UNITED AUTOMOBILE INSURANCE COMPANY, PETITIONER,
v.
HOLLYWOOD INJURY REHAB CENTER, A/A/O DAVID PRINCE, RESPONDENT
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United Automobile Insurance Company sought review of a circuit court decision that upheld summary judgment in favor of Hollywood Injury Rehab Center, which had challenged the validity of a peer review report used to deny PIP benefits. The Fourth District Court of Appeal granted the writ of certiorari, finding the circuit court departed from the essential requirements of law by incorrectly requiring an independent medical examination before denying a claim.
A valid peer review report as contemplated by section 627.736(7)(a), Florida Statutes, does not require an insurer to order an IME before denying a claim for PIP benefits. The circuit court departed from the essential requirements of law by affirming the county court's erroneous summary judgment.
[1] A circuit court departs from the essential requirements of law when it affirms a lower court's decision based on an erroneous interpretation of statutory requirements for…
[2] A peer review report used to defend a summary judgment motion in a PIP benefits case does not necessarily require a statement that the doctor physically examined the insu…
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Join FLexlaw to unlock all legal intelligence“a 'valid report' as anticipated by section 627.736(7)(a), Florida Statutes, does not require an insurer to order an IME before denying a claim for PIP benefits”
Establishes the core holding that peer review reports alone suffice without an independent medical examination
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Join FLexlaw to unlock all legal intelligenceUnited Auto furnished a peer review report to support a summary judgment motion denying a claim for Personal Injury Protection (PIP) benefits. The cou…
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Through this second tier petition for writ of certiorari, United Automobile Insurance Company seeks review of a circuit court’s decision affirming the county court’s summary judgment in favor of Hollywood Injury & Rehab Center. The circuit court agreed with the county court that the peer review report United Auto furnished to defend the summary judgment motion was not valid because it did not state that the doctor either physically examined the insured or that his opinion was based on an independent medical examination as required by section 627.736(7)(a), Florida Statutes. We grant the writ and quash the circuit court order.
Our review is limited to whether United Auto was afforded due process and whether the circuit court in its appellate capacity departed from the essential requirements of law. See Allstate Ins. Co. v. Kaklamanos, 843 So.2d 885, 889 (Fla.2003). The failure to apply the correct law is a departure from the essential requirements of law. See Haines City Cmty. Dev. v. Heggs, 658 So.2d 523, 530 (Fla.1995).
We find a departure based on the law as explained by this court in the recent decision of Cent. Magnetic Imaging Open MRI of Plantation, Ltd. v. State Farm Fire & Cas. Ins. Co., 22 So.3d 782 (Fla. 4th DCA 2009). As this court noted, a “valid report” as anticipated by section 627.736(7)(a), Florida Statutes, does not require an insurer to order an IME before denying a claim for PIP benefits. In Cent. Magnetic Imaging, we noted that our case law before the 2001 amendment at issue clearly permitted “‘peer review reports’ and squarely held that an insurer was not required to obtain an IME before denying a PIP claim.” Id. at 784 (citing Nationwide Mut. Fire Ins. Co. v. Se. Diagnostics, Inc., 766 So.2d 229 (Fla. 4th DCA 2000)).1
By erroneously affirming the county court’s summary judgment in favor of Hollywood Injury Rehab Center, the circuit court departed from the essential requirements of law. We grant the petition for *745writ of certiorari, quash the circuit court’s order, and remand for proceedings consistent with this opinion.
TAYLOR, HAZOURI and CIKLIN, JJ„ concur.
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Previewing 3 of 6 citing cases — full citator treatment, depth of discussion, and citing context are member features.
Join FLexlaw to unlock all legal intelligenceAuthorities Cited
- Haines City Cmty. Dev. v. Leila Heggs, 658 So. 2d 523 (Fla. 1995)
- Allstate Ins. Co. v. Keely Kaklamanos, 843 So. 2d 885 (Fla. 2003)
- United Auto. Ins. Co. v. Santa FE Med. Ctr., 21 So. 3d 60 (Fla. 3d DCA 2009)
- State Farm Mut. Auto. Ins. Co. v. Rhodes & Anderson, D.C., P.A., 18 So. 3d 1059 (Fla. 2d DCA 2008)
- P'rs IN Health Chiropractic v. United Auto. Ins. Co., 21 So. 3d 858 (Fla. 3d DCA 2009)
- McALLISTER v. Breakers Seville Ass'n, Inc., 981 So. 2d 566 (Fla. 4th DCA 2008)
- Cent. Magnetic Imaging Open MRI OF Plantation, Ltd. v. State Farm Fire & Cas. Ins. Co., 22 So. 3d 782 (Fla. 4th DCA 2009)
- Nationwide Mut. Fire Ins. Co. v. Se. Diagnostics, Inc., 766 So. 2d 229 (Fla. 4th DCA 2000)
- Stom v. State, 22 So. 3d 120 (Fla. 1st DCA 2009)
- United Auto. Ins. Co. v. Eduardo J. Garrido, D.C., P.A., 22 So. 3d 120 (Fla. 3d DCA 2009)