2004

29 Fla. L. Weekly D2342c

Insurance — Personal injury protection — Allowable amount to be paid by PIP insurer to providers of magnetic resonance imaging — The allowable amount under Medicare Part B, as used in section 627.736(5)(b)5, refers to the participating physician fee schedule of Medicare Part B

29 Fla. L. Weekly D2828b

Insurance — Personal injury protection — Trial court erred in finding that insurer has the right to require a medical provider to submit to an Examination Under Oath when the provider has accepted assignment of benefits from insured and asserted the right to pursue personal injury protection benefits — When an insured assigns benefits to a health care provider, the obligation to attend an Examination Under Oath remains with the insured, and the insurer has a good defense to the provider’s claim if the insured refuses to attend an EUO — Obligation to attend EUO does not shift to the provider merely because the insured assigns benefits

29 Fla. L. Weekly D652e

Insurance — Personal injury protection — Coverage — Medical assistants who were not licensed as physical therapists were authorized to perform physical therapy modalities enumerated in section 486.021(11), Florida Statutes (2001) for purposes of qualifying for payment of assigned personal injury protection benefits — PIP insurer is obligated to pay for such services rendered to its insured

29 Fla. L. Weekly D2310a

Insurance — Personal injury protection — Coverage — PIP statute does not require payment of mileage reimbursement for travel to necessary medical treatment — Conflict certified — Trial court correctly held that parties’ insurance contract required insurer to reimburse claimant for mileage driven traveling to compulsory medical examination set by insurer where policy required insured to “submit to mental or physical examinations at our expense” without defining “at our expense” — Court need not address question certified by county court as to whether PIP statute requires this reimbursement

29 Fla. L. Weekly D24c

Insurance — Personal injury protection — Trial court and circuit court acting in its appellate capacity failed to correctly apply newer version of section 627.736 when calculating amount due under PIP policy to insured who was involved in automobile accident during course and scope of employment and was paid two-thirds of his lost wages under workers’ compensation scheme before filing PIP claim — Certiorari review is appropriate — Circuit court directed to reverse county court’s summary judgment and remand to county court for further proceedings

29 Fla. L. Weekly D783a

Insurance — Personal injury protection — Company which owns portable diagnostic testing equipment, and takes its equipment to the office of health care providers to perform diagnostic tests on patients, is not a “clinic” that is required to register with Department of Health under section 456.0375, Florida Statutes (2001) — PIP insurer could not properly refuse to pay company for diagnostic tests performed for insureds on ground that company rendered services at time when company was not registered

29 Fla. L. Weekly D889a

Insurance — Administrative law — Immediate final order of Office of Insurance Regulation ordering insurance company to cease and desist from the transaction of any new or renewal business in Florida — Order is deficient for failure to include a factual recitation demonstrating the existence of an immediate danger to the public health, safety, or welfare — Allegation of a statutory violation is insufficient to support immediate final order

29 Fla. L. Weekly D2025b

Administrative law — Declaratory statements — Office of Insurance Regulation — Petition which essentially challenged correctness of OIR’s approved rate increase to petitioner’s single-life, small group HMO plan was properly dismissed

29 Fla. L. Weekly D2289c

Administrative law — Office of Insurance Regulation — Immediate final order finding that corporation was in violation of insurance laws for conducting viatical settlements without a license and directing corporation and all parties involved to immediately cease and desist from transacting any new viatical insurance business alleged specific and particularized facts sufficient to demonstrate risk of immediate and ongoing harm to insurance buying public

29 Fla. L. Weekly D1594a

Administrative law — Office of Insurance Regulation — Licensing — Revocation — Service of process — Publication — Attempted personal service on licensee was legally inadequate where personal service at last known residence was unsuccessful, but agency made no attempt to contact licensee by telephone or through his known attorneys — Because this was not case where personal service could not be made, service by publication was not justified — Remanded for proceedings on merits