Volume 9

9 Fla. L. Weekly Supp. 529a

Insurance — Personal injury protection — Failure to authenticate medical provider’s bill within thirty days does not prevent insurer from raising defense that avoids liability for paying the bill in question — If, within thirty days of receiving provider’s bill, benefits have been exhausted, insurer can raise exhaustion of benefits as defense, even if exhaustion were not previously claimed — Exhaustion of limits after thirty-day period is not relevant — Affirmative defenses of waiver, estoppel, or laches were waived where those defenses were not raised in defendant’s answer — Section 627.736(4) does not contain express requirement that insured or provider contest insurer’s decision to reduce bill — When insurer reduces a reasonable bill for necessary and related services, it does so at its own risk

9 Fla. L. Weekly Supp. 660b

Insurance — Personal injury protection — Notice of loss — No error in directing verdict for insurer when insured failed to introduce any evidence that his medical providers possessed required occupational licenses — Where insured not only pled generally that all conditions precedent to bringing suit have been met, but also alleged specifically that he gave notice of covered losses to insurer, insurer’s failure to specifically deny that condition precedent created by statutory requirement that notice of loss contain some statement that medical providers had required licenses had been met did not waive defense based on notice — Insurer’s general denial of specific allegation placed insured on notice that he would have to prove at trial that notice which complied with statute was given

9 Fla. L. Weekly Supp. 252a

Insurance — Personal injury protection — Dispute between medical provider and insurer — Examination under oath — Summary judgment in favor of insurer granted where insurance policy provides that answering questions at EUO is a condition precedent to suit, and medical provider assignee failed to attend EUO

9 Fla. L. Weekly Supp. 592b

Insurance — Personal injury protection — Where claimant injured while driving insured’s vehicle failed to maintain insurance on her own vehicle, admitted to driving own vehicle until right before the accident, but claimed that own vehicle was inoperable until repaired, there exists genuine issue of material fact regarding whether claimant’s vehicle was operable at time of the accident and, thus, whether registration and security was required on vehicle — Error to enter summary judgment in favor of insurer

9 Fla. L. Weekly Supp. 126a

Insurance — Personal injury protection — Coverage — Reasonable and necessary care — PIP carrier’s motion for summary judgment as to declaratory action count seeking declaration as to whether insurer that reduces bills loses its right to coverage defenses if it does not obtain a written report stating that medical treatment is not reasonable, related, or necessary within thirty days of submission of medical charges is granted pursuant to appellate decisions finding that insurer does not lose right to defenses

9 Fla. L. Weekly Supp. 83c

Insurance — Personal injury protection — Error to find that insurer forfeited right to assert affirmative defense to insured’s claim for PIP benefits because insurer failed to obtain medical report showing bills were unreasonable within 30 days of receipt of bills — On remand, if trial court finds material issue of fact regarding insurer’s defense of illegality, insurer should be permitted to prove defense — If insured succeeds on claim at trial, insurer will be required to pay outstanding bills, plus statutory interest and attorney’s fees

9 Fla. L. Weekly Supp. 557a

Insurance — Personal injury protection — Punitive damages — Where insurer claims that defendants falsely represented through the submission of HCFA-1500 and MRI reports that they had provided MRI services to insured to induce insurer to pay for MRI that defendants did not perform or interpret, and insurer justifiably relied on false representations in making payment to defendants for services they did not render, leave to add claim for punitive damages is granted

9 Fla. L. Weekly Supp. 567a

Insurance — Personal injury protection — Claim form — Countersignature — Insured does not have to countersign insurance claim form as condition precedent to insurer paying claim to assignee medical provider — Plaintiff’s motion for partial summary judgment granted

9 Fla. L. Weekly Supp. 708a

Insurance — Personal injury protection — Statute does not require person receiving service or treatment to countersign HCFA-1500 form, nor does it require medical provider actually providing service or treatment to sign HCFA-1500 form — Summary judgment granted in favor of assignee where insurer’s sole basis for nonpayment of bills was absence of signature and countersignature on HCFA-1500 forms

9 Fla. L. Weekly Supp. 224b

Insurance — Personal injury protection — Coverage — Exclusions — Injuries sustained by named insured while occupying motor vehicle owned by named insured and not insured under policy — Action against insurer which denied coverage for injuries sustained by plaintiff who was insured under policy covering vehicle owned by his mother but who was injured while driving a vehicle of contested ownership which was not covered under policy — Error to enter summary judgment in favor of insurer where, although vehicle insured was driving was titled in the name of insured’s mother and father, evidence that insured’s parents were separated for five years prior to accident raises possibility that insured’s mother did not in fact own the vehicle