Florida/Georgia Personal Injury & Workers Compensation

...es and the like, in order not to drive them into dire financial circumstances with the possibility of swelling the public relief rolls. Lasky v. State Farm Ins. Co., 296 So.2d 9, 16 (Fla.1974). The statutory provision at issue in the instant case is section 627.736(4), which describes when personal injury protection (PIP) benefits are due and the method by which notice must be given. The intent of this provision is to promote the prompt resolution of PIP claims. See Rodriguez, 808 So.2d at 86. Under section 627.736(4), PIP benefits "shall be due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered by the policy." An insured may seek the payment of benefits for a covered loss by submitting "reasonable proof of such loss to the insurer; if the benefits are not paid within thirty days and the insurer does not have reasonable proof that it is not responsible for the payment, the payment is "overdue." See § 627.736(4)(b), Fla....

...(2001); Rodriguez, 808 So.2d at 86. However, even where written notice is furnished to the insurer as provided by the statute, a payment is not deemed overdue "when the insurer has reasonable proof to establish that the insurer is not responsible *892 for the payment." § 627.736(4)(b), Fla....

...See Rodriguez, 808 So.2d at 86; AIU Ins. Co. v. Daidone, 760 So.2d 1110, 1111 (Fla. 4th DCA 2000). If the insurer is ultimately found liable for a contested claim, then the statutory penalties of interest and attorney's fees would be applicable. See § 627.736(4)(c), (8), Fla....

...Further, the recipient of such bills is entitled to sue the defaulting insurer for PIP and medpay benefits when the benefits have not been "paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." § 627.736(4)(b), Fla....

...pril 25, 1985. However, on March 9, 1985, [Quanstrom] sustained bodily injuries while riding as a passenger in a vehicle owned by [Terry Nelson] and insured by [Standard Guaranty Insurance Company] for personal injury protection (PIP) benefits under section 627.736(4)(d)4., Florida Statutes....

...n, finding that Quanstrom was not entitled to coverage. The Fifth District Court of Appeal identified the issue as follows: [W]hether a person injured while occupying a motor vehicle covered by personal injury protection (PIP) insurance is barred by section 627.736(4)(a), Florida Statutes (1985), from recovering PIP benefits from the insurer of the owner of that vehicle because the insured person is the owner of an uninsured motor vehicle which is not in fact being driven or operated on the roads of this state because of needed repairs....

...nt of the $1,250 in medical treatment expenses that were in excess of Masis's policy deductible. United asserted the affirmative defense that Masis's failure to appear for the scheduled medical examination was "unreasonable" as a matter of law under section 627.736(7), Florida Statutes (2001). The relevant portion of this statute provides: If a person unreasonably refuses to submit to an examination, the personal injury protection carrier is no longer liable for subsequent personal injury protection benefits. § 627.736(7)(b) (emphasis supplied)....

...The purpose of the no-fault statutory scheme is to "provide swift and virtually automatic payment so that the injured insured may get on with his life without undue financial interruption." Ivey, 774 So.2d at 683-84 (quoting Gov't Emps. Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987)). To this end, section 627.736(4)(b) provides that PIP insurance benefits "shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." After an insurance company receives notice of a claim, the insurer has the opportunity to evaluate a claim through procedures such as a medical examination. In pertinent part, section 627.736(7), Florida Statutes (2001), provides: (a) Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury p...

...11th Cir. Ct. June 19, 2001) ("Assuming arguendo that her failure to appear could be determined as a matter of law to be a `refusal' . . . ."). In addition, there are scenarios in which an insured could reasonably refuse to submit to an examination. See § 627.736(7)(b), Fla....

...to receive further subsequent PIP benefits. See U.S. Sec. Ins. Co. v. Cimino, 754 So.2d 697, 699, 701-02 (Fla.2000) (indicating that attendance at a PIP medical examination is a condition precedent to the receipt of subsequent PIP benefits and that section 627.736 contemplates "a situation . . . where the insured `reasonably refuses to submit'" to a medical examination). The plain text of section 627.736(7)(b), Florida Statutes (2001), supports the analysis presented in Cimino: "If a person unreasonably refuses to submit to an examination, the [PIP] carrier is no longer liable for subsequent [PIP] benefits." § 627.736(7)(b), Fla....

...examination is an affirmative defense, which the defensive pleader must establish if the case progresses to trial. See 661 So.2d at 948-49. Interestingly, United was also the insurer in Zulma and, in that case, this same insurer conceded that under section 627.736(7), Florida Statutes, "[the insurer] would have to prove that [the insured] unreasonably refused to submit to an examination," which is contrary to the position later adopted by the Third District in Custer II....

...examination when the insured is claiming an entitlement to continued benefits and the insurer is questioning the necessity for same. In order to continue receiving benefits the insured must comply with the requirements of the insurance contract and section 627.736....

...roper cost of treatment for one injury. Ivey filed the present action seeking payment of the proper PIP amount alleging that Allstate had not provided full payment within thirty days after receiving written notice of the covered loss, as required by section 627.736(4)(b), Florida Statutes (1995)....

...It was only after the filing of the legal action and the completion of some discovery that Allstate finally paid the additional amount to which the doctor was actually entitled and for which Ivey had initially submitted a claim. Ivey then requested an award of attorney's fees pursuant to sections 627.736(8) and 627.428(1), Florida Statutes (1995), because Allstate had conceded and paid the additional amount actually due and owing....

...that the injured insured *684 may get on with his life without undue financial interruption." Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987) (citing Comeau v. Safeco Ins. Co., 356 So.2d 790 (Fla.1978)). To this end, section 627.736(4)(b), Florida Statutes (1995), clearly provides that PIP insurance benefits "shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." For over...

...Ivey to an award of attorney's fees." Ivey, 728 So.2d at 283. To the contrary, Florida law is clear that in "any dispute" which leads to judgment against the insurer and in favor of the insured, attorney's fees shall be awarded to the insured. See §§ 627.736(8), 627.428(1); see also Dunmore, 301 So.2d at 503....

...Despite repeated rescheduling, she ultimately failed to attend the exam. Under the PIP statute, "[i]f a person unreasonably refuses to submit to an examination, the personal injury protection carrier is no longer liable for subsequent personal injury protection benefits." § 627.736(7)(b), Fla....

...The attorney's fees provision in the PIP statute, entitled "Applicability of provision regulating attorney's fees," states that "[w]ith respect to any dispute under the provisions of [the PIP statute] between the insured and the insurer, the provisions of s. 627.428 shall apply." § 627.736(8), Fla....

...r of judgment statute the insurer will be awarded fees incurred after the offer. Given the lack of conflict between the statutes, the question becomes whether the expression of one thing (i.e., attorney's fees for insureds under sections 627.428 and 627.736) implies the exclusion of another (i.e., attorney's fees under the offer of judgment statute)....

...Weesner, 711 So.2d at 1194. Nichols attempts to distinguish PIP suits from these other insurance cases on the ground that section 627.428 applies to PIP suits through a separate provision in the PIP statute, which incorporates it by reference. See § 627.736(8), Fla....

...must have been to foreclose the application of any other attorney's fees provisions to PIP suits. Otherwise, she argues, the provision would be redundant with section 627.428. We find this argument unpersuasive. If the Legislature had enacted *1076 section 627.736(8) for the sole purpose of excluding all other attorney's fees provisions in PIP suits, then presumably it would have used exclusionary language, rather than the inclusive language it used. The words in the statute are the best guide to legislative intent. Here, section 627.736(8) gives no clue that the Legislature intended to prohibit application of the offer of judgment statute....

...ed Auto. Ins. Co. v. Rodriguez, 808 So.2d 82, 85 (Fla.2001). In my view, application of section 768.79 to PIP cases would completely circumvent and thwart the purposes of the No-Fault Act and the specific provisions relating to PIP benefits found in section 627.736....

...The Florida Legislature enacted the No-Fault Act to "provide for medical, surgical, funeral, and disability insurance benefits without regard to fault" and to limit "the right to claim damages for pain, suffering, mental anguish, and inconvenience." § 627.731, Fla. Stat. (2001). In order to accomplish this objective, section 627.736(1) requires that every owner of a motor vehicle obtain motor vehicle liability insurance that provides "personal injury protection ......

...nd his or her family will have access to necessary funds for family support to replace the income lost as a result of any debilitating injury suffered by the insured; and certain death benefits to ensure prompt payment of necessary funeral expenses. § 627.736(1), Fla....

...uption.'" Id. at 683-84 (emphasis added) (quoting Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987)). The assurance of swift and virtually automatic provision of PIP benefits is accomplished through the requirements of section 627.736(4)(b), which provides that PIP insurance benefits shall be overdue if not provided within thirty days after the insurer is furnished written notice of a covered loss and of the amount of same....

...ey's fees to the injured insured in achieving the purpose of the No-Fault Act: Florida law is clear that in "any dispute" which leads to judgment against the insurer and in favor of the insured, attorney's fees shall be awarded to the insured. See §§ 627.736(8), 627.428(1); see also Dunmore[ v....

...Co., 838 So.2d 604 (Fla. 5th DCA 2003). In Nationwide Mutual Fire Insurance Co. v. Pinnacle Medical, Inc., 753 So.2d 55 (Fla.2000), the court, in holding unconstitutional the requirement of mandatory arbitration and awards of attorney's fees to the prevailing party under section 627.736(5), again emphasized the importance of the provision for fees to the insured under section 627.428 by explaining: An objective of Florida's Motor Vehicle No-Fault Law was to provide persons injured in an accident with prompt payment of benefits....

..." § 627.733(1), Fla. Stat. (2001). Subsection (3) provides that "[s]uch security shall be provided: (a) [b]y an insurance policy ... which provides the benefits and exemptions contained in ss. 627.730-627.7405." § 627.733(3)(a), Fla. Stat. (2001). Section 627.736 contains the provisions that specify what the security requirements are: medical, disability and death benefits....

...read in context with the rest of the Florida Automobile Reparations Reform Act. In this context, the purpose of the required security is clearly to provide financial responsibility to pay any "no-fault" personal injury protection benefits due under Section 627.736....

...*1085 Section 768.79 is part of Chapter 768, Florida Statutes, wherein the Legislature included section 768.71(3), which provides that "[i]f a provision of this part is in conflict with any other provision of the Florida Statutes, such other provision shall apply." The PIP statute found in section 627.736 specifically provides that in PIP cases, "the provisions of s. 627.428 shall apply...." § 627.736(8), Fla. Stat. (2001) (emphasis added). This provision is significant because section 627.428 would apply to PIP cases regardless of the provisions of section 627.736(8). In my view, the Legislature intended that the specific provisions of section 627.428 should apply over the general provisions of section 768.79. In other words, specifically including section 627.428 in the provisions of section 627.736(8), to the exclusion of any other statutory provision for fees, clearly indicates the Legislature's intention that section 627.428 be the exclusive authority for an award of fees in PIP cases....

...te (the more general statute), which dictates that each party's liability is limited to that party's percentage of fault, so that the comparative fault statute had to yield to the wrongful death statute). I note that the Legislature recently amended section 627.736 by adding subsection (11), which requires that the insured provide the insurer with written notice of an intent to file a claim for benefits. Ch. 2001-271, § 6, at 1759, Laws of Fla.; § 627.736(11)(a), Fla. Stat. (2001). Section 627.736(11)(d) provides that "[t]he insurer shall not be obligated to pay any attorney's fees if the insurer pays the claim within the time prescribed by this subsection." In my view, this provision reaffirms the Legislature's intention that...

