Volume 9

9 Fla. L. Weekly Supp. 196c

Insurance — Personal injury protection — Dispute between medical provider and insurer — Section 627.736 does not specifically require medical provider to countersign HCFA form or include its credentials or degrees on HCFA form — Medical provider granted summary judgment with prejudice on affirmative defense that provider failed to comply with proof section of statute by failing to countersign HCFA form and include credentials or degrees on form — Medical provider granted summary judgment without prejudice on affirmative defense that bill for radiology services did not have enclosed with it a report to substantiate charges where insurer failed to allege sufficient ultimate facts to support defense — Medical provider granted summary judgment without prejudice on affirmative defense that medical bills were not timely submitted to insurer for payment where insurer failed to allege with sufficient particularity which bill was untimely filed — Affirmative defense that there is a deductible is not a valid or appropriate affirmative defense under Florida law — Affirmative defense that there are no justiciable issues of law or fact and insurer is entitled to sanctions under section 57.105 is not a valid or appropriate affirmative defense under Florida law

9 Fla. L. Weekly Supp. 489b

Insurance — Personal injury protection — Action by insured against PIP insurer — Where insured erroneously requested payment for medical bills related to automobile accident from health insurance provider, bills were paid by health insurance provider, insured’s attorney represented to insured’s PIP insurer that insured had entered into a settlement agreement with health insurance provider for payment of a reduced amount as full and final satisfaction of health insurance provider’s lien, PIP insurer relied on attorney’s representation in tendering reduced amount to health insurance provider, and PIP insurer had a detrimental change in position caused by that representation in that it satisfied the lien as represented by the insured and did not tender payment in full or otherwise attempt to negotiate lien to a lesser amount, summary judgment is granted in favor of PIP insurer

9 Fla. L. Weekly Supp. 323b

Insurance — Personal injury protection — Dispute between medical provider and insurer — Where insurer denied medical provider’s presuit request for a copy of PIP log, which provider sought to verify insurer’s claim that provider’s bill was applied to insured’s deductible, provider properly sought declaratory relief on issue of whether insurer was required to provide log — Motion to dismiss because suit was moot after log was provided during discovery is denied — Jurisdiction to award attorney’s fees to medical provider reserved

9 Fla. L. Weekly Supp. 866a

Insurance — Personal injury protection — Chiropractic care after the date of the independent medical examination is found to be necessary where treating physician testified that care might not cure insured’s cervical injury but condition would worsen without care, and that all care was in accordance with accepted standards of practice and clinically appropriate, and IME physician agreed with treating physician’s diagnoses and treatment rendered up to date of examination, concluded that further treatment did not appear necessary on date of examination but may be appropriate if insured experienced “flare-ups,” and had no opinion as to whether insured had actually experienced “flare-ups”

9 Fla. L. Weekly Supp. 714a

Insurance — Personal injury protection — Coverage — Passenger — Insurer has burden of proving that passenger is not covered under driver’s PIP policy because passenger owned a vehicle at the time of the accident — Where the only evidence presented by insurer that passenger owned a motor vehicle operated on the roads of this state is application for registration of vehicle sold by passenger for salvage value prior to accident, there is no competent evidence that passenger possessed a vehicle at the time of the accident, much less maintained an operable vehicle at that time

9 Fla. L. Weekly Supp. 862a

Insurance — Personal injury protection — Coverage — Unregistered medical providers — Mobile diagnostic facility — Section 456.0375 definition of clinic subject to registration requirement as a business operating in a single structure or facility at which health care services are provided must be read together with failure to include mobile diagnostic facilities in thirty exemptions, which indicates that no exception for moving or traveling facilities was intended by legislature — Department of Health’s interpretation of statute as requiring registration of mobile facilities is consistent with plain meaning of statute and is entitled to considerable weight — Because mobile diagnostic facility was not registered, treatment rendered was not lawful, and insurer was not obligated to pay bills — Summary judgment granted in favor of insurer — Questions certified: Is a mobile diagnostic health care facility such as Diagnostic Services of South Florida required to be registered with the Department of Health pursuant to Section 456.0375, Florida Statutes, and, if “yes,” is an automobile insurance carrier relieved of its obligation to pay for such services if such services were rendered when the mobile diagnostic facility was not so registered?

9 Fla. L. Weekly Supp. 858a

Insurance — Personal injury protection — Coverage — Unregistered medical providers — Mobile diagnostic facility is subject to registration requirement of section 456.0375 because it is a clinic within meaning of statute and is not exempted by statutory exclusions — Department of Health’s interpretation of statute as requiring registration of mobile facilities is logical interpretation of statute which cannot be avoided — Because mobile diagnostic facility was not registered as required, it cannot recover on claims against insurer — Summary judgment granted in favor of insurer

9 Fla. L. Weekly Supp. 855a

Insurance — Personal injury protection — Coverage — Unregistered medical providers — Mobile diagnostic facility — Registration requirement of section 456.0375 is inapplicable to mobile diagnostic providers, regardless of the absence of a specific exclusion for mobile providers, because mobile providers fall within class of medical providers not included in already broad definition of “clinic” as a business operating in a single facility or structure — Insurer’s reliance on Department of Health’s interpretation of statute as requiring registration of mobile facilities is unavailing where interpretation is unfounded and in direct conflict with plain meaning of statute — Questions certified: (1) Is a mobile diagnostic health care facility which only conducts diagnostic testing at clinics registered with the Florida Department of Health and at the request and direction of the on staff treating physicians of those facilities required to be registered with the Department of Health pursuant to Section 456.0375, Florida Statutes, and, (2) If the answer to No. (1) above, is “yes,” is an automobile insurance carrier relieved of its obligation to pay for such services if such services were rendered when the mobile diagnostic facility was not so registered? — Summary judgment granted in favor of medical provider

9 Fla. L. Weekly Supp. 131c

Insurance — Dispute between medical provider and insurer — Standing — Assignment — Patient information form is not legally sufficient assignment — Insurer’s motions for summary judgment and to strike attorney’s fees claim granted

9 Fla. L. Weekly Supp. 131b

Insurance — Personal injury protection — Standing — Plaintiff which did not perform necessary medical services and is not a “physician, hospital, clinic, or other person or institution lawfully rendering treatment to an injured person for a bodily injury covered by PIP insurance” is not entitled to payment for MRI services from insurer or insured