FIRST MEDICAL AND REHAB OF BRADENTON, LLC, A/A/O CHRISTINA BELONY,
v.
ALLSTATE INSURANCE COMPANY,
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This case involves medical providers appealing summary judgments granted to insurers. The appellate court affirmed the insurer's right to use permissive fee schedules but reversed because the insurers failed to provide evidence of payment according to those schedules.
The court held that the policies provided legally sufficient notice of the insurers' election to use permissive fee schedules. However, the court also held that the insurers failed to provide evidence of payment pursuant to those fee schedules.
[1] An insurer's election to use permissive fee schedules under section 627.736(5)(a)2., Florida Statutes (2009), is legally sufficient if the policy provides notice of such…
[2] An insurer seeking summary judgment on a claim for unpaid benefits must present evidence, such as an affidavit, demonstrating payment pursuant to applicable fee schedules…
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Join FLexlaw to unlock all legal intelligence“We discern no error and affirm the entry of summary judgment to the extent the trial court found that the policies at issue provide legally sufficient notice of the insurer’s election to use the permissive fee schedules identified in section 627.736(5)(a)2., Florida Statutes (2009).”
establishes the court's affirmation regarding the sufficiency of notice for using fee schedules.
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceMedical providers sued insurers for breach of personal injury protection policies, alleging non-payment for medical services. The trial court granted …
The full statement of facts, procedural history, and disposition for this case are member content.
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LOBREE, J. In this consolidated appeal,1 the medical providers appeal final summary judgments entered in favor of the insurers (collectively referred to as “Allstate”), on respective claims that Allstate breached the applicable personal injury protection policies by failing to pay benefits due for medical services provided to the insureds. We discern no error and affirm the entry of summary judgment to the extent the trial court found that the policies at issue provide legally sufficient notice of the insurer’s election to use the permissive fee schedules identified in section 627.736(5)(a)2., Florida Statutes (2009).2 Co. v. Orthopedic Specialists, 212 So. 3d
973, 979 (Fla. 2017). We are constrained to otherwise reverse, however, because the record is devoid of an affidavit, or any summary judgment evidence, showing that Allstate paid pursuant to the fee schedules. See Gonzalez v. Citizens Prop. Ins. Corp., 273 So. 3d 1031, 1036 (Fla. 3d DCA 2019) (explaining that summary judgment movant “must offer sufficient admissible evidence to support his claim of the non-existence of a genuine issue. If he fails to do this his motion is lost.” (quoting Harvey Bldg., Inc. v. Haley, 175 So. 2d 780, 782–83 (Fla. 1965))). As such, we affirm in part, reverse in part, and remand for further proceedings consistent with this opinion. Affirmed, in part, reversed, in part, and remanded.
Tampa v. State Farm Mut. Auto. Ins. Co., 334 So. 3d 577, 582 (Fla. 2021). This renumbering has no impact on our analysis.
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