Florida Insurance Blog

Florida Insurance Blog

Providing Insight Into Florida Insurance Law and Litigation

Mark A. Nation is a civil trial lawyer who limits his practice to wrongful death, personal injury, and insurance cases. He is a member of the Million Dollar Advocates Forum whose members must have settled one or...MORE

Category Archives: PIP

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2 Lawsuits Against 21st Century for Failing to Pay Medical Payments Coverage

Posted in PIP
My clients were injured in a motor vehicle accident.  Before the accident, they wisely took out substantial automobile insurance to protect them, including coverages for bodily injury liability, uninsured motorists coverage, personal injury protection, and medical payments. As a result of the accident, they incurred medical expenses.  These medical expenses were properly submitted to their … Continue Reading

4th DCA (Mis?)Speaks on Releasing Future PIP Benefits

Posted in PIP
In United Automobile Insurance Company v. Palm Chiropractic Center, Inc., a/a/o Thomas, ____ So.3d ____ (Fla. 4th DCA 2010), the PIP insurer sent the insured for a compulsory medical examination.  Based on the results of the CME, the PIP insurer advised the insured’s medical provider that it would not pay for any further chiropractic care.  The … Continue Reading

PIP Fee Schedules DO NOT Apply to Accidents Occurring Before 1/1/08

Posted in Auto Insurance, PIP, Reimbursable PIP Charges
In Geico Indemnity Company v. Physicians Group, LLC, a/a/o Paul Androski, ____ So.3d ____ (Fla. 2nd DCA August 13, 2010), the 2nd DCA ruled that the PIP fee schedules which went into effect on January 1, 2008, do not apply to any accidents that occurred before that date.  The opinion was fairly short and straightforward.  Specifically, … Continue Reading

4th DCA Agrees With 3rd That 627.736(7)(a) “Valid Report” Does Not Require a Physical Examination

Posted in PIP
In Central Magnetic Imaging Open MRI of Plantation, Ltd a/a/o v. State Farm Fire and Casualty Insurance Company, ____ So.3d ____ (Fla. 4th DCA November 18, 2009), State Farm received an MRI bill on one of its PIP insureds.  State Farm sent the MRI bill and its PIP insured’s medical records to be reviewed by its own physician to … Continue Reading

Important Decision on Fee Multiplier Issued by 1st DCA

Posted in Attorney's fees, PIP
Today, in Massie v. Progressive Express Insurance Company, ____ So.3d ____ (Fla. 1st DCA November 17, 2009), the Circuit Court sitting in its appellate capacity reversed the trial judge’s order awarding a multiplier.  The Circuit Court reversed because the insured did not testify that she had difficulty securing counsel to represent her in the cause without … Continue Reading

3rd DCA Holds that a “Valid Report” Used by PIP Insurer to Withdraw Benefits Need Not Be Based on a Physical Exam by the Reviewing Physician

Posted in PIP
In United Automobile Insurance Co. v. Garrido, a/a/o Rodriguez, ____ So.3d ____ (Fla. 3d DCA October 28, 2009), the 3rd once spoke on the circumstances under which a PIP insurer can withdraw future PIP benefits.  According to the 3rd, a ‘valid report,’ even where appropriately required under section 627.736(7)(a) [i.e. when withdrawing future benefits - as opposed to denying … Continue Reading

PIP Insurer Only Needs a Written Medical Report Prior to Withdrawing Future Benefits, Not Prior For Denying Past Benefits

Posted in PIP
In United Automobile Insurance Company v. Garrido, a/a/o Alarcon, ____ So.3d ____ (Fla. 3rd DCA October 28, 2009), United Auto – a PIP insurer – denied payment for past services rendered by Dr. Garrido to the insured.  United Auto did not first obtain a written report from a physician saying that the denied charges were not reasonable, necessary … Continue Reading

“Valid Report” Not Needed for Denial of PIP Benefits (Only for Withdrawal of PIP Benefits)

Posted in PIP
In United Automobile Insurance Company v. Santa Fe Medical Center, ____ So.3d ____ (Fla. 3d DCA October 7, 2009), the medical provider took an assignment of PIP benefits from its patient.  Santa Fe submitted bills to United Auto for treatment rendered, and United Auto denied payment claiming that the treatment was not reasonable, necessary or related … Continue Reading

3rd DCA Holds that Insurer can Withdraw PIP Benefits Based on Records Review as Long as Records Document a Physical Exam by the Treating Doctor

Posted in PIP
In United Automobile Insurance Company v. Metro Injury & Rehab Center, ___ So.3d ___ (Fla. 3rd DCA July 29, 2009), the PIP insurer withdrew PIP benefits based on a peer review of the treating doctor’s records.  Those records contained information concerning physical examination(s) which the treating physician performed on the insured.  The county court granted summary judgment against … Continue Reading

3rd DCA Holds PIP Insurer Can Retroactively Rescind for Material Misrep in Application

Posted in Misrepresentation in Application, PIP
Pursuant to Florida Statute Section 627.409, an insurer can retroactively rescind a policy if it later finds a material misrepresentation in the application for insurance.  A misrepresentation is "material" if the misrepresentation was material to the acceptance of the risk by the insurer, or, if the insurer in good faith would not have issued the policy … Continue Reading

First Party Bad Faith Judgment Reversed

Posted in Bad Faith, PIP
Recently, Florida’s Fourth District Court of Appeals reversed a First Party Bad Faith verdict and judgment. In United Automobile Insurance Company v. Colon, Ms. Colon sued her PIP insurer for bad faith claims handling in failing to pay her doctors under her PIP policy. Although she disclaimed any non-economic damages for emotional distress, the insured … Continue Reading

Fourth DCA Rules on “Additional” PIP

Posted in PIP
In Flaxman v. Government Employees Ins. Co.,  993 So.2d 597 (Fla. 4th DCA 2008), the insured had PIP with GEICO which paid statutorily mandated benefits of 80% of medical expenses as well as 60% of lost wages up to a total of $10,000. The insured also had available under the same policy "Additional" PIP or APIP … Continue Reading

Nation Law Firm Files Suit for PIP Insurance Benefits Arising from Road-Rage Incident

Posted in PIP
While our client was stopped at a traffic light, another driver got out of his car and attacked our client in a random road rage incident.  Our injured client submitted her medical bills to her PIP No-Fault insurer, Nationwide, for reimbursement.  PIP insurers in Florida are required to pay for all medical expenses that are "related" to the … Continue Reading

Victory in Battle Over Who is a “Resident Relative”

Posted in PIP
The Nation Law Firm was recently successful in a suit against Progressive Select Insurance Company for Personal Injury Protection benefits. Our client was injured in a car accident and sought PIP benefits from Progressive, which insured the car he was riding in at the time of the accident.  Progressive denied the claim and said that our client … Continue Reading