...§ 627.733(4), F.S.A., provides that an owner of a motor vehicle as to which security is required and who does not have such security in effect at the time of an accident has no tort immunity, but is personally liable for payment of the benefits under F.S. § 627.736, F.S.A., for personal injury and has all the obligations of an insurer under the no-fault insurance act....

...In contrast to the property damage tort immunity section, all right of recovery is not denied, but only recovery for particular intangible elements of damage in a few situations; there is no immunity from tort liability for tangible damages resulting from injury except where the benefits provided in F.S. § 627.736(1), F.S.A., are payable to the injured party by his insurer or would be so payable but for an authorized deduction or exclusion....

...[9] In computing the one thousand dollar figure, a person entitled to receive free medical *15 and surgical benefits is credited with the equivalent value of the services so provided him, as a part of the $1,000. § 627.737(2). We also deem worthy of note that § 627.736(1) and (1)(a) specify as to medical expenses that these must be such as are "reasonable" and that such expenses shall be "for necessary medical, etc." services....

...cation, a point later discussed more fully. It is also provided that even where these conditions are not present as a basis for suit by the injured party against the tortfeasor, the injured party is still entitled to receive the benefits provided by § 627.736(1) (medical bills, loss of income, etc.) from his own insurer, which benefits are payable regardless of fault....

...he prior tort law. F.S. § 627.737, F.S.A., grants an exemption from liability in tort for vehicular accidents, to persons meeting the insurance requirements of F.S. § 627.733, F.S.A., to the extent that benefits are payable under the provisions of § 627.736(1) and also to the extent that an injured party may not recover for pain, suffering, mental anguish and inconvenience unless certain threshold criteria have been met. The act also requires [14] persons within its ambit to provide and maintain security for the provision of the benefits required under § 627.736(1); failure to maintain such security results in revocation of the registrant's driving license and vehicle registration....

...Tort actions against persons not required to provide security are unaffected. F.S. § 627.740, F.S.A. Persons required to provide security and failing to do so have no tort immunity and are personally liable, under F.S. § 627.733(4), F.S.A., for the payment of benefits provided for in F.S. § 627.736, F.S.A....

...enough to vitiate a legislative classification based in reason. Lindsley v. National Carbonic Gas Co., supra . We have further above noted that the $1,000 "threshold" amount refers to "all reasonable expenses for necessary medical," etc., expenses (§ 627.736(1)(a)) and that § 627.736(5) indicates that "reasonable expenses" are not to be determined solely by the amount of the bill rendered by the physician or hospital, that section providing that the physician, hospital, etc., may charge only a reasonable amount for the...

...e compound, comminuted, displaced or compressed fracture, may properly be severed from the remainder of that section, and therefore that the remaining portions of that section are constitutionally valid and enforceable. Nor do the provisions of F.S. § 627.736(4), F.S.A., providing that workmen's compensation benefits received must be credited against the first-party benefits which are provided, violate equal protection, despite the fact that benefits received from other collateral sources need not be so credited....

...Where the "threshold" amount has not yet been reached, the cause of action cannot be said to accrue until such time as the "threshold" is crossed. Accordingly, we remand the cause to the Circuit Court in and for Broward County to proceed, upon any required amendment, based upon the benefits payable to appellants under F.S. § 627.736(1)(a), F.S.A., having now exceeded in amount the sum of one thousand dollars, in order to allow an opportunity to pursue a recovery in tort of damages for pain, suffering, mental anguish and inconvenience pursuant to F.S....

...It further provides that any person who is entitled to receive free medical and surgical benefits shall be deemed in compliance with the requirements of this subsection upon a showing that the medical treatment received has an equivalent value of at least $1,000. Fla. Stat. § 627.736, F.S.A., in explaining what is meant by "reasonable amount," explains that no charge may be in excess of the amount the person or institution customarily charges for like products, services and accommodations in cases involving no insurance....

...As used hereafter in this opinion, the term "insurance" refers to the security required to be maintained by F.S. § 627.733(3), F.S.A., whether the means by which such security is provided is insurance or some other approved method. [9] F.S. § 627.737(2), F.S.A., referring to benefits payable under F.S. § 627.736(1)(a), F.S.A....

...Wellness sought payment of 80% of the amount it had billed Sanchez, but Allstate paid a lower amount based on its interpretation of Sanchez’s policy. Instead of paying 80% of the total amount billed, Allstate paid Wellness only 80% of certain amounts set out in the statutory fee schedule contained in Fla. Stat. § 627.736(5)(a). The general rule for PIP coverage in Florida is that an insurance policy must cover 80% of all reasonable costs for medically necessary treatment resulting from 2  Case: 14-10001 Date Filed: 02/14/2014 Page: 3 of 13 an automobile accident, subject to certain limits. See Fla. Stat. § 627.736(1)(a). That is the payment Wellness sought from Allstate. Florida law also provides, however, that an insurer may opt out of the general payment rule and instead limit payment to 80% of a statutory fee schedule. See id. § 627.736(5)(a)....

...Its complaint proposed the following class: Any and all health care providers and insureds who submitted claims for no-fault benefits under PIP policies which were in effect from March, 2008, where Allstate utilized the reimbursement methodology pursuant to Florida Statute 627.736(5)(a)2(a-f) (2008) (the fee schedule) to limit reimbursement to the provider or the insured where the policy did not expressly and unambiguously indicate Defendant’s election to limit reimbursement in accordance with Florida Statute 627.736(5)(a)2 as its sole methodology for payment of No Fault claims. 3  Case: 14-10001 Date Filed: 02/14/2014 Page: 4 of 13 The complaint seeks no monetary damages. It seeks only a declaration that the form language Allstate used in the class members’ PIP insurance policies did not clearly and unambiguously indicate that payments would be limited to the levels provided for in § 627.736(5)(a). Allstate removed the case to federal court in August 2013, asserting that the Class Action Fairness Act (CAFA), 28 U.S.C....

...or reimbursement” of medical expenses based on PIP coverage under Allstate Florida auto policies during the relevant time period. She calculated that Allstate had paid out $126,474,216.25 in benefits for those claims based on the fee schedule in § 627.736(5)(a). She also calculated that if Allstate had not limited payment based on § 627.736(5)(a), then the putative class members would have been entitled to $194,651,033.94 in benefits (80% of the billed amounts)....

...It contended that Allstate had not established that the amount in controversy exceeds $5 million because the complaint did not seek damages but only a declaration that the language of the Allstate insurance policies did not clearly and unambiguously adopt the coverage caps of § 627.736(5)(a), as Florida law requires for them to be effective....

...Under Florida law, a party seeking to file a suit to recover PIP benefits must first submit a pre-suit 8  Case: 14-10001 Date Filed: 02/14/2014 Page: 9 of 13 demand letter to the insurer for payment of benefits. Fla. Stat. § 627.736(10)(a)....

...If the insurer rejects that demand for payment, the party may file suit and may be entitled to additional payment, but only if the relevant factfinder determines that the treatment in question was (1) related to an accident, (2) medically necessary, and (3) billed at a reasonable rate. See id. § 627.736(4)(b)(6). Wellness argues that with all of those contingencies standing between any class member and recovery, valuing a declaratory judgment is far too speculative. That speculation argument rests on two premises....

...the reasonableness of charges on 1,655,733 different bills. If that did not occur, however, the putative class members would have to request the additional payment from Allstate and wait for Allstate to deny the request before they could file suit. See Fla. Stat. § 627.736(10)(a). 10  Case: 14-10001 Date Filed: 02/14/2014 Page: 11 of 13 viewed in the aggregate, is too uncertain to satisfy the amount in controversy requirement.”)....

...Rollins, 704 So.2d 630 (Fla. 4th DCA 1997), in which the district court recognized conflict with the opinion in Kokotis v. DeMarco, 679 So.2d 296 (Fla. 5th DCA 1996), and certified the following question to this Court: WHETHER THE TERM "PAID OR PAYABLE" IN SECTION 627.736(3), FLORIDA STATUTES (SUPP.1996), *296 SHOULD BE DEFINED AS "THAT WHICH HAS BEEN PAID, OR PRESENTLY EARNED AND CURRENTLY OWING" SO THAT THE STATUTORY LANGUAGE OF SECTION 627.736 WILL NOT BE INTERPRETED TO PERMIT ANY REMAINING PERSONAL INJURY PROTECTION BENEFITS TO BE USED FOR SETOFFS FOR FUTURE COLLATERAL SOURCES....

...was hit by another car driven by Dasha Marie Cates and owned by Jane Rollins. The Pizzarellis sued Rollins and Cates. Medical bills incurred prior to trial by the Pizzarellis in the amount of $13,212.60 were admitted into evidence without objection. Section 627.736(1)(a), Florida Statutes (1991), provides that personal injury protection ("PIP") benefits will cover 80% of medical bills....

...During the trial, the issue arose as to whether the jury should be advised that $524.78 in additional PIP benefits were available to the Pizzarellis to defray the cost of future medical expenses. The defendants, Rollins and Cates, argued that the plain language of section 627.736(3), Florida Statutes (1991), [1] required the court to instruct the jury not to compensate the Pizzarellis for PIP benefits that had been paid or were to be paid in the future....

...The jury awarded the Pizzarellis $5000 in future medical expenses and $48 in lost earnings. The jury also found that the victim suffered permanent *297 injury and awarded the Pizzarellis $20,000 for past and future pain and suffering. After trial, both parties stipulated that there remained $524.78 in available PIP benefits. Section 627.736(3) provides that "An injured party who is entitled to bring suit under the provisions of §§ 627.730-627.7405, or his legal representative, shall have no right to recover any damages for which personal injury protection benefits are...

...court concluded that the remaining $524.78 in PIP benefits fit the definition of "payable" and therefore set off the $524.78 from the $5000 future medical expense award. On appeal, the Fourth District Court of Appeal agreed with the trial court that section 627.736(3) applied rather than section 627.7372....

..."Ambiguity suggests that reasonable persons can find different meanings in the same language." Forsythe v. Longboat Key Beach Erosion Control Dist., 604 So.2d 452, 455 (Fla.1992). We find that because the term "payable," as used by the Legislature in section 627.736(3), is susceptible to more than one reasonable interpretation, it is necessary to resort to principles of statutory construction to ascertain legislative intent....

...d therefore do not represent a liability or a "payable" benefit of the PIP carrier. This definition is also consistent with the usage given to the term "payable" in the very next subsection of the PIP statute to describe when PIP benefits are "due." § 627.736(4). [4] That subsection provides that PIP benefits are " due and payable as loss accrues, upon receipt of reasonable proof of such loss." Id. (emphasis supplied). This use of the term "payable" in section 627.736(4) supports the construction of the term as referring to those medical expenses that have been already been incurred....

...Neither section uses the more limited term "payable." Just as the legislative use of different terms in different portions of the same statute is evidence that different meanings were intended, see State v. Mark Marks, P.A., 698 So.2d 533, 541 (Fla.1997), the use of the more limited term "payable" in section 627.736(3) is evidence that the Legislature did not intend to set off future benefits....

...et for PIP benefits. Instead, the PIP carrier received a pro rata share of the plaintiffs recovery based on an equitable distribution formula, but only PIP "payments made" to the insured were subject to reimbursement based on equitable distribution. § 627.736(3)(b), Fla....

