Tag Archives: Florida Supreme Court

by | August 7, 2019 · 5:32 pm

Florida Supreme Court Dismisses Review of Assignment of Benefits Dispute

A divided Florida Supreme Court discharged jurisdiction and dismissed the review proceeding of an assignment of benefits case due to a law that was passed this spring revamping the AOB system.

According to court documents, the policyholders, John and Liza Squitieri assigned benefits to Restoration 1 to clean up water damage in their home. However, their insurance company Ark Royal Insurance Co. refused to pay the full amount. Restoration 1 sued Ark Royal for breach of contract but lost in circuit court and appeals court.

Click here to read the article.

Filed under Legislation, Property (Homeowners)

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by | October 10, 2017 · 2:34 pm

Florida Supreme Court Issues Order Extending Legal Time Limits for Miami-Dade Courts

We hope you withstood the wrath of Hurricane Irma with the least amount of damage to your home and surroundings. We want to keep you advised of the status of the litigation you have entrusted to us here at ROIG Lawyers. On September 19th, the Florida Supreme Court issued an administrative order extending all time limits through close of business on Monday, September 18th, 2017. This includes any deadline allowed by rule of procedure, court order, statutes applicable to court proceedings, or otherwise pertaining to court proceedings.

The Court further recognized in its order that there may be instances where, because of this emergency, these and other time limits applicable to matters in or outside Miami-Dade County could not be met even upon application of the periods stated above. If such a claim is made, the Court in which jurisdiction vested is directed to resolve the issue on a case-by-case basis when a party demonstrates that the lack of compliance with requisite time periods was directly attributable to this emergency.

If you have any questions or would like to discuss this issue in greater detail, please feel free to contact us by emailing marketing@roiglawyers.com.php73-37.phx1-1.websitetestlink.com or call us at 1-855-ROIGLAW.

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by | April 21, 2017 · 10:56 am

Geico Sues Florida Health Clinic for ‘Unnecessary’ Massage Claims

As reported by Law360, Geico sued Medical Wellness Services Inc. of Miami, FL for allegedly making $1.2 million in claims for providing medically unnecessary treatments for automobile accident victims who were eligible for coverage under their no-fault insurance policies. According to Geico, some of the claims were for services that were not actually provided and contained billing codes that misrepresented and exaggerated the services.

“The defendants do not now have — and never had — any right to be compensated for the fraudulent services that were billed to Geico through Medical Wellness,” Geico said. Geico claims Medical Wellness Services Inc. submitted claims for massage therapist services which are not reimbursable because Florida law prohibits no-fault insurance reimbursement for massages or other similar services.

According to the suit, the scheme began no later than 2013 and continues to this day. In addition to the request for $1.2 million in damages, Geico is also requesting a declaration from the court saying it will not have to pay any pending fraudulent claims by the health clinic which totals more than $75,000.

Click here for the full story (subscription required).

Filed under Personal Injury Protection (PIP)

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by | December 26, 2014 · 11:34 am

Florida Needs 35 More Judges, Says Florida Supreme Court

The texting while driving law that took effect in October, 2013 is one of several reasons why the Florida judicial system needs 32 additional county court judges and three new circuit court judges, according to an annual Certification of Need for Additional Judges published December 22 by the Florida Supreme Court.

The recent news that Florida has surpassed New York to become the third largest state in the nation, while not cited by the Court, coincides with increasing pressure on the state’s judicial system.

The Florida Supreme Court analysis breaks down judicial needs by county, with the greatest number of county court certified judicial position recommendations as follows:

  • Three judges in the Fourth Circuit of Duval County (Jacksonville area)
  • Eight judges in the Eleventh Circuit of Miami-Dade County
  • Eight judges in the Thirteenth Circuit of Hillsborough County (Tampa area)
  • Five judges in the Fifteenth Circuit of Palm Beach County

A total of three circuit court judges are also suggested. One circuit court certified judicial position is requested for the First Judicial Circuit, which serves Escambia, Santa Rosa, Okaloosa, and Walton counties in northwest Florida. This circuit experiences a heavy criminal workload and a steady number of tobacco cases, according to the court analysis.

