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Reversal of Prior Ruling and Denial of Plaintiff’s Motion for Summary Judgment on Hotly-Contested “Billed Amount” PIP Issue

Michael S. Walsh, of our Ft. Lauderdale office, obtained a very important denial of Plaintiff’s motion for summary judgment on the “billed amount” issue, a critical issue in PIP litigation. Specifically, Plaintiff filed a motion for summary judgment alleging underpayment and arguing that the insurer was required by 627.735 (5)(a)(5), Fla. Stat., to pay one hundred percent of the charges as opposed to eighty percent, even though the policy had no Medical Payment Coverage relying on Geico Indem. Co. v. Accident & Injury Clinic, Inc. a/a/o Frank Irizarry, 290 So. 3d 980 (Fla. 5th DCA 2019). Though the Judge previously ruled in favor of Plaintiff on the “billed amount,” Mike was able to distinguish the Fifth District Court of Appeal case as well as § 627.736 (5)(a)(5), by focusing on the permissive language of “may” versus the mandatory language of “shall,” and successfully convinced the judge to reverse his prior ruling. Mike also pointed out that for the in question, Plaintiff always demanded eighty percent of the charges, but years later, sought more.

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