...Thus, in Purdy there was an implicit assumption that "payable" was limited to those expenses already incurred. More recently, in Mansfield v. Rivero, 620 So.2d 987 (Fla.1993), we confronted the issue of whether a plaintiff, by failing to claim PIP benefits, could avoid the setoff provisions of section 627.736(3)....

...The issue presented in this case is whether an award of future medical damages should be set off by the amount of remaining personal injury protection (PIP) benefits, if such benefits remain at the time of judgment. The answer to this question depends on the definition of the term "payable" as found in section 627.736(3), Florida Statutes (Supp.1996)....

...injury protection benefits paid or payable. In all cases in which a jury is required to fix damages, the court shall instruct the jury that the plaintiff shall not recover such special damages for personal injury protection benefits paid or payable. § 627.736(3), Fla....

...he demand. Thus, after setting off the available PIP benefits, the judgment was no longer 25% greater than the demand and the trial court found the Pizzarellis were no longer entitled to reasonable costs and attorney's fees under section 768.79. [4] Section 627.736(4), Florida Statutes (1991), provides in relevant part: (4) BENEFITS; WHEN DUE.—Benefits due from an insurer under ss....

...[3] Accordingly, the Third District *876 reversed the summary judgment entered in favor of the insureds, leaving as the only issue to be litigated whether Progressive's letters constituted a denial of the claim, which would obviate the need to comply with the presuit notice provisions. See § 627.736(11)(a), Fla. Stat. (2001). ANALYSIS The dispositive issue before this Court is whether section 627.736(11), Florida Statutes (2001), can be applied retroactively to an insurance policy issued prior to the enactment of the statute....

...has been provided documentation or information at the insurer's request pursuant to subsection (6). Such notice may not be sent until the claim is overdue, including any additional time the insurer has to pay the claim pursuant to paragraph (4)(b). § 627.736(11)(a), Fla....

...rd to fault"). The No-Fault Law mandates security that can be established by alternative means, one of which is PIP insurance. See § 627.733, Fla. Stat. (2006). The "Required Personal Injury Protection" provision, or the PIP statute, is codified at section 627.736 and is "an integral part of the no-fault statutory scheme." Flores v. Allstate Ins. Co., 819 So.2d 740, 744 (Fla.2002). The statute requires motor vehicle insurance policies issued in Florida to provide PIP benefits for bodily injury "arising out of the ownership, maintenance, or use of a motor vehicle." § 627.736(1), Fla....

...hes new legal consequences to events completed before its enactment." Metro. Dade County, 737 So.2d at 499 (quoting Landgraf v. USI Film Prods., 511 U.S. 244, 270, 114 S.Ct. 1483, 128 L.Ed.2d 229 (1994)). In order to answer this question, we compare section 627.736 as it existed at the time the insureds' insurance *878 policy was issued with the 2001 amendment. Before the addition of the statutory presuit notice provision, section 627.736 did not require an insured to provide notice to an insurer before filing an action for overdue benefits. PIP benefits became overdue if the insurer failed to pay within thirty days after receiving notice from the insured of the fact of a covered loss and the amount of such loss. § 627.736(4)(b), Fla. Stat. (2000). Any overdue payment was subject to a ten percent simple interest rate per year. § 627.736(4)(c), Fla. Stat. (2000). However, if the insurer had reasonable proof to establish that it was not responsible for the payment, the payment was not overdue. § 627.736(4)(b), Fla. Stat. (2000). In contrast, the statute as amended in 2001 requires an insured to provide a presuit notice of intent to initiate litigation and provides an insurer additional time to pay an overdue claim. § 627.736(11)(a), (d), Fla. Stat. (2001). Second, the amendment mandates that the payment from the insurer must include interest and penalties not exceeding $250. § 627.736(11)(d), Fla....

...Third, if the insurer pays within the additional time provided by the statute, the payment precludes the insured from bringing suit for late payment or nonpayment and shields the insurer from a claim for attorneys' fees. Id. Finally, the amendment tolls the statute of limitations. § 627.736(11)(e), Fla....

...claim within thirty days after receiving notice of loss. Moreover, an insured had the right to bring suit for an overdue claim once the thirty days had expired. See Crooks v. State Farm Mut. Auto. Ins. Co., 659 So.2d 1266, 1268 (Fla. 3d DCA 1995) ("Section 627.736(4)(b) unambiguously states that an insurer, who fails to pay out benefits within thirty days of receiving proper notice, will be liable to the insured."). Yet, pursuant to the 2001 version of section 627.736, an insurer has an additional period of time [6] to meet its obligation under the statute, and an action for a claim of benefits cannot be initiated until the additional time for payment has expired. Thus, the statute substantively alters an insurer's obligation to pay and an insured's right to sue under the contract. In our view, the statute, when viewed as a whole, is a substantive statute. Pursuant *880 to the 2001 version of section 627.736, an insured must now take additional steps beyond filing an application for PIP benefits and beyond complying with section 627.727(4)....

...Consequently, we conclude that the Third District erred in holding that requiring the insureds to comply with the presuit notice requirements of the statute did not "violate the general rule against retrospective operation." Menendez, 979 So.2d at 331. CONCLUSION For the foregoing reasons, we hold that section 627.736(11), Florida Statutes (2001), does not apply retroactively to the insurance policy issued to the insureds, because it is a substantive statute....

...es for the proceedings at the district court and before this Court. It is so ordered. QUINCE, C.J., and CANADY, POLSTON, LABARGA, and PERRY, JJ., concur. LEWIS, J., concurs in result only. NOTES [1] The statutory requirements originally contained in section 627.736(11), Florida Statutes (2001), are now located in section 627.736(10), Florida Statutes (2009). Section 627.736(11) was renumbered as subsection (10) by chapter 2007-324, section 20, Laws of Florida, which became effective January 1, 2008. To avoid any confusion, we refer in this opinion to the text of section 627.736(11), as originally enacted in 2001, as the "statutory presuit notice provision." [2] Menendez's husband, Louis R....

...[3] As to the other issues on appeal, the Third District held: (1) that the trial court erred in granting the partial summary judgment because a material disputed issue of fact existed as to whether Progressive denied the insureds' claim; (2) that section 627.736(11) applied to all types of PIP benefit claims, including lost supplemental wages claims; and (3) that the insureds waived any argument on appeal that the claim for benefits could have been abated until the failure to comply with the...

...Article I, section 10, of the Florida Constitution states: "No bill of attainder, ex post facto law or law impairing the obligation of contracts shall be passed." [5] Under the 2001 version of the statute, the statute of limitations was tolled for fifteen business days. § 627.736(11)(e), Fla. Stat. (2001). The current version of the statute tolls the statute of limitations for thirty business days. § 627.736(10)(e), Fla....

...[6] The 2001 amendment to the statute allowed an additional seven days after receipt of the notice of intent to litigate for the insurer to pay the claim. Under the current version of the statute, an insurer has an additional thirty days to pay a claim after receiving the notice of intent to litigate. § 627.736(10)(d), Fla. Stat. (2009). Both the 2001 and the current version of the statute state that the notice of intent to litigate may not be sent until the claim for benefits is overdue. § 627.736(11)(a), Fla. Stat. (2001); § 627.736(10)(a), Fla....

...Petitioner relies on numerous cases where the automobile was found to be merely the situs of acts or incidents arising from completely independent causes. We find those cases to be inapposite and unpersuasive. The extent of the coverage is governed by the policy language and the statute regulating such policies. Section 627.736(1), Florida Statutes (1981), requires that automobile insurance policies provide personal injury protection benefits for any "loss sustained ......

...Holding the subjective intent of an assailant determinative as to the "use" of a vehicle for PIP entitlement would require insurers to guess whether particular assaults and resulting injuries are covered under the PIP policy language required by law. See § 627.736(1), Fla....

...read in context with the rest of the Florida Automobile Reparations Reform Act. In this context, the purpose of the required security is clearly to provide financial responsibility to pay any "no fault" personal injury protection benefits due under Section 627.736....

...ources for which no right of subrogation exists. See § 768.76(1), Fla. Stat. (2000). However, because this was a motor vehicle accident, the jury would not award damages for personal injury protection ("PIP") benefits that were paid or payable. See § 627.736(3), Fla....

...With these basic principles in mind, we consider the general law regarding both PIP and UM coverage. PIP insurance is a statutorily required coverage for those policies complying with the security requirement of the Florida Motor Vehicle No-Fault law. See § 627.736(1), Fla. Stat. (1997); see also Allstate Ins. Co. v. Rudnick, 761 So.2d 289, 291 (Fla.2000). The purpose of PIP benefits is to provide up to $10,000 for medical bills and lost wages without regard to fault. See, e.g., §§ 627.731, 627.736, Fla....

...This coverage must be supplied in any "automobile liability insurance covering liability arising out of the ownership, maintenance, or use of any motor vehicle ..." Id. Likewise, personal injury protection "arising our of the ownership, maintenance, or use of a motor vehicle" is required in auto policies. Section 627.736(1), Florida Statutes (1979)....

...See Department of Legal Affairs v. District Court of Appeal, Fifth District, 434 So.2d 310 (Fla.1983). Statutory PIP coverage provides benefits for losses up to $10,000, as a result of bodily injury "arising out of the ownership, maintenance or use" of a motor vehicle. § 627.736(1), Fla....

...o third-party claims and thus already had been dismissed by the court's prior order. In this third order, the trial court first addressed and rejected the defendants' claim that section 817.234 was unconstitutionally vague because it conflicted with section 627.736(7)(b), Florida Statutes (1987), the personal injury protection benefits statute....

...denied, 279 So.2d 305 (Fla.1973). In personal injury protection claims, a party must turn over all medical records concerning a specific condition only after requesting and receiving a copy of medical reports from a medical examination requested by the insurer. § 627.736(7)(b), Fla....

...Joseph had assigned his right to PIP benefits to the Provider at the time he received treatment. The No-Fault Law, however, appears to require some form of writing. A medical provider's authorization to receive payment directly from the insurer derives from section 627.736(5)(a), Florida Statutes (1999), which provides in part: Any physician, hospital, clinic, or other person or institution lawfully rendering treatment to an injured person for a bodily injury covered by personal injury protection insura...

...Hartford Ins. Co. of the S.E. v. St. Mary's Hosp., Inc., 771 So.2d 1210, 1212 (Fla. 4th DCA 2000) (holding that there was no *1289 evidence that the insured assigned PIP benefits to the hospital because the insured never signed a document described in section 627.736(5)(a))....

...In this case, the record contains nineteen documents dated between October 4, 1999, and November 29, 1999 — signed by Mr. Joseph — acknowledging the services provided to him on the dates specified. Arguably, a fact issue exists on whether these documents are "invoices" under section 627.736(5)(a), which, combined with parol evidence, establish that Mr....

...the uninsured/underinsured third party tortfeasor for damages for bodily injury. Id. at 634. Although Kilbreath involved an uninsured motorist claim, the Fladd court believed the Kilbreath rationale should apply to a cause of action for a PIP claim: Section 627.736(4)(d)4, Florida Statutes (1981), specifically provides that the insurer of the owner of the motor vehicle must pay PIP benefits for accidental bodily injury sustained in this state by any other person while occupying the owner's motor vehicle. Section 627.736(3), Florida Statutes (1981), provides that the injured party, or his legal representative, may not recover any damages for which PIP benefits are paid or are payable....