Two circuit court judicial positions are recommended for the Fifth Judicial Circuit, which encompasses Citrus, Hernando, Lake, Marion, and Sumter Counties. The Fifth circuit is the ninth most populous circuit with 5.5% of Florida’s population, according to the court.

There is no request for new judges in the District Courts of Appeal at this time

In its analysis, the Court cites recent trends in the volume and type of cases:

  • Six percent increase in probate filings
  • Nine percent increase in dependency filings
  • One percent increase in circuit civil filings (excluding real property)

The Court also reported declines in domestic relations filings (three percent), felony and juvenile delinquency filings (seven percent each).

The Florida Supreme Court request notes that judges across the state continue to bear the burden of increasing workloads after the number of support staff – including case managers, law clerks and magistrates – was reduced in earlier budget cut backs.

Click on the link to read the full annual Certification of Need for Additional Judges published December 22 by the Florida Supreme Court.

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by | May 30, 2014 · 4:56 pm

Attorney Fee Conflict Settled in Advanced Chiropractic v. UAIC

On May 29, 2014, the Florida Supreme Court issued a decision settling a conflict over the timeliness of filing for attorney’s fees.

The case originated in Broward County with an action filed by Advanced Chiropractic against United Automobile Insurance Co. (“UAIC”) for PIP benefits. During the course of the action, the attorney for Advanced moved offices and filed a change of address with the Clerk of Court. Two months later, Advanced and UAIC entered into a settlement agreement in which UAIC agreed to pay Advanced’s attorney’s fees. The trial court judge subsequently entered an order of dismissal in the case.

Advanced’s attorney never received a copy of the dismissal because the Clerk of Court failed to update its records concerning the address change. Once he learned of the dismissal, months later, counsel for Advanced filed a motion for attorney’s fees. Because the motion was filed past the mandatory 30-day deadline, the attorney moved to vacate the order of dismissal based on excusable neglect due to the court’s failure to update its records.

In a hearing on the motion to vacate the dismissal, the attorney for Advanced and an employee of the Clerk of Court both filed unsworn statements. The county court found that Advanced had established excusable neglect, vacated the order of dismissal, and allowed Advanced’s attorney to file a motion for attorney’s fees.

UAIC appealed the decision to the circuit court, contending that counsel for Advanced had not established excusable neglect. The circuit court held that, because the statements from the attorney and the Court’s employee were unsworn, there was not sufficient evidence to support the finding of excusable neglect. The circuit court therefore reinstated the order of dismissal.

Advanced appealed to the Fourth District, asserting that the circuit court had failed to apply the correct legal standard. The Fourth District concluded that Advanced had been denied due process and therefore quashed the decision of the circuit court.

Advanced then filed a motion for attorney’s fees. UAIC opposed the motion on the basis that it was untimely pursuant to the FL Rules of Appellate Procedure. The District Court dismissed UAIC’s argument based on the Rules of Appellate Procedure, but nonetheless denied the motion for attorney’s fees on the basis of the FL Supreme Court’s 1991 holding in Stockman v. Downs, which requires parties to plead entitlement to attorney’s fees.

The Fourth District held that, pursuant to the Stockman decision, the request for attorney’s fees must be made in the pleadings which, in this case, would be the petition, the response, or the reply. Because Advanced did not request fees in the petition or reply, the district court held that the motion was untimely. The state Supreme Court then agreed to review the case to consider whether the Fourth District misapplied the Stockman decision.

In the Stockman case, the Supreme Court addressed whether a prevailing party could raise entitlement to attorney’s fees for the first time by motion after trial. The Court held that a claim for attorney’s fees based upon a contract or statute is waived unless it is made in the pleadings. The Court explained that the fundamental concern is that the parties have notice of the claim as it may affect the decisions of the parties with respect to the case.

In distinguishing Stockman from this case, the Court noted that Stockman involved a request at the trial level and that the primary concern—lack of notice—is not implicated in the case at hand. Since Advanced requested attorney’s fees in both the county and circuit courts,   UAIC could not contend unfair surprise when Advanced again claimed entitlement to attorney’s fees. Consequently, the Court quashed the decision in the court below and remanded to the district court for a determination of the amount of attorney’s fees to which Advanced is entitled.

The case is Advanced Chiropractic And Rehabilitation Center, Corporation vs. United Automobile Insurance Company, Supreme Court of Florida, Case No. SC13-153, May 29, 2014.

