2016

41 Fla. L. Weekly D2208a
208 So. 3d 741

NOT FINAL VERSION OF OPINION
Subsequent Changes at 42 Fla. L. Weekly D893a

Insurance — Personal injury protection — Sufficiency of language in PIP policy to put insureds on notice that reimbursement of medical bills will be limited by statutory schedule — Appeals — Certiorari — Jurisdiction — Petitioner is not entitled to second-tier certiorari review of decision of circuit court appellate division regarding sufficiency of PIP policy language where there was no violation of a clearly established principle of law resulting in a miscarriage of justice by circuit court — There was no clearly established principle of law where there are conflicting decisions of district courts of appeal on issue, and Florida Supreme Court has accepted jurisdiction to resolve the conflicting decisions

41 Fla. L. Weekly D2145a
202 So. 3d 437

Insurance — Personal injury protection — Coverage — Medical expenses — Reasonableness of charges — Circuit court sitting in its appellate capacity departed from clearly established principles of law resulting in miscarriage of justice when it held that PIP insurer that had initially used fee schedule in paying billed amounts, although policy did not clearly and unambiguously elect statutory fee schedule limitation, was thereafter precluded from engaging in discovery and contesting reasonableness of billed amounts

41 Fla. L. Weekly D793b
226 So. 3d 262

Insurance — Personal injury protection — Coverage — Medical expenses — Statutory fee schedules — Clear and unambiguous notice to insured of insurer’s intent to determine reasonableness by reference to Medicare fee schedules — Language of policy endorsement stating that amounts payable “shall be subject to any and all limitations, authorized by section 627.736, or any other provisions of the Florida Motor Vehicle No-Fault Law, as enacted, amended or otherwise contained in the law, including but not limited to, all fee schedules” gave insureds and their respective medical care providers legally sufficient notice of insured’s election to use Medicare fee schedules

41 Fla. L. Weekly D805b
189 So. 3d 970

Civil procedure — Summary judgment — Notice of summary judgment evidence on which adverse party intends to rely — Trial court properly interpreted rule 1.510 as requiring adverse party to file notice in response to a motion for summary judgment even if the evidence upon which it seeks to rely is already in the record — Insurance — Personal injury protection — Coverage — Medical expenses — Reasonable, related and necessary treatment — Trial court did not err in finding that insurer did not satisfy rule 1.510(c) by filing, during discovery, a doctor’s affidavit stating affiant’s conclusion that portions of treatment were not reasonable, related, or medically necessary, which was accompanied by notice stating insurer’s intent to rely upon the affidavit “for any purpose permitted pursuant to the Florida Rules of Civil Procedure and Florida Evidence Code” — Circuit court acting in its appellate capacity did not depart from essential requirements of law by affirming county court ruling

41 Fla. L. Weekly D1619c
201 So. 3d 169

Insurance — Personal injury protection — Sufficiency of policy language to give notice of insurer’s election to limit reimbursements to health care providers to 80% of 200% of Medicare Part B schedules — An insurance policy which contains a limits of liability provision that states, “Any amounts payable under this coverage shall be subject to any and all limitations, authorized by section 627.736, or any other provisions of the Florida Motor Vehicle No-Fault Law, as enacted, amended or otherwise continued in the law, including but not limited to, all fee schedules,” clearly and unambiguously elects the section 627.736(5)(a)(2), Florida Statutes (2008), methodology of reimbursement as required by the Florida Supreme Court in GEICO v. Virtual Imaging Servs., Inc., 141 So. 3d 147 (Fla. 2013) — Conflict certified

41 Fla. L. Weekly D888b
187 So. 3d 1278

Insurance — Personal injury protection — Deductible — All claims, including emergency service provider’s priority claim, are properly applied to personal injury protection deductible in order that they are received — Trial court erred in holding that benefits to be paid from $5000 reserve imposed by statute for emergency services were not subject to an otherwise applicable deductible

41 Fla. L. Weekly D335b
183 So. 3d 489

Insurance — Personal injury protection — Deductible — Emergency services provider — Circuit court erroneously found that emergency services provider that submitted its bill within thirty-day window contemplated by statute was entitled to have its bill paid regardless of existence of deductible in insured’s insurance contract

41 Fla. L. Weekly D564a
187 So. 3d 898

Insurance — Personal injury protection — Deductible — Claim of emergency services provider should be applied to PIP deductible

41 Fla. L. Weekly D435e
186 So. 3d 588

Insurance — Personal injury protection — Deductible — Emergency service provider claims

41 Fla. L. Weekly D2018b
202 So. 3d 88

Insurance — Personal injury protection — Coverage — Medical expenses — Emergency medical condition — Statute requires that qualified medical provider determine that an emergency medical condition exists for benefits under Florida’s PIP statute to exceed $2500 — If there is no determination of whether insured has emergency medical condition or there has been a determination that insured does not have emergency medical condition, benefits would be limited to $2500 — Trial court properly limited recovery to $2500, although plaintiff eventually submitted a determination that insured had emergency medical condition after suit was filed, where insurer had requested written report of insured’s medical condition to determine whether insured was entitled to payment exceeding $2500, but plaintiff initially failed to respond to request and instead submitted demand letter for payment of benefits