...asor for damages for bodily injury." Id. at 632, 633. The cause of action in this case is a first party claim in contract for failure to pay the contractual obligation for personal injuries sustained, regardless of fault. The coverage is mandated by section 627.736(1), Florida Statutes (1981), in all policies complying with the security requirements of section 627.733, Florida Statutes. With regard to the payment of PIP benefits, section 627.736(4)(b) provides: Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same....

...Fradley, 187 So.2d at 49. In determining when the insurance contract at bar was breached, when an action could have been brought, and thus, when the statute of limitations began to run, the statutory provision regarding PIP benefits is also relevant. Section 627.736(4)(b), Florida Statutes (1995), provides in part: "Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a...

...te provides that a cause of action exists only if there is a conviction, or that other causes of action are pre-empted.” Nationwide Mut. Co. v. Ft. Myers Total Rehab Ctr., Inc., 657 F.Supp.2d 1279, 1287 (M.D. Fla. 2009) (discussing Fla. Stat. Ann. § 627.736 (12), which similarly provides an insurer a “cause of action against any person convicted of, or who, regardless of adjudication of guilt, pleads guilty or nolo contendere to insurance fraud under s....

...2016) (violations of sections 5.1.0117 and 560.204(1)); State Farm Mutual Auto. Ins. Co. v. B & A Diagnostic, Inc., 104 F.Supp.3d 1366, 1372 (S.D. Fla. 2015) (violations of the Health Care Clinic Act and the Radiological Personnel Certification Act)) . See, e.g., Fla. Stat. Ann. § 627.736 (5)(b)(l)(c) ("An insurer or insured is not required to pay a claim or charges.....

...equal to the amount demanded in such claim of lien, plus interest thereon at the legal rate for 3 years, plus $500 to apply on any court costs which may be taxed in any proceeding to enforce said lien. [4] See § 627.756, Fla. Stat. (1987). [5] See § 627.736(8), Fla....

...At the time, Carruthers was covered under an automobile insurance policy issued by GEICO General Insurance Company. Pursuant to Florida’s Motor Vehicle No- Fault Law, the policy provided him with $10,000 in personal injury protection (PIP) benefits. See Fla. Stat. § 627.736(1) (mandating that automobile insurers provide PIP benefits “to a limit of $10,000”)....

...To be entitled to the full $10,000, however, the statute required that Carruthers—like all PIP beneficiaries—be diagnosed by an authorized health care provider with an “emergency medical condition” (EMC); without such a diagnosis, he was limited to $2,500 in benefits. See id. at § 627.736(1)(a)(3)-(4); Robbins v....

...2  Case: 17-15606 Date Filed: 05/30/2019 Page: 3 of 23 neither Robbins’ nor Enivert’s claim was supported by [an EMC determination], neither Garrison nor Progressive violated Fla. Stat. § 627.736 by limiting benefits to $2,500”); accord, e.g., Progressive Am....

...Rodriguez's medical bills for review to a doctor who issued a report to United Auto on January 19, 1998, outside the thirty-day statutory time period. Ms. Rodriguez sued [in county court] to recover the amount of the unpaid medical bills plus interest. § 627.736(4)(b), (c), Fla....

...5th DCA 1997), wherein the court noted that failure to pay within the thirty-day period exposes an insurer to the statutory penalties but does not bar the insurer from contesting the claim. [2] The instant cases present the following issue: If the payment of benefits for a PIP claim is "overdue" under section 627.736, *85 Florida Statutes (1997), are the penalties set forth in Florida Statutes the only penalties that may be levied against the insurer, or is the insurer also forever barred from contesting the claim....

...its, for motor vehicles required to be registered in the state and, with respect to motor vehicle accidents, a limitation on the right to claim damages for pain, suffering, mental anguish, and inconvenience. §§ 627.730, 627.731, Fla. Stat. (1997). Section 627.736 sets forth the benefits that are required for personal injury protection (PIP) and mandates coverage if the loss is sufficiently related, reasonable, and necessary: 627.736 Required personal injury protection benefits; exclusions; priority....

...ness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle as follows: (a) Medical benefits.—Eighty percent of all reasonable expenses for necessary medical, surgical, X-ray, dental, and rehabilitative services.... § 627.736(1)(a), Fla. Stat. (1997) (emphasis added). Section 627.736 also defines an "overdue" payment of benefits and sets forth the penalties that may be levied: (4) BENEFITS; WHEN DUE.— Benefits due from an insurer under ss....

...ear. . . . . (8) APPLICABILITY OF PROVISION REGULATING ATTORNEY'S FEES.—With respect to any dispute under the provisions of ss. 627.730-627.7405 between the insured and the insurer, the [attorneys' fees] provisions ofs. 627.428 shall apply. [ [4] ] § 627.736, Fla....

...thirty days, the insurer must pay the claim, i.e., the insurer can no longer contest the claim. The insurer also is liable for the statutory interest penalty. This holding violates the plain language of the Law. As noted above, the plain language of section 627.736 provides that an insurer is subject to specific penalties for an "overdue" payment: ten percent interest and attorneys' fees....

...Further, the district court held that in order to escape the thirty-day rule, an insurer must obtain a "medical report" showing that the insurer is not responsible for payment. [9] Amici Allstate Insurance Company and Geico Casualty Company point out that this requirement of a medical report is not mentioned anywhere in section 627.736(4) and they contend it is erroneous....

...CONCLUSION Under the language of the Florida No-Fault Law, an insurer is subject to specific penalties once a payment becomes "overdue"; the penalties include ten percent interest and attorneys' fees. The insurer, however, is not forever barred from contesting the claim. Our reading of section 627.736(4) is consistent with the decisions of other district courts that have addressed this statute, including the Third District Court of Appeal's own en banc decision in Fortune Insurance Co....

...LEWIS, J., dissents with an opinion, in which QUINCE, J., concurs. PARIENTE, J., concurring. I concur with the majority. I write to emphasize that this case involves an issue of statutory construction, which must be guided by the express language of section 627.736(4), Florida Statutes (1997), and not our own view of the best policy for resolving insurance disputes. See Rollins v. Pizzarelli, 761 So.2d 294, 299 (Fla.2000). Legislative intent must be determined primarily from the language of the statute. See id. at 297. Although the statutory language of section 627.736(4) may not be a model of clarity, reading the statute as a whole does not support either the Third District or the dissent's interpretation that the failure of the insurer to obtain reasonable proof within thirty days after the claim...

...Co., 774 So.2d 679, 683-84 (Fla.2000), the purpose of the no-fault scheme does not logically extend to require an insurer to automatically pay for bills for which the insurer is not responsible. I thus take issue with the dissent's suggestion that the majority opinion renders the "reasonable proof" language of section 627.736(4)(b) and the limitation on withdrawal of payment for treating physicians in section 627.736(7), Florida Statutes (1997), "meaningless and without any field of operation." Dissenting op. at 91. Section 627.736(4) provides in pertinent part: (b) Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss.......

...t written *89 notice has been furnished to the insurer.... (c) All overdue payments shall bear simple interest at the rate of 10 percent per year. (Emphasis added). I agree with Judge Klein's interpretation of the statute: [T]he thirty-day period in section 627.736(4) applies only to benefits which are reasonable and necessary as a result of the accident. Section 627.736(4), Florida Statutes begins with the words "benefits due" and states in subsection (b) that "personal injury protection benefits paid pursuant to this section shall be overdue if not paid within thirty days." If an insured submits a b...

...However, the penalty for "overdue" payments, which runs from the expiration of the thirty-day period, applies only if the insurer is ultimately found liable for the claim. The insurer does not forfeit its ability to contest payment by its failure to obtain reasonable proof in the thirty-day period. As for section 627.736(7)(a), this statute deals exclusively with the requirements for withdrawal of payment: An insurer may not withdraw payment of a treating physician without the consent of the injured person covered by the personal injury protection, unless the insurer first obtains a report by a physician licensed under the same chapter as the treating physician whose treatment authorization is sought to be withdrawn, stating that the treatment was not reasonable, related, or necessary. § 627.736(7)(a) (emphasis added). This statute requires that a PIP insurer obtain a medical report as a condition precedent to withdrawing benefits. Nothing in the language of section 627.736(4)(b) suggests that the "reasonable proof" necessary to avoid "overdue" status is limited to the "report" necessary to "withdraw" payment of a treating physician under section 627.736(7)(a). See § 627.736(4)(b). In my view, this interpretation of the "reasonable proof" requirement in section 627.736(4)(b) and the medical report requirement of section 627.736(7)(a) give meaning and effect to both statutory provisions, with each section operating independently of the other....

...ts within thirty days of receiving written notice of the fact of a covered loss and the amount of same, and that—absent reasonable proof establishing non-responsibility for payment—PIP benefits are overdue if not paid within those thirty days. See § 627.736(4), Fla. Stat. (1997). As a corollary, section 627.736(7), Florida Statutes (1997), requires that before *90 an insurer may withdraw payment of a treating physician on the basis that medical treatment was not reasonable, not related, or not necessary, it must obtain a report from a like-l...

...t so that the injured insured may get on with his life without undue financial interruption." Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987) (citing Comeau v. Safeco Ins. Co., 356 So.2d 790 (Fla.1978)). To this end, section 627.736(4)(b), Florida Statutes (1995), clearly provides that PIP insurance benefits "shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." For over...

...es to simply disregard the specific provisions of chapter 627 which require the payment of benefits to injured persons within thirty days, absent reasonable proof—obtained within that time period—that they are not responsible for payment. [15] See § 627.736(4), (7), Fla....

...view, the reasoning of the majority and concurring opinions today undermines the validity of the entire no-fault framework and places the legislative scheme at risk. In essence, the majority decision renders the "reasonable proof" language found in section 627.736(4) and the limitation on the withdrawal of payment for treating physicians in section 627.736(7) meaningless and without any field of operation. The statute specifically states: 627.736(4) BENEFITS; WHEN DUE.— ....

...he trial court ... shall adjudge or decree against the insurer and in favor of the insured or beneficiary a reasonable sum as fees or compensation for the insured's or beneficiary's attorney prosecuting the suit in which the recovery is had. [5] See § 627.736(4), Fla. Stat. (1997) (explaining that an insured must submit "reasonable proof of such loss and amount of expenses"). [6] See § 627.736(4)(b), Fla....

...nt of same.... However, any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding that written notice has been furnished to the insurer."). [7] See § 627.736(4)(c), Fla. Stat. (1997) (explaining that "[a]ll overdue payments shall bear simple interest at the rate of 10 percent per year"). This ten percent interest rate has been in force since the Law was enacted in 1971. See § 627.736(4)(c), Fla. Stat. (1971). In contrast, the statutory interest rate on judgments in 1971 was six percent. See § 55.03, Fla. Stat. (1971). [8] See § 627.736(8), Fla....

...ncorrect.") [9] See Perez, 746 So.2d at 1125 ("The PIP statute clearly requires that the insurer must obtain, within thirty days, a medical report providing `reasonable proof' that it is not responsible for payment." (Emphasis added.)). [10] But see § 627.736(7), Fla. Stat. (1997) (explaining that a physician's report is required for the non-consensual withdrawal of PIP benefits). [11] § 627.736(4), Fla....

...To be sure, subsection (7) does not require insurance companies to obtain a similar report when its challenge is based on the bill itself (i.e., the amount being charged). [15] Senate Bill 1092, which was passed by our Legislature during the 2001 Session and approved by the Governor on June 19, 2001, adds language to section 627.736(4)....