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by | August 6, 2013 · 10:08 am

PIP Legislative Calendar Governs EUO Requirements

Florida insurers are now being forced to navigate between sometimes conflicting rulings on Examinations Under Oath (“EUO”) based on pre- and post-2012 changes to the PIP/No-Fault laws.

Insurance companies and their defense law firms were disappointed when the Florida Supreme Court ruled in late June that GEICO could not withhold benefits to a policyholder in a pre-2012 auto case based on the policyholder’s unwillingness to attend an EUO.

In the matter Merly Nunez v. GEICO General Insurance Company, the Florida Supreme Court was asked by the U.S. Court of Appeals for the Eleventh Circuit to rule on, “[w]hether, under FLA. STAT. § 627.736, an insurer can require an insured to attend an [examination under oath] as a condition precedent to recovery of [personal injury protection] benefits?”

The Court’s answer was in the negative, in a split 5-2 vote. The majority ruled that, “[t]he Florida No-Fault statute is mandatory and does not recognize such a condition. It is therefore invalid and contrary to the statutory terms.”

“Swift and virtually automatic payment” is the primary intent of PIP laws, notes the majority. While GEICO argued the need for fraud prevention and claims investigations, the Court viewed these actions as contrary to a fast case resolution.

The majority opinion was written by Justice Perry, with Justices Pariente, Lewis, Quince, and Labarga concurring. Justice Canady wrote a dissenting opinion, in which Justice Polston concurred.

“Insurers have relied on the discretionary use of examinations under oath (EUOs) in appropriate cases to obtain relevant, needed information not only for the assessment of claimed losses, but for the prevention of fraud and abuse of the PIP system,” said Donovan Brown, Florida counsel and regional manager for the Property Casualty Insurers Association of America as quoted in an Insurance Journal article. “This ruling is another blow to Florida’s consumers in the fight against PIP fraud because the ruling further exposes consumers to the rampant PIP fraud that has plagued the Florida auto insurance system for far too long.”

Florida Governor Rick Scott approved changes to the state’s PIP statutes in May, 2012. As of January 1, 2013, insureds must now comply with all terms of a No-Fault policy, including any requirement to submit to an Examination Under Oath.

Click on the link to read the Supreme Court of Florida ruling in Merly Nunez v. GEICO General Insurance Company, No. SC12-650, dated June 27, 2013.

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by | April 26, 2012 · 7:14 am

Florida Supreme Court to Decide Fee Schedule Issue

Yesterday the 3rd District Court of Appeal rendered its decision Geico v. Virtual Imaging (a/a/o Maria Tirado). While the Court ruled it was bound by its prior decision denying the use of the Fee Schedule as found in Florida Statute 627.736, the Court also certified the fee schedule to the Florida Supreme Court. In certifying the question as a matter of great public importance the court found that

The Legislature’s amendment to the PIP statute sought to address the enormous costs and inefficiencies of the law prior to amendment. Litigation and fee-shifting to determine “reasonable” costs of standardized medical procedures should be passé by now. An MRI, for example, is now a common procedure. The medical cost accounting and national metrics supporting the Medicare Part B reimbursement figures for MRIs and other standard medical services are widely used and understood. An alternative charge based essentially on whatever the market will bear, on the other hand, invites litigation. A prevailing provider or insured may also recover attorney’s fees and costs, and resolution of these disputes also requires judicial resources at the expense of all State taxpayers. All of these circumstances are contrary to the original, no-fault objectives of the PIP statute.

Finally, a court that understands the legislature’s intent. The certified question reads as follows

WITH RESPECT TO PIP POLICIES ISSUED AFTER JANUARY 1, 2008, MAY THE INSURER COMPUTE PROVIDER REIMBURSEMENTS BASED ON THE FEE SCHEDULES IDENTIFIED IN SECTION 627.736(5)(a), FLORIDA STATUTES, EVEN IF THE POLICY DOES NOT CONTAIN A PROVISION SPECIFICALLY ELECTING THOSE SCHEDULES RATHER THAN “REASONABLE MEDICAL EXPENSES” COVERAGE BASED ON SECTION 627.736(1)(a)?

To read the entire opinion click here.

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