VELO CHIRO FIZIK, INC., A/A/O DAILY LUGO
v.
ALLSTATE PROPERTY AND CASUALTY INSURANCE COMPANY

Fla. 3d DCA | 2022-08-10
No. 21-0181
LOBREE, J., MILLER, J., BOKOR, J., Milena Abreu, Judge
Florida District Court of Appeal, Third District (2022)

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Synopsis

The Third District Court of Appeal affirmed summary judgment to the extent the trial court found the insurance policies provided legally sufficient notice of the insurers' election to use permissive fee schedules under Florida Statutes § 627.736(5)(a)2, but reversed and remanded because the record lacked evidence that Allstate actually paid pursuant to those fee schedules.


Holding

An insurer's election to use permissive fee schedules must be supported by evidence that the insurer actually paid benefits according to those schedules, not merely that the policy provided notice of the election.


Headnotes

[1] An insurer seeking summary judgment on a breach of contract claim based on use of permissive fee schedules must present affidavit or summary judgment evidence demonstrati…

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Facts & Procedural History

Multiple medical providers sued Allstate insurance companies for breach of personal injury protection policies, claiming Allstate failed to pay benefi…

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Opinion of the Court

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 See Allstate Ins. Co. v. Orthopedic Specialists, 212 So. 3d

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.

3

Footnotes
1 These cases, which were consolidated for the purpose of oral argument, are hereby consolidated for opinion purposes as well. See J.M.B. v. State, 776 So. 2d 353, 354 (Fla. 1st DCA 2001) (“Cases may also be consolidated for oral argument, issuance of an opinion, or both.”). 2 Some of the relevant policies were issued in 2013, and thus the applicable Medicare fee schedules appear in section 627.736(5)(a)1., Florida Statutes (2013), under the 2012 reorganization of the statute. See MRI Assocs. of
2 973, 979 (Fla. 2017). We are constrained to otherwise reverse, however,

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