Teodora Siderova and Sean Becker of our Tampa office successfully defended an insurance carrier in a declaratory judgment action filed by an insured seeking a determination of whether her medical treatment was reasonable, related, and necessary in connection with a motor vehicle accident pursuant to section 627.736(7), Florida Statutes. The insurer made Personal Injury Protection (“PIP”) benefit payments to the insured’s medical providers before obtaining two valid peer review reports as permitted under the statute and suspending benefits based on the peer review physicians’ medical opinions.

At trial, the defense presented two peer review physicians of the same licensing chapter as the insured’s treating physician, while the plaintiff presented one treating physician as her expert. After a two-day bench trial, the court found that the insured’s treatment was not reasonable. The defense also successfully defeated the plaintiff’s claim for attorney’s fees and costs under section 86.121, Florida Statutes, as there was no total denial of coverage and some PIP benefits had been paid to the insured’s medical providers.