Civil Litigation
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Total Pip Cases: 10
The insured, who was involved in a car accident, received medical treatment from a number of health care providers. His policy from the insurer included the standard personal injury protection (PIP) coverage codified at § 627.736, Fla. Stat., as part of the Florida Motor Vehicle No-Fault Law, §§ 627.730 - 627.7405, Fla. Stat. The issues presented in the case were (1) whether the insurer was required to set aside a reserve fund for claims that were reduced or denied when other valid health care provider claims continued to be submitted; and (2) whether the insurer was liable for PIP benefits after the full extent of the available PIP coverage was paid. The reviewing court found that no requirement existed to set aside a reserve for disputed claims, and, in the absence of a showing of bad faith, the insurer was not liable for benefits once benefits were exhausted.
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The First District Court of Appeal found that the trial court abused its discretion in excluding portion of a doctor's deposition regarding future medical treatment and future medical costs. The court held that whatever qualification was placed on the doctor's opinion goes to the weight of the opinion, and not its admissibility. The jury should have been allowed to hear and weigh the doctor's testimony regarding future medical care and costs.
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Giles v. Luckie
27 Fla. L. Weekly D1126 (Fla. 1st DCA May 24, 2002)
2002-05-24
PIP
Section 627.737(2) has long been interpreted to exempt a covered defendant from liability for all non-economic damages, not only those specifically listed, except in cases involving a threshold injury. The non-economic damage threshold is
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The Florida Supreme Court quashed the decision of the district court and remanded with directions that a new trial be granted based on certain jurors failing to provide honest responses during voir dire questioning. The Court relied on De La Rosa v. Zequeira, 659 So.2d 239 (Fla. 1995), wherein a three-prong test was established to determine whether a juror
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The two part rule to determine whether a case is subject to dismissal for lack of prosecution is first, that the defendant establishes that no record activity occurred for a period of over one year, and second, that the plaintiff does not have good cause for failing to meet this requirement. Here, the party filed a motion for summary judgment based upon a partial list of the claimed defenses. Within the one-year time limit, the party filed another motion for summary judgment incorporating the same issues as before but including the remained of the claimed defenses. The court found that, although similar, these two motions were separate because the later attempted to resolve the entire case whereas the first only attempted to resolve several of the issues.
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The court found that the arbitration clause could not be claimed by the newly formed company because it was neither a signatory nor intended third-party beneficiary. Rather, only the parties actually agreeing to the non-compete clause could arbitrate. Furthermore, in dicta, the court found that there was insufficient evidence to prove that the new company was an alter ego of the defendant. Therefore, the court found that, unlike the plaintiff, the newly formed company could not compel arbitration.
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In a declaratory judgment action to determine whether coverage exists, the insurer can properly assert the work-product privilege against production of its claims file. The privilege belongs to the insurer and may not be waived by the insured.
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Certiorari was denied where summary judgment was entered in favor of Allstate. Allstate failed to pay PIP benefits that were due pursuant to a provision in the PIP policy which provided that Allstate could refuse to pay for medical expenses that it deemed unreasonable or unnecessary.
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Section 627.736(6) permits PIP insurers to obtain informal discovery without having to file a lawsuit in order to obtain information about the treatment of persons seeking PIP benefits. According to the court, the discovery contemplated by the statute is the same as discovery authorized by Rule 1.280(a), and includes depositions, interrogatories, and the production of documents or other things. The court found that good cause is shown when there are sworn statements from the insureds denying that they had received health care for which the health care providers were seeking payment.
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Under the language of the Florida no-fault law, an insurer is subject to specific penalties once a payment becomes overdue. The penalties include 10% interest and attorney
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