...Respect for the separation of governmental powers requires no less. The decision of the Third District Court of Appeal is quashed, and the case is remanded for further proceedings consistent with this opinion. OVERTON, C.J., and BOYD and SUNDBERG, JJ., concur. ADKINS and HATCHETT, JJ., dissent. NOTES [1] § 627.736(4)(d), Fla....

...[5] Allstate put the word "owner" in its policy in order to effect what it perceived to be the legislative intent. Its refusal to pay is based on the policy term, which Heredia says cannot be substituted for the specific legislative directive. [6] See, e.g., §§ 627.736(8), and 627.738(4), Fla....

...tion he might have against this Defendant to his medical care provider, and the exclusive remedy of the medical care provider is binding arbitration." Contemporaneously with the motion to dismiss, Allstate filed a demand for arbitration, pursuant to section 627.736(5), Florida Statutes....

...mproperly considered the allegations of the motion to dismiss. Because the complaint itself makes no reference to an assignment, appellant reasons the trial court could not determine that a dispute was subject to arbitration pursuant to section *394 627.736(5), without reference to the motion to dismiss....

...Therefore, the absence of a transcript of proceedings in the lower tribunal does not require affirmance of the trial court's ruling on the motion to dismiss. See Doan v. Amelia Retreat Condominium Ass'n, Inc., 604 So.2d 1292, 1293 (Fla. 1st DCA 1992). The statute applicable, section 627.736(5), Florida Statutes, provides in pertinent part: (5) ......

...The provision shall specify that the provisions of chapter 682 relating to arbitration shall apply. The prevailing party shall be entitled to attorney's fees and costs. (Emphasis supplied). Florida courts have determined that arbitration is mandatory under section 627.736(5), "even in the event that the insurance policy between the insured and the insurance company does not include an arbitration provision with regard to the medical provider." See Omni Insurance Co....

...State Farm Mutual Automobile Insurance Co., 697 So.2d 988 (Fla. 4th DCA 1997). In U.S. Security Insurance Co. v. Magnetic Imaging Systems, I, Ltd., 678 So.2d 872, 873, fn. 2 (Fla. 3d DCA 1996), the court stated expressly "that this arbitration provision [§ 627.736(5)] should be read into the policy so that it complies with applicable Florida Law." In a related vein, "[m]edical service providers......

...nt upon which Allstate based its claim of entitlement to arbitration. [3] It is the assignment of the insured's interest in personal injury protection benefits to medical services providers which authorizes the insurer's demand for arbitration under section 627.736(5)....

...iropractic Wellness Center, and MedScan Open-MRI, Amici Curiae. WELLS, J. We have on appeal Delta Casualty Co. v. Pinnacle Medical, Inc., 721 So.2d 321 (Fla. 5th DCA 1998), a decision in which the Fifth District Court of Appeal declared a portion of section 627.736(5), Florida Statutes (1995), unconstitutional....

...Pinnacle submitted the medical bills to Delta, which refused to pay them. Pinnacle, as Raymond's assignee, brought an action for breach of the insurance contract. Delta moved to dismiss the case, claiming that the dispute had to be referred to binding arbitration in accordance with section 627.736(5), Florida Statutes (1995). The trial court denied Delta's motion to dismiss and to compel arbitration. The trial court found that section 627.736(5) was unconstitutional under Lasky v....

...1974), in which this Court held that the test used to determine whether a statute violates due process "is whether the statute bears a reasonable relation to a permissible legislative objective and is not discriminatory, arbitrary or oppressive." Id. at 15. The trial court determined that the legislative objective of section 627.736(5) was to deny the right to litigate certain claims in court based on who owns the claim and that, given the right to seek redress in court provided by article I, section 21 of the Florida Constitution, this could not be considered a legitimate government objective. The trial court concluded that the mandatory arbitration provision of section 627.736(5) violated the parties' due process rights in violation of article I, section 9 of the Florida Constitution. On appeal, the Fifth District affirmed. The district court determined that under *57 Lasky section 627.736(5) violated due process by arbitrarily discriminating against medical providers....

...The district court determined that if the legislative objective of the statute was to reduce court congestion, that objective could not be achieved in such an arbitrary and discriminatory manner. The Fifth District also considered the provision as to prevailing party attorney fees in section 627.736(5)....

...The district court found that the provision arbitrarily discriminates against medical providers by subjecting them to a prevailing party test of attorney fees, while allowing insureds to recover fees under section 627.428(1), Florida Statutes (1995). The district court concluded that section 627.736(5) violated article I, section 9 of the Florida Constitution. LAW AND ANALYSIS Under Florida's Motor Vehicle No-Fault Law, [1] motorists provide their own PIP insurance for medical payments and lost wages up to a statutorily mandated amount. Section 627.736(5) requires that any charges for medical services provided to a person covered by PIP be reasonable and allows for an insurer to pay benefits directly to those providing the services. The portion of section 627.736(5) declared unconstitutional by the district court states: Every insurer shall include a provision in its policy for personal injury protection benefits for binding arbitration of any claims dispute involving medical benefits arising...

...The provision shall specify that the provisions of chapter 682 relating to arbitration shall apply. The prevailing party shall be entitled to attorney's fees and costs.[ [2] ] We agree with the Fifth District that the mandatory arbitration provision of section 627.736(5) is unconstitutional. However, we reach this conclusion by finding that the provision violates the right of medical providers to access to courts provided under article I, section 21 of the Florida Constitution. We also find that the attorney-fee provision of section 627.736(5) violates the due process rights of medical providers in violation of article I, section 9 of the Florida Constitution. Section 627.736(5) prohibits medical provider-assignees from pursuing a breach of contract claim in court....

...re cannot abolish that right without providing a reasonable alternative unless the Legislature can show an overpowering public necessity for its abolishment and no alternative method of meeting such public necessity. Id. at 4. Petitioner argues that section 627.736(5) does not violate medical providers' access to courts because there is no preexisting right of medical providers to recover directly from insurers and that an alternative means of redress has been provided. We disagree. The right of an assignee to sue for breach of contract to enforce assigned rights predates the Florida Constitution. See Robinson v. Nix, 22 Fla. 321 (1886). As an alternative to seeking redress in the courts, section 627.736(5) provides for arbitration *58 pursuant to the provisions of Florida's Arbitration Code....

...We noted, however, that a statutory requirement that the arbitration board's decision be presumed correct in the trial de novo would raise serious concerns as to whether such a statute would violate access to courts because it would diminish the right to have the ultimate decision in a case made by a court. Id. at 714. Section 627.736(5) does not provide for a trial de novo in the circuit court. Section 627.736(5) states that the provisions of chapter 682, Florida's Arbitration Code, shall apply....

...Bonanno, 568 So.2d 24 (Fla.1990), or the *59 mediation or arbitration was a prerequisite to filing the cause of action in court. See Carter v. Sparkman 335 So.2d 802 (Fla. 1976). No such commensurate benefits or procedural safeguards exist for medical providers subject to arbitration pursuant to section 627.736(5)....

...Medical providers still must prove they are entitled to recover under the assigned contract, with limited appellate review of the issue, and are subject to additional liability due to the prevailing party standard of determining an award of attorney fees. Section 627.736(5) does not provide a reasonable alternative to medical providers having their claims heard in court, nor has the Legislature shown an overpowering public necessity for abolishing this right. Therefore, we conclude that the mandatory arbitration provision in section 627.736(5), Florida Statutes (1997), denies medical providers access to courts in violation of article I, section 21 of the Florida Constitution. We also find that the attorney-fee provision in section 627.736(5) violates medical providers' due process rights....

...nsurance companies from contesting valid claims and to reimburse successful insureds for their attorney fees when they are compelled to sue to enforce their insurance contracts. See State Farm Fire & Cas. Co. v. Palma, 629 So.2d 830, 833 (Fla.1993). Section 627.736(5) replaces section 627.428(1) attorney fees with an award of attorney fees based on who was the "prevailing party" at arbitration. [5] Under section 627.736(5), medical provider-assignees are subject to attorney fees, while insureds suing to enforce the exact same contract enjoy the one-way imposition of attorney fees against insurers provided in section 627.428(1). This distinction does nothing to further the prompt payment of benefits or to discourage insurers' denial of valid claims. The effect of the attorney-fee provision in section 627.736(5) is to further delay insureds from receiving medical benefits by encouraging medical providers to require payment from insureds at the time the services are rendered rather than risk having to collect through arbitration. Thus, the prevailing party attorney-fee provision of section 627.736(5) arbitrarily distinguishes between medical providers and insureds, violating medical providers' due process rights, and is unconstitutional under article I, section 9 of Florida's Constitution. Accordingly, we affirm the decision of Fifth District Court of Appeal below and hold to be unconstitutional the portion of section 627.736(5), Florida Statutes (1997), requiring mandatory arbitration for all medical provider assignees and requiring a prevailing party standard to apply with regard to attorney fees....

...It is so ordered. HARDING, C.J., SHAW, ANSTEAD, PARIENTE, LEWIS and QUINCE, JJ., concur. NOTES [1] §§ 627.730-627.7405, Fla. Stat. (1997). [2] The method used to determine whether a party is a "prevailing party" was added to the statute in 1998. § 627.736(5)(c)1-3, Fla....

...[5] In order to be considered a "prevailing party," a party seeking payment through arbitration must obtain an arbitration award that is greater than the amount the opposing party offered plus fifty percent of the difference between the amount offered and the amount that party was seeking. See § 627.736(5)(c)1-3, Fla....

...cted from his vehicle causing him further injury. The trial court ruled these allegations were insufficient to allege that appellant suffered bodily injuries arising out of the ownership, maintenance or use of his motor vehicle within the meaning of section 627.736(1), Florida Statutes (1979), relating to the personal injury protection benefits and of section 627.727(1), Florida Statute (1979), relating to uninsured motorist provisions of his automobile insurance policy and dismissed the complaint....

...e, a procedural rule, or a constitutional provision may be the basis for granting certiorari review." Kaklamanos, 843 So.2d at 890. Because we conclude that: (1) the circuit court [appellate division] has incorrectly interpreted and applied sections 627.736(4)(b) and 627.736(7)(a), Florida Statutes (2003); (2) the circuit court's interpretation and application of sections 627.736(6)(4)(b) and 627.736(7)(a) are a departure from the essential requirements of law; and (3) the "circuit court's decision establishes a rule of general application" for future county court cases, "thus exacerbating the effect of the [circuit court appellate panel's] legal error," Progressive Express Ins....

...Chiropractic, 913 So.2d 1281, 1287 (Fla. 2d DCA 2005), we grant certiorari review. See also Gould v. State, 974 So.2d 441 (Fla. 2d DCA 2007); State Farm Fla. Ins. Co. v. Lorenzo, 969 So.2d 393, 398 (Fla. 5th DCA 2007). ANALYSIS Our analysis involves the application of two subsections of section 627.736—subsections (4)(b) and (7)(a)....

...Subsection (4)(b) pertains to circumstances where "the insurer has either reduced, omitted, or declined" payment of PIP claims that are reasonable, necessary, and related, whereas subsection (7)(a) sets forth the necessary requirements that an insurer must satisfy before it may withdraw future PIP benefits. A. Application of section 627.736(4)(b): The circuit court's failure to consider Dr....

...The circuit court agreed with the trial court, finding that because Dr. Millheiser's affidavit was obtained more than thirty days after Santa Fe submitted its claim to United Auto, it was untimely. The trial court and the circuit court's findings are based upon an incorrect interpretation of section 627.736(4)(b)....

