2001

26 Fla. L. Weekly D1992d

Insurance — Uninsured motorist — Stacked coverage — Trial court erred in entering summary judgment finding that there was no uninsured motorist coverage for death of insured while occupying an owned vehicle not listed in policy because insured had signed valid nonstacked coverage election form when policy was first issued, where there was factual issue as to whether insurer had sent insured required annual notices of UM coverage options — When insurer has failed to send required annual notice, insurer is required to provide full UM coverage regardless of insured’s initial election of reduced coverage — When insurer has sent required annual notices to insured, insured is bound by original election of reduced UM coverage

26 Fla. L. Weekly D2588a

Contracts — Insurance — Risk management pool — Municipal corporations — Government in the sunshine — Trial court correctly determined that amended interlocal agreement and by-laws of risk management pool of several municipalities clearly and unambiguously set forth manner in which each member was to be assessed, that parol evidence was not necessary for interpretation, and that city was not liable for certain assessments imposed after city left pool — Trial court properly found that meetings of risk management pool at which city was assessed payments were held in violation of Florida’s Sunshine Law — Initial meeting was not properly noticed, and subsequent ratification was merely perfunctory and did not correct problem — Assessments made at those meetings were void — Breach of fiduciary duty — No error in ruling in favor of risk management pool, the pool’s management firm, and a third entity on city’s counterclaim for breach of fiduciary duty — Attorney’s fees — City not entitled to attorney’s fees on breach of contract claims, although interlocal agreement provided for award of fees to prevailing party, where city failed to adequately plead its demand for attorney’s fees based on contract — City is entitled to prevailing party attorney’s fees for Sunshine Act claims — As prevailing party, city is entitled to recover its costs

26 Fla. L. Weekly D734a

Insurance — Personal injury protection — Where PIP insurer which had been paying benefits for chiropractic treatment requested independent medical examination, and chiropractic physician who conducted examination concluded that insured had reached maximum medical improvement and that further chiropractic treatment was not medically necessary, insurer’s reliance on that report to withdraw authorization for future chiropractic treatment was in compliance with requirements of section 627.736(7)(a) — Circuit court sitting in its appellate capacity misapplied law when it found that section 627.736(7)(a) could not be used to withdraw authorization for future treatment and reversed county court judgment for insurer in insured’s action against insurer — Circuit court also disobeyed clearly established principles of law when it issued written opinion directly and expressly conflicting with dispositive precedent from district court of appeal

26 Fla. L. Weekly D1619a

Insurance — Personal injury protection — Claimant who was struck by automobile while riding bicycle and who sought PIP benefits under policy covering car that struck him challenging insurer’s denial of coverage on ground that claimant was not resident of Florida — Residency requirement in section 627.736(4)(d)(4), Florida Statutes (1993), is intended by legislature as pure residence requirement, not as requirement for domicile, legal residence, or citizenship — Trial court erred by allowing extensive evidence of claimant’s status as illegal alien and by instructing jury on that subject because, for purposes of statute, claimant’s status as illegal alien was of marginal relevance — Under circumstances, any probative value was clearly outweighed by its prejudicial effect because claimant’s alien status, rather than his residency, became focus of jury’s attention — If jury trial should be necessary on remand, jury may need more complete instruction on definition of “resident” so that they do not confuse that term with concepts of domicile or citizenship

26 Fla. L. Weekly D1637b
788 So. 2d 403

Insurance — Personal injury protection — Plaintiff is not entitled to recover PIP benefits for magnetic resonance imaging services allegedly provided to insureds, where plaintiff does 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”

26 Fla. L. Weekly D1999cNOT FINAL VERSION OF OPINION
Subsequent Changes at 27 Fla. L. Weekly D88b

Insurance — Personal injury protection — Appeals — Certiorari — Petition for writ of certiorari to review circuit court opinion affirming summary judgment in favor of insurer based on conclusion that insured was not prejudiced by insurer’s payment of only that portion of medical expenses it deemed reasonable and necessary because insured suffered no damages until sued by a medical provider for unpaid amount — Where established law provided no controlling precedent, circuit court cannot be said to have violated a clearly established principle of law — Argument that PIP statute is violated by policy provision that requires injured person to be sued by medical provider before he can contest the reasonableness and necessity of medical expenses presents matter of statutory construction unsuitable for limited standard of review of certiorari proceeding — County courts encouraged to certify issue

Quashed at 28 Fla. L. Weekly S287a
Circuit court order at 7 Fla. L. Weekly Supp. 760a

26 Fla. L. Weekly D1886b
810 So. 2d 514

NOT FINAL VERSION OF OPINION
Subsequent Changes at 27 Fla. L. Weekly D551e

Insurance — Personal injury protection — Error to hold that insurer could not defend against PIP claims of its insureds because insurer did not timely obtain reasonable proof that medical procedures were unreasonable, unnecessary, or unrelated to motor vehicle accidents — Although trial court rightly perceived conflict between district courts on issue, court should have followed Fifth District’s decision

26 Fla. L. Weekly S747a

Insurance — Personal injury protection — Where payment of benefits for a PIP claim is overdue because insurer has not paid benefits within 30 days after receipt of notice of claim and insurer does not have reasonable proof that it is not responsible for payment, insurer is liable for payment of statutory interest and attorney’s fees, but is not barred from contesting the claim — For purpose of insurer avoiding 30-day rule by showing that insurer has “reasonable proof” to establish that it is not responsible for payment, a medical report is not required to establish reasonable proof

26 Fla. L. Weekly D869a

Insurance — Personal injury protection — Error to enter summary judgment finding that insurer was liable for payment of PIP benefits plus interest on ground that insurer did not pay benefits within thirty days after claim, where conflicting opinions in physician affidavits created genuine issues of material fact regarding whether treatment insured received was reasonable — If insurer has refused to pay bill within thirty days and does not have reasonable proof to establish that it is not responsible, this does not deprive insurer of its right to contest payment — 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 ten percent interest when bill is paid

26 Fla. L. Weekly D1722a

Insurance — Personal injury protection — Insurer’s failure to obtain written report required under section 627.736(7) within thirty days of receiving written notice of loss does not preclude insurer from defending on the basis that the medical bills are not reasonable, not related, and/or not necessary — Conflict certified