2002

27 Fla. L. Weekly D814a

Insurance — Personal injury protection — In action by insured against insurer which had failed to pay medical bills incurred for injuries received in an automobile accident, trial court erred in entering summary judgment for insurer on ground that insured had suffered no damage because he had not been sued by medical providers — Insured’s right of action against PIP and medical payments insurer arises thirty days after written notice to the insurer that reasonable and necessary medical treatment covered by the insurance has resulted in a debt

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

27 Fla. L. Weekly D1681c

Insurance — Personal injury protection — Trial court properly ruled that unambiguous language of Florida endorsement to policy did not provide PIP coverage for accident which occurred outside Florida when insured was occupying rental vehicle — Endorsement specifically provided that there would be no PIP coverage for injury to insured outside Florida unless insured was occupying either vehicle owned by the insured or vehicle owned by the insured’s relative for which security is maintained under Florida No-Fault Law — Language is consistent with applicable statute — “Special Provision for Rented or Leased Vehicles” merely adopted language consistent with section 627.7263 establishing which insurance coverage is primary when insured is operating a rental vehicle, and even if this part of endorsement were ambiguous, that ambiguity would not contravene plain language of PIP provisions expressly limiting PIP coverage for accidents occurring outside state

27 Fla. L. Weekly D371a

Insurance — Personal injury protection — Arrangement whereby company “leased” space, equipment and services from entity which performed MRI, entity billed the referring company, and company, in turn, billed insurer an increased amount for the MRI is nothing more than fee-splitting scheme to compensate for MRI referrals, which is prohibited by statute — Referral and billing services do not constitute medical services under PIP provisions — Trial court properly granted summary judgment in favor of insurer

27 Fla. L. Weekly D321a

Insurance — Personal injury protection — Trial court erred in declaring unconstitutional statute providing that insurer is not required to pay charges for treatment or services rendered more than 30 days before postmark date of provider’s statement and that injured party is not liable for charges that are unpaid because of the provider’s failure to comply with 30-day requirement — Equal protection — Legislature had legitimate state purpose for distinguishing between services provided by medical providers and services provided by hospital emergency departments and ambulance providers — Timely statement requirement ensures that PIP insurer is aware of commencement of treatment, places insurer in a better position to assure that treatment is reasonable, related to motor vehicle accident, or necessary and also reduces practice of bulk billing by some medical providers which, in turn lowers insurer’s cost of providing PIP coverage and makes independent medical examination a more effective cost-control tool — Because medical providers frequently provide ongoing medical treatment involving regular office visits, while services provided by hospital emergency room or ambulance provider usually occur only once, immediately following motor vehicle accident, logical basis exists for placing statutory time limit upon medical providers only — Due process — Rational basis analysis applied to equal protection claim applies also to claim that statute violates provider’s due process rights — Statute does not violate medical providers’ due process rights — Access to courts — Statute does not deny access to courts by medical providers who fail to meet timely statement requirement, but merely imposes a reasonable restriction or a condition precedent to filing a claim — There is no conflict between statute, which establishes 30-day period, and section 95.11(2)(b), which affords medical providers five years to initiate claims to recover PIP benefits since provider would have had five years to assert cause of action against insurer had provider complied with timely statement requirement

27 Fla. L. Weekly D551e
810 So. 2d 514

Insurance — Personal injury protection — Appellate attorney’s fees — Order awarding appellate attorney’s fees to appellant insurance company which prevailed on appeal should have been conditioned on company ultimately prevailing in litigation — Assignee of insured who did not prevail on appeal is not entitled to conditional award of appellate attorney’s fees based on section 627.428, Florida Statutes

27 Fla. L. Weekly D1158a

Insurance — Medical malpractice — Coverage — Prejudgment interest and costs over stated limits of policy — Prejudgment interest under section 766.209, which is designed to encourage prompt resolution of medical malpractice claims, is distinguished from prejudgment interest traditionally imposed on liquidated damages under Argonaut Ins. Co. v. May Plumbing Co. — Trial court erred in finding no coverage for prejudgment interest based on its conclusion that prejudgment interest was part of “damages,” and parties’ settlement had exhausted the policies’ limits for damages — Florida case law has long held that insurance policies generally provide coverage for costs over the stated limits of liability, and both policies at issue specifically provide for the payment of taxable costs under “Other Payments” or “Additional Benefits” provisions of the policies

27 Fla. L. Weekly D1904a

Insurance — Uninsured motorist — Settlement agreement — Mediation — Confidentiality — Where settlement agreement plainly and unambiguously required insurer to pay plaintiff “$75,000.00 by 2:00 p.m. on 7/20/01,” trial court was required to enforce the contract according to its plain meaning — Evidence adduced at hearing demonstrated that no mention was made during mediation of an offset of $40,000 to be credited to insurer and, accordingly, any mistake in failing to provide that settlement amount would be reduced by $40,000 insurer previously paid to plaintiff was unilateral mistake on insurer’s part — Court did not exceed its authority by considering evidence of what occurred during mediation proceedings — Confidentiality privilege which attaches to communications made during court-ordered mediation did not apply where mediation resulted in settlement agreement signed by the parties, and one of the parties claimed that there was mutual mistake

27 Fla. L. Weekly D467a

Administrative law — Department of Insurance properly revoked license to operate as a viatical settlement provider of company which failed to report to Division of Insurance Fraud that life insurance policies sold by viators had been fraudulently obtained by denying on insurance applications the existence of specific known and diagnosed medical conditions — Statute requiring that licensee report to Division of Insurance Fraud a fraudulent insurance act of which licensee has knowledge is not unconstitutionally vague

27 Fla. L. Weekly D973a

Administrative law — Department of Insurance — Disciplinary action for falsifying application for insurance — Where Department gave notice on eve of administrative hearing that it was adding a document to its exhibit list, administrative law judge erred in overruling objection that Department’s action was unfairly prejudicial because there would be no opportunity to prepare a response or bring forward other evidence