...rmitted under, or in violation of, subsection (5). Such assertion by the insurer may be made at any time, including after payment of the claim or after the 30-day time period for payment set forth in this paragraph. (Emphasis added). The language of section 627.736(4)(b) is clear and unambiguous. Section 627.736(4)(b) imposes on the insurer a thirty-day time period in which to pay PIP benefits, if the claim is reasonable, related, and necessary....

...Under subsection (4)(b), a claim is due within the thirty-day period only if it is reasonable, related, and necessary. The statutory penalty for failing to pay a claim that is later determined to have been reasonable, related, and necessary, is an assessment of interest against the insurer, see § 627.736(4)(d), and potentially an award of attorney's fees, see § 627.736(8)....

...er the thirty-day period, that the treatment was not reasonable, necessary, or related. See United Auto. Ins. Co. v. Millennium Diagnostic Imaging Ctr., Inc., 12 So.3d 242, 246 (Fla. 3d DCA 2009) (finding that the thirty-day time period set forth in section 627.736(4)(b) applies to the payment of claims that are necessary, reasonable, and related, and the failure to contest a claim within this thirty-day period does not serve to forever bar a contest to the claim); Bermudez, 980 So.2d 1213, 1216-17 (Fla. 3d DCA 2008) (concluding that "section 627.736(4) ... deals with timing as to when PIP benefits that are properly due must be paid by an insurer before they are considered overdue.... [S]ection 627.736(4) expressly provides that `[t]his paragraph does not preclude or limit the ability of the insurer to assert that the claim was unrelated, was not medically necessary, or was unreasonable'"); AIU Ins. Co. v. Daidone, 760 So.2d 1110, 1112 (Fla. 4th DCA 2000) (holding "that the thirty-day period in section 627.736(4) applies to benefits which are reasonable and necessary as a result of the accident"). Because the thirty-day period for the payment of PIP benefits contained in section 627.736(4)(b) only applies to the payment of benefits that are reasonable, necessary, and related, and the insurer may contest the claim at any time, we conclude that the trial court departed from the essential requirements of the law in refusing to consider Dr. Millheiser's affidavit when ruling on Santa Fe's motion for summary judgment, even though it was generated more than thirty days after Santa Fe submitted the PIP claim. *65 B. Application of section 627.736(7)(a): The circuit court's failure to consider Dr....

...ted Auto was required to obtain a "valid report" before it could deny payment. The circuit court agreed with the trial court's refusal to consider Dr. Millheiser's affidavit because the affidavit did not constitute a "valid report" as required under section 627.736(7)(a)....

...er reasonable proof at any time to establish that the insurer is not responsible for payment of the claim. "[A]ny payment shall not be deemed overdue when an insurer has reasonable proof to establish that the insurer is not responsible for payment." § 627.736(4)(b)....

...It is important to note that the statute does not require the insurer to obtain a report or proof under subsection (4)(b) before denying a claim. In United Automobile Insurance Co. v. Rodriguez, 808 So.2d 82, 87 (Fla.2001), the Florida Supreme Court noted that nowhere in section 627.736(4)(b) does it require that a medical report (let alone a "valid [medical] report") be obtained showing that the insurer is not responsible for payment: Amici Allstate Insurance Company and Geico Casualty Company point out that this requirement of a medical report is not mentioned anywhere in section 627.736(4) and they contend it is erroneous....

...proof" to mean only a medical report, the district court has rewritten the statute. This too was error. (Footnotes omitted). Additionally, Justice Pariente, in her concurring opinion in Rodriguez, explained that the "reasonable proof" requirement in section 627.736(4)(b) is not synonymous with the "valid report" requirement of section 627.736(7)(a), and that the "reasonable proof" requirement of section 627.736(4)(b) (relating to the denial of benefits), is only necessary to avoid "overdue" status. This statute [section 627.736(7)(a)] requires that a PIP insurer obtain a medical report as a condition precedent to withdrawing benefits. Nothing in the language of section 627.736(4)(b) suggests that the "reasonable proof" necessary to avoid "overdue" status is limited to the "report" necessary to "withdraw" payment of a treating physician under section 627.736(7)(a). See § 627.736(4)(b). In my view, this interpretation of the "reasonable proof" requirement in section 627.736(4)(b) and the medical report requirement of section 627.736(7)(a) give meaning and effect to both statutory provisions, with each section operating independently of the other....

...Rodriguez, 808 So.2d at 89 (Pariente, J., concurring). In State Farm Mutual Automobile Insurance Co. v. Rhodes & Anderson, D.C., P.A., 18 So.3d 1059 (Fla. 2d DCA 2008), Judge Canady (now Justice Canady) authored a comprehensive opinion addressing the identical question: whether a "valid report" under section 627.736(7)(a) is required before an insurer may deny payment of a claim for PIP benefits. The Second District answered the question in the negative, holding that the insurer's refusal to pay for certain tests was a denial, not a withdrawal, of payment, and thus the "valid report" requirement in section 627.736(7)(a) did not apply. The court found, instead, that because the claim was denied, the insurer was only required to provide reasonable proof that the insurer was not responsible for the claim. Id. at 1064. Our interpretation of section 627.736(7)(a) is consistent with this Court's earlier opinion in United Automobile Insurance Co. v. Viles, 726 So.2d 320 (Fla. 3d DCA 1998). Unlike the instant case, Viles was a withdrawal case. Thus, section 627.736(7)(a) applied, and the insurer was required to obtain a valid report before withdrawing or refusing to pay any further PIP benefits....

...This Court concluded that prior to withdrawing payment, the insurer was required to obtain a valid report. [W]e agree with the trial court's well reasoned analysis concluding that United Auto was required to first obtain a physician's report before refusing to pay further medical bills. The statute [section 627.736(7)(a)] plainly provides that an insurer must first obtain the referenced report before electing to withdraw payment....

...independent physical examination of the insured. 980 So.2d at 1214. This Court concluded that a valid report for the withdrawal of benefits may be based upon the reporting physician's review of another physician's examination. "[W]e hold that under section 627.736(7)(a) a medical report issued for the withdrawal of PIP benefits may be based on a physical examination of the insured that is conducted by either the physician preparing the report or another physician's examination." Bermudez, 980 So.2d at 1215. Although Bermudez, in dicta, suggests that Viles also applies the section 627.736(7)(a) valid medical report requirement to the denial of PIP benefits, a careful reading of the case demonstrates that it does not. Viles only applies section 627.736(7)(a) to the withdrawal or termination of authorization for further treatment, not to an initial outright denial of benefits. "The statute plainly provides that an insurer must first obtain the referenced report before electing to withdraw payment." Viles, 726 So.2d at 321 (emphasis added). "[S]ection 627.736(7)(a) sets up a procedural requirement that an insurer cannot withdraw payment of a treating physician unless the decision is supported by an expert that the treatment does not comply with the statutory criteria." Id....

...or termination of payments or to the withdrawal or termination of authorization for treatment"; holding that "denial of a single claim for payment does not constitute the withdrawal of a physician's `treatment authorization'" and does not implicate section 627.736(7)(a) because that section "does not address situations in which one charge for treatment has been denied by the insurer"). We, therefore, recede from that portion of Bermudez suggesting that the holding in Viles also applies to denial of benefits cases. Because this is a denial case, section 627.736(7)(a) is not implicated. Therefore, United Auto was not required to obtain a "valid medical report" to deny payment of Santa Fe's claim, and the circuit court erred in granting Santa Fe's motion for summary judgment based upon United Auto's failure to comply with section 627.736(7)(a). CONCLUSION We grant the instant petition because the circuit court departed from the essential requirements of law by incorrectly interpreting the language of subsections (4)(b) and (7)(a) of section 627.736, and by failing to apply the correct law set forth in subsection (4)(b)....

...2  Case: 15-14415 Date Filed: 05/08/2018 Page: 3 of 28 extends to “medically necessary” services, including emergency transport, “to a limit of $10,000.” Fla. Stat. § 627.736(1)(a). The PIP statute, Florida Statutes § 627.736, permits an insured to choose one of two methods for calculating the reimbursement of medical claims under his automobile insurance policy. See Allstate Ins. Co. v. Orthopedic Specialists, 212 So. 3d 973, 976 (Fla. 2017). The first method requires the auto insurer to reimburse “[e]ighty percent of all reasonable expenses for medically necessary . . . services.” Fla. Stat. § 627.736(1)(a). To determine a reasonable amount, any “relevant” information may be considered. Id. § 627.736(5)(a)....

...Under this first method, a medical provider can bill the insured for the reasonable fee that remains after his auto insurance has paid its portion. The second method permits an insured and insurer to “limit reimbursement to 80 percent” of a schedule of charges that mostly 1 tracks Medicare rates. Id. § 627.736(5)(a)1. For example, an insurer may limit reimbursement for “emergency transport and treatment” to “200 percent of Medicare.” Id. § 627.736(5)(a)1.a....

...in excess of such limits, except for amounts that are not covered by the insured’s 1 As to emergency hospital care, the fee schedule restricts reimbursement to “75 percent of the hospital’s usual and customary charges.” Fla. Stat. § 627.736(5)(a)1.c. 3  Case: 15-14415 Date Filed: 05/08/2018 Page: 4 of 28 personal injury protection coverage due to the coinsurance amount or maximum policy limits.” Id. § 627.736(5)(a)4....

...Lenworth Bailey was a passenger in the vehicle at the time of the accident. Lemar Bailey received coverage under Hyde’s automobile insurance policy because he was a passenger in the vehicle at the time the accident occurred. See Fla. Stat. § 627.736(1)....

...We illustrate these consequences by walking through each method with an example. The first method requires an auto insurer to reimburse “[e]ighty percent of all reasonable expenses for medically necessary . . . services.” Fla. Stat. § 627.736(1)(a)....

...a medical provider is prohibited from charging the insured for any amount in excess of the fee schedule, “except for amounts that are not covered by the insured’s personal injury protection coverage due to the coinsurance amount or maximum policy limits.” Fla. Stat. § 627.736(5)(a)4....

...orce in apprehending and arresting [petitioner], that [petitioner] was injured." Respondent admitted the above allegation but denied coverage on the basis that the injury did not arise out of the use, operation or maintenance of a motor vehicle. See § 627.736(1), Fla....

...Stat. (1983). Cross motions for judgment on the pleadings were filed and the trial court entered judgment for petitioner. On appeal the district court reversed, holding that tort concepts of causation were applicable in determinations of coverage under section 627.736(1)....

...nder the insurance policy issued by respondent. The insurance policy issued by respondent is required by statute to provide benefits for bodily injury, sickness, disease or death "arising out of the ownership, maintenance or use of a motor vehicle." § 627.736(1)....

...at 350 (quoting Royal Indemnity Co. v. Government Employees Insurance Co., 307 So.2d 458, 460 (Fla. 3d DCA 1975)). Both Lumbermens Mutual and Royal Indemnity dealt, however, with an aspect of the Florida Motor Vehicle No-Fault Law which is not at issue in this case. Section 627.736(4)(d)1, Florida Statutes (1983), requires payment of P.I.P....

...Plaintiffs responded with the contention that section 627.737 is unconstitutional as a denial of access to courts, due process, and equal protection. The trial court issued an order holding for the defendants and finding the statute constitutional. On appeal, the district court found sections 627.736(1), [1] 627.737, [2] and 627.739 [3] of *15 the no-fault statute unconstitutional....

