2000

25 Fla. L. Weekly D316a

Insurance — Personal injury protection — Where injured insured’s treating physician requested nerve conduction test, and insurer obtained report from physician licensed under same statutory chapter as treating physician stating that test was medically unnecessary, insurer could properly deny payment for test, although physician who prepared report did not conduct physical examination of insured — Insurer is not required by section 627.736(7)(a), Florida Statutes, to obtain a medical report based upon a physical examination of an insured before it may withdraw personal injury protection benefits

25 Fla. L. Weekly D1625a

Insurance — Personal injury protection — Coverage — Reasonable and necessary care — PIP carrier does not lose its right to contest necessity of care or reasonableness of bill when it fails to obtain a written report stating that care is unnecessary or bill is unreasonable within thirty days of receipt of bill — Conflict certified — Statute providing that benefits are overdue if not paid within thirty days after notice to insurer applies only to benefits which are reasonable and necessary as result of accident — If insurer has refused to pay bill within thirty days and does not have reasonable proof to establish that it is not responsible, insurer is liable for interest when bill is paid, but insurer does not lose right to contest payment

25 Fla. L. Weekly D2245a

Insurance — Personal injury protection — Insurer seeking certiorari review of order in which circuit court sitting in appellate capacity affirmed county court ruling on PIP claim — Insured was free to initiate lawsuit to have case determined on merits where by time insurer requested an examination under oath, claim was already overdue under thirty-day provision of statute — Claim that county court erred by entering final judgment against insurer without allowing insurer to pursue any defenses to coverage it might have had not raised in appeal to circuit court — Petition for writ of certiorari denied

25 Fla. L. Weekly D1811a

Insurance — Uninsured motorist — Coverage — Error to find insured entitled to UM coverage for injuries sustained when insured was physically assaulted while he was in his vehicle stopped at traffic light — Injuries did not arise out of ownership, maintenance, or use of uninsured vehicle where uninsured automobile merely transported or contained assailant — Argument that vehicle in which assailant was riding was used to chase insured down does not require different result

25 Fla. L. Weekly D1761b

Insurance — Policy was properly voided pursuant to policy provision voiding policy upon intentional concealment or misrepresentation by insured

25 Fla. L. Weekly D1022c

Insurance — Uninsured motorist — Rescission of policy — Material misrepresentations on application — Waiver — Applicant’s misrepresentation of his military status on application was material where insurer was reciprocal inter-insurance exchange which limited membership to active, retired, and former commissioned military officers and their families and which was not open to general public — Insurer was entitled to void policy due to insured’s material misrepresentation — Error to hold that insurer waived its right to rescind policy because birth date and commission date noted on application, which if accurate would have made insured a commissioned officer at age 17, gave insurer constructive knowledge of misrepresentation — Evidence showed that information on applicant’s birth and commission dates was provided over the phone to insurer’s senior sales representative who input information on different computer screens that did not display two dates next to each other so that age discrepancy was not readily apparent and did not call attention to any situation leading to further inquiry

25 Fla. L. Weekly D1501c

Insurance — Mediation — Sanctions — Error to strike insurer’s pleadings and to enter default as sanction for violating order referring parties to mediation on ground that insurer violated order by failing to send a representative other than its outside attorney to mediation — Where order required that insurer send only a single, duly authorized representative to mediation with full settlement authority, insurer complied with order by sending its outside counsel who was duly authorized and had full settlement authority — Portion of order which required insurer who has assumed defense of a party to send a representative who is not insurer’s outside counsel was not applicable where insurer was sued directly for breach of contract and had not assumed the defense of a party

25 Fla. L. Weekly D51a

Insurance — Uninsured motorist — Limitation of actions — Statute of limitations on action by insured against uninsured motorist insurer not tolled until time of payment from tortfeasor’s liability carrier, where policy does not preclude policy holder from filing suit against insurer until after proceedings against tortfeasor have been concluded

25 Fla. L. Weekly D1527b

Insurance — Life — No action clause in insurance contract operates as condition precedent that bars suit against insurer until compliance with relevant policy provisions — Where policy provided that no legal action could be brought against insurer until 60 days after written proof of death, and it was undisputed that beneficiary furnished only oral notice of death, trial court properly granted insurer’s motion for summary judgment and dismissed beneficiary’s suit without prejudice — Beneficiary not estopped from re-filing suit if she complies with condition precedent

25 Fla. L. Weekly D2571b

Insurance — Liability — Nonrenewal of policy — Insurer’s failure to give statutory notice of nonrenewal of policy was excused where insured had obtained replacement coverage with another insurer — Error to enter judgment determining that policy provided coverage for accident where insured had procured coverage with another insurer prior to expiration of policy — Insurer’s failure to give statutory notice was excused even though replacement policy did not provide exact same coverage as prior policy