EXCEL MEDICAL DIAGNOSTICS, INC., A/A/O CATHY HILL,
v.
ALLSTATE FIRE AND CASUALTY INSURANCE COMPANY,
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This case involves medical providers appealing summary judgments granted to insurers. The court affirmed that the insurance policies provided legally sufficient notice of the insurer's election to use permissive fee schedules but reversed because the insurers failed to provide evidence of payment according to those schedules.
Yes, the policies provided legally sufficient notice of the insurer's election to use the permissive fee schedules. However, the insurers failed to provide evidence of payment according to those 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] Summary judgment for an insurer on claims for unpaid medical benefits requires evidence that the insurer paid benefits pursuant to the 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 in the insurance policies.
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 appealed summary judgments entered in favor of insurers, arguing the insurers breached personal injury protection policies by failin…
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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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