...rendered the alternative no longer reasonable. The two changes the district court was most concerned about were the lowering of the personal injury protection (PIP) benefits and the raising of the permissible PIP "deductible." When we decided Lasky, section 627.736(1) provided for recovery of 100% of medical expenses and 100% or 80% of lost income depending on whether the benefits were to be included in gross income for federal income tax purposes. Chapter 77-468, section 33, Laws of Florida, amended that section reducing the benefits to 80% of medical expenses and 80% or 60% of lost income. Other provisions in the no-fault act when Lasky was decided required PIP coverage of $5,000, section 627.736(1), Florida Statutes (1971), with a maximum deductible of $1,000....

...Thus the provisions of section 627.737 still provide a reasonable alternative to the traditional action in tort and therefore do not violate the right of access to courts guaranteed by article I, section 21 of the Florida Constitution. *18 DUE PROCESS OF LAW The district court found that sections 627.736(1), 627.737(1), and 627.739(1), Florida Statutes (1979), unconstitutionally denied due process in that they did not bear a reasonable relationship to permissible legislative objectives. The district court explained: The changes to sections 627.736, 627.737 and 627.739 noted above cause the 1979 no-fault act to no longer be reasonably related to several of the permissible legislative objectives noted in Lasky: (1) injured parties are able to initiate suits for expenses not payable by an...

...prolonged pain to recover damages to recompense them, while not granting such right of recovery to those substantially less likely to incur any prolonged pain. Lasky v. State Farm Insurance Co., 296 So.2d at 19. In conclusion, we find that sections 627.736(1), 627.737, and 627.739 of the Florida Statutes (1979), do not violate the rights of access to courts, due process, or equal protection....

...SUNDBERG, C.J., concurs in part and dissents in part with an opinion, in which ADKINS, J., concurs. OVERTON, Justice, concurring. I concur but find that the act as amended is at the absolute outer limits of constitutional parameters, particularly in the amendment of section 627.736(1), Florida Statutes (1979), which reduced personal injury protection for medical expenses and loss of earnings....

...Although I concur substantially with the majority opinion, I feel compelled to dissent from the holding that section 627.737(2), Florida Statutes (1979), is constitutional insofar as it eliminates all causes of action for intangible damages for nonpermanent injuries. Furthermore, I must observe that the provisions of section 627.736(1)(a) — (b), Florida Statutes (1979), reducing the medical expenses and lost income benefits come perilously close to "the outer limits of constitutional tolerance." Carter v....

...could the right to damages for permanent injuries. For this reason I dissent from the holding that section 627.737(2) is constitutional insofar as it prohibits recovery of intangible damages for nonpermanent injuries. ADKINS, J., concurs. NOTES [1] 627.736 Required personal injury protection benefits; exclusions; priority....

...missions, is hereby exempted from tort liability for damages because of bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use of such motor vehicle in this state to the extent that the benefits described in s. 627.736(1) are payable for such injury, or would be payable but for any exclusion or deductible authorized by ss....

...ment for repair work. — In order to prevent duplication with other private or governmental insurance or benefits for senior citizens and others with access to such insurance or benefits, each insurer providing the coverage and benefits described in s. 627.736(1) shall offer to the named insureds modified forms of personal injury protection as described in this section....

...(2) Insurers shall offer coverage wherein at the election of the named insured all benefits payable under 42 U.S.C. s. 1395, the federal "Medicare" program, or to active or retired military personnel and their dependent relatives shall be deducted from those benefits otherwise payable pursuant to s. 627.736(1). (3) Insurers shall offer coverage wherein at the election of named insured the benefits for loss of gross income and loss of earning capacity described in s. 627.736(1)(b) shall be excluded....

...ed Auto. Ins. Co. v. Rodriguez, 808 So.2d 82, 85 (Fla.2001). In my view, application of section 768.79 to PIP cases would completely circumvent and thwart the purposes of the No-Fault Act and the specific provisions relating to PIP benefits found in section 627.736....

...The Florida Legislature enacted the No-Fault Act to "provide for medical, surgical, funeral, and disability insurance benefits without regard to fault" and to limit "the right to claim damages for pain, suffering, mental anguish, and inconvenience." § 627.731, Fla. Stat. (2001). In order to accomplish this objective, section 627.736(1) requires that every owner of a motor vehicle obtain motor vehicle liability insurance that provides "personal injury protection ......

...nd his or her family will have access to necessary funds for family support to replace the income lost as a result of any debilitating injury suffered by the insured; and certain death benefits to ensure prompt payment of necessary funeral expenses. § 627.736(1), Fla....

...uption.'" Id. at 683-84 (emphasis added) (quoting Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987)). The assurance of swift and virtually automatic provision of PIP benefits is accomplished through the requirements of section 627.736(4)(b), which provides that PIP insurance benefits shall be overdue if not provided within thirty days after the insurer is furnished written notice of a covered loss and of the amount of same....

...ey's fees to the injured insured in achieving the purpose of the No-Fault Act: Florida law is clear that in "any dispute" which leads to judgment against the insurer and in favor of the insured, attorney's fees shall be awarded to the insured. See §§ 627.736(8), 627.428(1); see also Dunmore, 301 So.2d at 503....

...Ivey, 774 So.2d at 684 (emphasis added). In Nationwide Mutual Fire Insurance Co. v. Pinnacle Medical, Inc., 753 So.2d 55 (Fla.2000), the court, in holding unconstitutional the requirement of mandatory arbitration and awards of attorney's fees to the prevailing party under section 627.736(5), again emphasized the importance of the provision for fees to the insured under section 627.428 by explaining: An objective of Florida's Motor Vehicle No-Fault Law was to provide persons injured in an accident with prompt payment of benefits....

..." § 627.733(1), Fla. Stat. (2001). Subsection (3) provides that "[s]uch security shall be provided: (a) [b]y an insurance policy ... which provides the benefits and exemptions contained in ss. 627.730-627.7405." § 627.733(3)(a), Fla. Stat. (2001). Section 627.736 contains the provisions that specify what the security requirements are: medical, disability and death benefits....

...read in context with the rest of the Florida Automobile Reparations Reform Act. In this context, the purpose of the required security is clearly to provide financial responsibility to pay any "no-fault" personal injury protection benefits due under Section 627.736....

...Section 768.79 is part of Chapter 768, Florida Statutes, wherein the Legislature included section 768.71(3), which provides that "[i]f a provision of this part is in conflict with any other provision of the Florida Statutes, such other provision shall apply." The PIP statute found in section 627.736 specifically provides that in PIP cases, "the provisions of s. 627.428 shall apply...." § 627.736(8), Fla. Stat. (2001) (emphasis added). This provision is significant because section 627.428 would apply to PIP cases regardless of the provisions of section 627.736(8). In my view, the Legislature intended that the specific provisions of section 627.428 should apply over the general provisions of section 768.79. In other words, specifically including section 627.428 in the provisions of section 627.736(8), to the exclusion of any other statutory provision for fees, clearly indicates the Legislature's intention that section 627.428 be the exclusive authority for an award of fees in PIP cases....

...te (the more general statute), which dictates that each party's liability is limited to that party's percentage of fault, so that the comparative fault statute had to yield to the wrongful death statute). I note that the Legislature recently amended section 627.736 by adding subsection (11), which requires that the insured provide the insurer with written notice of an intent to file a claim for benefits. Ch.2001-271, § 6, at 1759, Laws of Fla.; § 627.736(11)(a), Fla. Stat. (2001). Section 627.736(11)(d) provides that "[t]he insurer shall not be obligated to pay any attorney's fees if the insurer pays the claim within the time prescribed by this subsection." In my view, this provision reaffirms the Legislature's intention that...

...he paid a premium. [7] This is evident by the Legislature's *754 pronouncement that the purpose of PIP insurance is to "provide for medical, surgical, funeral, and disability insurance benefits...." § 627.731, Fla. Stat. (2001). Other provisions in section 627.736 support this view. Section 627.736(11)(a) provides that the insurer must provide written notice "[a]s a condition precedent to filing any action for an overdue claim for benefits under paragraph (4)(b)...." Section 627.736(4) provides that "[b]enefits due from an insurer ... shall be due and payable as loss accrues ..." and section 627.736(4)(b) provides that "[p]ersonal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." Section 627.736(7) applies to situations where an insurer seeks to withdraw benefits covering a treating physician's care because the treatment, as opposed to the amount of the charge for that treatment, is not reasonable, necessary or related....

...5th DCA 1996) (citing Bird Lakes Dev. Corp. v. Meruelo, 626 So.2d 234, 238 (Fla. 3d DCA 1993), review denied, 637 So.2d 233 (Fla.1994)). [7] In order to determine what the "required benefits" are that flow from the coverage provisions of a PIP insurance policy, we turn to section 627.736(1), which provides that "[e]very insurance policy complying with the security requirements of s....

...n the benefits the insured was otherwise entitled to. [8] See § 627.731, Fla. Stat. (2001) ("The purpose of ss. 627.730-627.7405 is to provide ... a limitation on the right to claim damages for pain, suffering, mental anguish, and inconvenience."); § 627.736(3), Fla....

...American Arbitration Ass'n, 398 So.2d 469 (Fla. 4th DCA 1981). GEICO failed to take either course. (b) After the hospital withdrew its lien, it was then all the more incumbent on GEICO to pay the $10,000 in lost wages to Gonzalez, certainly within the 30 day period provided by section 627.736(4)(b), Florida Statutes (1983)....

...Gorgei Enters., 345 So.2d 412 (Fla. 2d DCA 1977); Salter v. Nat'l Indem. Co., 160 So.2d 147 (Fla. 1st DCA 1964). Finally, we approve the award of pre-judgment interest from November 11, 1985, thirty days after the PIP notice was sent, when the payments became overdue. See § 627.736(4)(b), (c). Affirmed. NOTES [1] The trial court also awarded $1,000 plus pre-judgment interest for the plaintiff's separate medical payments coverage. No error is demonstrated in these rulings. [2] Section 627.736(8), Florida Statutes (1983), makes section 627.428 applicable to controversies involving PIP benefits like this one. [3] This was GEICO's own practice when faced with competing hospital and lost wage claims on PIP coverage. There is no explanation why this policy was not followed in this instance. [4] § 627.736(4)(b) states: (b) Personal injury protection insurance benefits shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same....

...BOYD, Justice. This is an appeal from a judgment rendered by the circuit court in Manatee County awarding the appellants $7,937.20 for damages incurred as a result of an automobile accident. Because the trial judge upheld the constitutionality of sections 627.736(3) [1] and 627.7372, [2] Florida Statutes *1327 (1977), we have jurisdiction pursuant to article V, section 3(b)(1) of the Florida Constitution (1972)....

...was over. At the end of the trial the jury awarded Mr. Purdy $11,318.00 as compensation for his injuries and Mrs. Purdy $500.00 as compensation for the loss of her car. At a post trial hearing the trial judge upheld the constitutionality of sections 627.736(3) and 627.7372, Florida Statutes (1977)....

...and no alternative method of meeting such public necessity can be shown. Kluger v. White, 281 So.2d 1, 4 (Fla. 1973). This holding does not apply to these statutes since they do not abolish any previous right of access to courts. Basically, sections 627.736(3) and 627.7372 reduce the amount of damages injured plaintiffs can recover from tortfeasors by the amount of benefits they have received from collateral sources....

