UPDATED THROUGH SEPTEMBER 4, 2012
Insurance - Personal Injury Protection. Question Certified: 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)(1)? Geico Gen. Ins. Co. v. Virtual Imaging Servs., Inc., No. SC12-905 ( review granted July 20, 2012). DCA decision: 90 So. 3d 321 (Fla. 3d DCA 2012). Status: briefing: oral argument will be set by seperate order.
Insurance – Compulsory Medical Examination. Whether an insured’s refusal to comply with policy’s requirement that she submit to a compulsory medical exam constitutes her failure to satisfy a condition precedent to recovery pursuant to the underinsured/uninsured benefits in the insurance policy. The Fifth District reversed her award, reasoning that “[h]er refusal constitutes a breach of the policy that prohibits her recovery.” State Farm Mut. Auto. Ins. Co. v. Curran, No. SC12-157 (review granted Feb. 29, 2012). DCA decision --- So. 3d ---, (Fla. 5th DCA 2011), Nos. 5D09-1488, 5D09-2091). Status: briefing complete; oral argument scheduled for Oct. 2, 2012.
Insurance – Homeowners. Whether an insurer’s refusal to pay for overhead and profit under the terms of a replacement cost policy was appropriate when the insured had not hired a contractor to repair the damage to his home. The Third District upheld summary judgment in favor of the insurer, reasoning that based on the policy language the insurer did not owe the insured overhead and profit. Trinidad v. Fla. Peninsula Ins. Co., No. SC11-1643 (review granted June 8, 2012). DCA Decision: 2011 WL 1878115, Fla. L. Weekly D1081a (Fla. 3d DCA May 11, 2011). Status: briefing; no oral argument.