Volume 9

9 Fla. L. Weekly Supp. 60a

Insurance — Personal injury protection — Where medical provider erroneously submitted bill for service to insurance company that was not proper insurer for claim and subsequently submitted bill to proper insurer more than thirty days after services were rendered, claim was mailed untimely and insurer is not required to pay bill

9 Fla. L. Weekly Supp. 877b

Insurance — Personal injury protection — Coverage — Exhaustion of benefits — Insurer had right to pay later-submitted bills during thirty-day period that it was allowed to pay or investigate assignee’s bill and was not obligated to pay the assignee’s bill once policy limits were exhausted by payment of those subsequent bills during the thirty-day period

9 Fla. L. Weekly Supp. 706a

Insurance — Personal injury protection — Where there is no evidence that assignee accepted reduced payments under protest with notice to insurer of intent to seek full amount of bills, and after policy limits were exhausted assignee filed suit seeking to recover difference between amount billed and amount paid out, summary judgment is granted in favor of insurer

9 Fla. L. Weekly Supp. 581e

Insurance — Personal injury protection — Medical provider to whom insured assigned rights against insurer had no further interest in insurance contract once PIP benefits were exhausted — Priority of payment — Assignee’s claim had priority over insured’s wage claims where assigned claim was submitted first — Insurer’s partial payment of what it deemed to be a reasonable amount of assignee’s claim satisfied priority of payment requirement — Where assignee did not request insurer to escrow unpaid amount in dispute, insurer was obligated under its contractual duties to the insured to continue paying other applicable claims, although that exhausted available benefits — Insurer was not required to obtain medical report as prerequisite to contesting reasonableness of bills submitted by provider — No error in entering final summary judgment for insurer

9 Fla. L. Weekly Supp. 392a

Insurance — Personal injury protection — Coverage — Medical expenses — Diagnostic range of motion testing is compensable medical service or treatment under Florida No-Fault statute — No merit to argument that insured must derive a medical benefit from ROM test in order for test to be compensable under PIP statute — ROM test that assisted medical provider in care and treatment of insured was meaningful service and contemplated to be compensable under statute — Section 627.736(5)(a) and (5)(d) do not require a handwritten signature on HCFA form; computer generated printed name is sufficient — Statute does not require signature of technician who performed service on HCFA form — By partially paying bill, insurer waived defense that this type of signature constituted improper notice — Insurer’s motion for summary judgment denied

9 Fla. L. Weekly Supp. 204b

Insurance — Personal injury protection — Error to enter summary judgment in favor of medical provider based on insurer’s failure to pay or obtain reasonable proof for denial within thirty days of receiving provider’s bill

9 Fla. L. Weekly Supp. 204a

Insurance — Personal injury protection — Error to enter partial summary judgment and final judgment precluding insurer from contesting medical bill on ground that it failed to obtain a written report stating that such care was unnecessary or bill was unreasonable within thirty days of receipt of bill

9 Fla. L. Weekly Supp. 21b

Insurance — Personal injury protection — Error to enter summary judgment in favor of insurer in insured’s action for PIP benefits on ground that insured unreasonably failed to attend independent medical examination where insurer waived defense of unreasonable refusal by rescheduling the IME — Language in notice of second IME, stating that failure to attend second IME would cause insured’s PIP benefits to be suspended as of date of prior appointment, did not negate waiver that ensued from rescheduling — By rescheduling IME, insurer waives right to deny PIP benefits for refusal to attend IME irrespective of whether insured unreasonably failed to attend first IME

9 Fla. L. Weekly Supp. 414a

Insurance — Personal injury protection — Coverage — Medical expenses — Insurer is required to pay claim by insured for reasonable expenses of MRI billed by MRI provider which contracted with an imaging facility to provide the MRI — Where insured did not assign her PIP benefits to MRI provider and was a stranger to any business dealings between MRI provider and the imaging facility, defense of illegality or violation of public policy is unavailable to insurer — No merit to insurer’s assertion that it was not on notice of claim because MRI provider did not identify the imaging facility on the HCFA Form 1500 — Insurer’s indemnification of insured does not excuse its failure to timely pay claim in accordance with the law and policy

9 Fla. L. Weekly Supp. 325a

Insurance — Personal injury protection — Dispute between medical provider and insurer — Where policy contained provision requiring insured to submit to examination under oath as a condition of insurance contract, insured’s failure to appear at examination was a material breach of the contract which relieves insurer from liability under the policy — Insured’s submission to examination under oath is condition precedent with which medical provider must comply before filing suit