2005

30 Fla. L. Weekly D1396b

Insurance — Personal injury protection — Medical benefits — MRI

30 Fla. L. Weekly D592a

Insurance — Personal injury protection — An insurer is not required to comply with the provisions of section 627.736(10) in order to take preferred provider reductions in the payment of PIP benefits for medical services rendered to its insureds — Conflict certified — Statute authorizes PIP insurers to enter into contractual arrangements for provision of preferred provider medical services and to issue preferred provider PIP policies under certain circumstances, but does not limit insurers to entering into only direct contracts with providers or permit only those PIP insurers who offer preferred provider policies to enter into contracts with health care providers — Remand for consideration of any outstanding issues concerning contracts between insurer and company in the business of establishing preferred provider networks and contracts between company and health care provider

30 Fla. L. Weekly D2286a

Insurance — Personal injury protection — Chiropractic services — Where chiropractic clinic was exempt from statutory registration requirement because the owner/supervisor of the clinic was a licensed chiropractor, but clinic lost its exemption when the licensed chiropractor was killed in an automobile accident, services provided by the clinic after the death of the licensed chiropractor and before the clinic complied with the registration requirement were not lawfully rendered — Because services were not lawfully rendered, insurer was not obligated to pay clinic for services under PIP policies — Sixty-day grace period for registration of existing clinics is not applicable to the registration of an existing, exempt clinic whose practitioner/owner is killed — Once clinic lost its exemption, it was required to cease its operation until it complied with registration requirement

30 Fla. L. Weekly D1156b
904 So. 2d 449

Insurance — Personal injury protection — Where provider accepted partial payment without advising insurer that amended claim for balance would be forthcoming, provider did not have a priority claim against funds remaining undisbursed — There is no requirement that insurance company set aside a “reserve” fund for claims that are reduced or denied

30 Fla. L. Weekly D2622b

Insurance — Personal injury protection — Standing — Health care provider which had not received an assignment of benefits from insured at time of filing of complaint against insurer for recovery of benefits had no standing to file suit — Assignment of benefits executed after filing of suit did not relate back to time of filing of complaint — Plaintiff’s lack of standing at inception of case is not a defect that may be cured by acquisition of standing after case is filed — Assignment of PIP benefits is not merely a condition precedent to maintain an action on a claim held by the person or entity who filed the lawsuit, but rather is the basis of the claimant’s standing to invoke the processes of the court in the first place — Circuit court departed from essential requirements of law with resulting miscarriage of justice when it reversed county court judgment dismissing action filed by provider who had no standing — Because circuit court’s decision establishes a general application concerning the relation back of amended pleadings to remedy claimant’s lack of standing when action is filed, decision results in miscarriage of justice that warrants exercise of certiorari jurisdiction

30 Fla. L. Weekly S197b

Insurance — No-fault — Personal injury protection — Section 627.736(5)(b), Florida Statutes (1999), which requires providers of non-emergency medical services and medical services not provided in and billed by a hospital to submit a statement of charges to insurers within thirty days of service, is constitutional — Thirty-day provision does not violate rights of equal protection, due process, and access to courts — District court properly found that Legislature had reasonable basis for distinguishing between certain medical providers — Legislature’s objectives of reducing bulk billing and ensuring that charges covered under no-fault insurance are reasonable, necessary, and related to motor vehicle accident are permissible legislative objectives and are reasonably related to thirty-day requirement imposed upon certain medical providers — Thirty-day requirement does not abolish medical providers’ access to courts, but imposes reasonable condition precedent to filing claim for certain insurance benefits

District Court opinion at 27 Fla. L. Weekly D321a
County court ruling at 7 Fla. L. Weekly Supp. 803a

30 Fla. L. Weekly D2845b

Estates — Insurance — Life insurance — IRA and annuity accounts — Where decedent had entered into marital settlement agreement with former wife which provided that each party would receive as their own certain assets, including the life insurance policies and various retirement plans in dispute in instant case, agreement made no mention of the “proceeds” or death benefits of the policies or retirement plans, and decedent never took the steps necessary to accomplish a change of beneficiary on the disputed policies and retirement plans although clearly authorized to do so by marital settlement agreement, trial court erred in finding that marital settlement agreement constituted a waiver of any claim former wife might have to proceeds of policies and retirement accounts upon death of former husband a year and a half later — Although wife also asserts that an ERISA preemption respecting certain of the assets compels reversal of trial court’s determination, appellate court need not address this issue — Assuming there is a federal common law right of waiver associated with ERISA benefit plans, minority rule among courts would require execution of particular documents referenced in ERISA benefit plan to change the beneficiary, which was not done; and majority rule would still require determination of what constitutes an effective waiver — Under applicable Florida Supreme Court precedent, parties were ineffective in their attempt at waiver — Remand for entry of judgment in favor of former wife

APPROVED. 36 Fla. L. Weekly S252a

30 Fla. L. Weekly D2088b
909 So. 2d 593

Insurance — Uninsured motorist — Limitation of actions — Conflict of laws — Action against uninsured motorist insurer seeking UM benefits pursuant to policy issued in Georgia for damages that resulted from automobile accident that occurred in Florida — Because Florida applies doctrine of lex loci contractus to determine where cause of action for UM benefits arose, cause of action arose where contract was executed, in Georgia, and Florida borrowing statute applies — Pursuant to Florida’s borrowing statute, court must look to Georgia law to determine if action is barred by applicable statute — Georgia law provides that the applicable statute of limitations is the time allowed for service of the defendant in the underlying tort action, which in this case was Florida’s four-year tort statute of limitations — Because action was filed within the four-year limitations period, trial court erred in determining that action was time barred

30 Fla. L. Weekly D2366a

Administrative law — Licensing — Department of Financial Services — Suspension of limited customer service representative insurance license, which authorized licensee to sell automobile insurance, but not other property and casualty insurance — License was properly suspended on basis that licensee acted as a general lines agent, outside her license restrictions, in selling mobile home homeowner’s insurance, that licensee sold an ancillary contract along with the mobile home homeowner’s policy without explaining that it was separate from the policy and entailed an additional cost, and that licensee assisted another person in selling insurance, knowing that the other person did not have a license to sell insurance — No merit to licensee’s contention that her conduct was exempt from statutory prohibitions because she was in training for licensing as a general lines agent, and her involvement in the transaction should be considered part of her training under the supervision of a licensed agent

30 Fla. L. Weekly D2364a

Administrative law — Licensing — Department of Financial Services — Suspension of license to sell insurance