protection — Dispute between medical provider and insurer — Insurer that sold non-PPO policy to insured was not prohibited by section 627.736(10) from agreeing directly or indirectly with medical provider for rate below reasonable and normal rate where insured was not limited in choice of provider