...886 (1932); Cappucio, Subrogation in Florida, 21 U.Miami L.Rev. 240, 247-49 (1966). This right of subrogation was statutorily recognized by the Florida Automobile Reparations Reform Act, sections 627.730-627.741, Florida Statutes (1971), when it was first enacted. Section 627.736(3) was previously a provision concerning an insurer's right to reimbursement of any payments made to an insured who subsequently recovered against a tortfeasor. § 627.736(3), Fla....

...[3] Its main purpose was to prevent injured plaintiffs from receiving double recovery. Cf. Aetna Casualty & Surety Co. v. Bortz, 271 So.2d 108 (Fla. 1972) (this was the purpose behind the Workmen's Compensation Subrogation Law, § 440.39(3), Fla. Stat. (1971), after which § 627.736(3), Fla....

...ly, other than yearly. We believe the statute refers to the costs incurred by claimants to secure the actual policies from which they received benefits for whatever period of time the policy is in effect. From this analysis we conclude that sections 627.736(3) and 627.7372, Florida Statutes (1977), do not deprive persons injured in automobile accidents of their right of access to the courts....

...Furthermore, there is nothing in the law which prevents injured persons from waiving their rights to receive insurance benefits and suing the tortfeasor for the full amount of their damages. Section 627.7372 sets off only those benefits which actually have been paid. Section 627.736(3) sets off benefits which are "paid or payable," which we interpret to include only those benefits a person is entitled to under his or her contract after he or she files a claim....

...Palma submitted the bill to her insurer, State Farm, which refused the claim. Palma brought suit against State Farm, which answered that it was not required to pay for the thermographic examination because this treatment did not constitute a necessary medical service consistent with section 627.736, Florida Statutes (1983)....

...In its judgment, the trial court summarized this counterclaim: "The action for declaratory relief asked the Court to declare that thermographic examinations in musculoskeletal injuries and nerve root impingement were not necessary medical treatment as defined under Florida Statute 627.736 (Personal Injury Protection) and, therefore, were not reimbursable to the plaintiff, or any plaintiff, under her PIP coverage in the insurance policy issued by State Farm. The policy language tracked F.S. 627.736....

...ter the date of the release of Quanstrom. For the reasons expressed, we approve the decision of the Fourth District Court of Appeal in this cause. It is so ordered. EHRLICH, C.J., and McDONALD, SHAW, BARKETT, GRIMES and KOGAN, JJ., concur. NOTES [1] Section 627.736, Florida Statutes (1983), states, in pertinent part: (1) REQUIRED BENEFITS....

...An application for "no fault" benefits was filed by appellant on January 16, 1973, including an executed authorization for medical information and wage and salary information. Payment of the benefits were not made within thirty days as required by Section 627.736(4)(d) and appellant filed suit. A default judgment was entered but later set aside. Appellee did not contest appellant's entitlement to the $5,000.00 benefits but merely disputed the allowance of attorney's fees. Section 627.736(4)(b) provides that personal injury protection benefits shall be paid within thirty days of claim. Section 627.736(8) states that "With respect to any dispute under the provisions of §§ 627.730-627.741 between the insured and the insurer, the provisions of § 627.428 shall apply." Section 627.428 provides that upon the rendition of a judgment against an insurer in this state, the court shall award attorney's fees....

...empt to "possess or use" the vehicle. He contends that under the facts of this case there was a sufficient connection between the maintenance and use of the vehicle and the resulting injury to justify PIP coverage. We agree. The controlling statute, section 627.736, Florida Statutes (1995), requires that motor vehicle insurance policies issued in Florida provide personal injury protection (PIP) benefits for bodily injury "arising out of the ownership, maintenance, or use of a motor vehicle": 627.736 Required personal injury protection benefits.......

...627.733 shall provide personal injury protection to the named insured ... to a limit of $10,000 for loss sustained by any such person as a result of bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle .... § 627.736, Fla....

...[3] The results under these standards, however, have not been consistent. [4] In an effort to resolve these inconsistencies, *1155 we now set forth the following guidelines. First, legislative intent—as always —is the polestar that guides an inquiry under section 627.736(1)....

...The motivation of the assailant—whether it be to "possess or use" the vehicle, or to steal the victim's wallet or purse, or simply to harm the victim—is a nonissue to the consumer. We note that insurance companies were placed on notice at the time of enactment of section 627.736(1)—and certainly by the time that Novak and Hernandez were decided—that the statute contemplates broad coverage....

...y confused, contradictory and badly in need of clarification."). [5] We disapprove Jun; Trott; Exilus; Furo; Parker; Doyle; Famigletti; and Reynolds. As explained above, the motivation of the assailant is not dispositive when deciding coverage under section 627.736(1).

...Supreme Court of Florida. March 31, 2005. *1092 Larry Mark Polsky, Daytona Beach, FL, for Appellant. Karen A. Barnett and Deborah L. Appel of Barnett and Associates, P.A., Tampa, FL, for Appellee. PER CURIAM. We have for review a challenge to the constitutionality of section 627.736(5)(b), Florida Statutes (1999), contained in Florida's Motor Vehicle No-Fault Law, which requires providers of non-emergency medical services and medical services not provided in and billed by a hospital to submit a statement of charges to insurers within thirty days of service....

...*1093 5th DCA 2002), the Fifth District summarized the facts as follows: State Farm Mutual Automobile Insurance Co. (State Farm), appeals a final judgment awarded to Dan Ray Warren, State Farm's insured, and Dr. Jack Rotstein, M.D., Warren's physician. The county court entered the judgment after holding section 627.736(5)(b), Florida Statutes (1999), unconstitutional as violative of Dr. Rotstein's rights to equal protection, due process and access to the courts. Section 627.736(5)(b) provides that "the insurer is not required to pay [for] charges for treatment or services rendered more than 30 days before the postmark date of the statement [of charges]....

...or Dr. Rotstein's tardy statements, he initiated an action for non-payment against State Farm and eventually joined Dr. Rotstein as a party plaintiff. The county court agreed with Dr. Rotstein's allegations that the thirty-day billing requirement of section 627.736(5)(b) is an "irrational legal hoop" and should be declared unconstitutional....

..."denies medical providers who are not hospitals and ambulance companies access to the courts." The court then entered judgment for $1,640.25 plus interest to Dr. Rotstein and awarded attorney's fees and costs in the amount of $12,699.26 pursuant to section 627.736(8), Florida Statutes (1999). Id. at 1076 (footnotes omitted) (alterations in original). State Farm appealed the county court's decision to the Fifth District Court of Appeal, which reversed the county court's ruling and held that section 627.736(5)(b) is constitutional under the federal and state constitutional provisions cited by petitioners....

...Rodriguez, 808 So.2d 82, 85 (Fla.2001). As a result, each motor vehicle owner or registrant required to be licensed in Florida is required to carry a minimum amount of personal injury protection, or PIP insurance, for the benefit of the owner and other designees. Section 627.736, Florida Statutes (1999), sets forth required PIP benefits, which are triggered if a loss is reasonable, necessary, and related to a motor vehicle accident. See Rodriguez, 808 So.2d at 85. Also included in the no-fault statute is a provision for a procedure through which medical providers may file claims and receive payment for services provided. See § 627.736(5)(a), Fla. Stat. (1999). Section 627.736(5)(b) sets forth the procedures with which treating medical providers must comply in order to receive payment from the no-fault insurer for services rendered....

...As a result, medical providers could potentially allow charges to mount, and submit charges for services rendered over a long period of time and distant from the time of the original accident. In 1998, pursuant to chapter 98-270, section 2, Laws of Florida, the Legislature amended section 627.736(5) to expressly provide a thirty-day limitation on medical provider billing. Section 627.736(5)(b), Florida Statutes (1999), requires medical providers to postmark claims no later than thirty days following the date of treatment, or be subject to automatic claim denial by the insurer....

...Under this test, a court must uphold a statute if the classification bears a rational relationship to a legitimate governmental objective. See Keys Title, 741 So.2d at 602. Our analysis in this case is governed by the rational relationship test because section 627.736(5)(b) does not implicate a fundamental right, nor do the petitioners claim to constitute a suspect class or claim that a fundamental right is at stake....

...nt is usually a straightforward process. We find that the different billing requirements are calculated to reduce unnecessary *1096 medical costs which in turn lowers the costs upon which insurers base PIP premiums and ultimately benefits consumers. Section 627.736(5)(b) is rationally related to this legitimate state purpose, and the classifications within the statute are reasonably designed to achieve that purpose....

...ch as a requirement for the timely submission of medical provider statements. Accordingly, as required by the applicable equal protection analysis, in a light deferential to the Legislature's action, we uphold the district court's determination that section 627.736(5)(b) does not offend equal protection....

...Additionally, the potentially oppressive aspect of the statute (from the petitioners' viewpoint), an inability to recover payment for services rendered, may be avoided by merely complying with the thirty-day requirement, of which the statute places medical providers on notice. Therefore, we hold that section 627.736(5)(b) does not violate due process....

...ts a valid use of legislative authority that does not interfere with the petitioners' equal protection or due process rights, nor does the statute violate the petitioners' rights of access to the courts. Therefore, we uphold the constitutionality of section 627.736(5)(b), Florida Statutes (1999), and approve the decision of the Fifth District Court of Appeal....

...PARIENTE, C.J., and WELLS, ANSTEAD and BELL, JJ., concur. PARIENTE, C.J., specially concurs with an opinion, in which ANSTEAD, J. concurs. LEWIS and QUINCE, JJ., dissent with opinions. CANTERO, J., recused. PARIENTE, C.J., specially concurring. I agree with the majority that section 627.736(5)(b), Florida Statutes (1999), is not an unconstitutional violation of due process or equal protection. I also agree that the statute does not unconstitutionally restrict access to courts on its face. However, in my view, there may be circumstances in which this statute results in an unconstitutional denial of access to the courts as applied. Section 627.736(5)(b) requires most providers of medical services to submit a statement of charges to insurers within thirty days of service or neither the insurers nor injured parties can be held liable for the charges....

...ion was unconstitutional as applied to a plaintiff who was financially unable to post the bond). Under these circumstances, the statute would result in an unconstitutional denial of access to the courts as applied. For these reasons, I conclude that section 627.736(5)(b) is not unconstitutional on its face but may be unconstitutional as applied to specific facts. In this case, because there is no allegation that Dr. Rotstein's failure to submit his bills within thirty days of treatment was a result of incorrect information provided by the insured, section 627.736(5)(b) was not unconstitutionally applied. ANSTEAD, J., concurs. LEWIS, J., dissenting. I respectfully dissent because, in my view, the very limited thirty-day billing deadline provided in section 627.736(5)(b) of the Florida Statutes unconstitutionally impinges upon medical providers' fundamental rights of property, due process and access to the courts....

...simply encourages, advances, and promotes the encroachment upon fundamental access to courts in the future. Accordingly, I dissent from the action taken by the majority today. QUINCE, J., dissenting. I dissent from the majority's determination that section 627.736(5)(b), Florida Statutes (1999), is constitutional; instead I would hold the section unconstitutional as violative of equal protection and access to the courts. Section 627.736(5)(b) provides: (b) With respect to any treatment or service, other than medical services billed by a hospital for services rendered at a hospital-owned facility, the statement of charges must be furnished to the insurer by the provid...

...Sims, 464 So.2d 251 (Fla. 4th DCA 1985). Thus, it is clear that one of the purposes of chapter 627 is to make sure that those persons injured in vehicle accidents receive prompt medical attention without having to put themselves into a dire financial position. Section 627.736(5)(b) does not further this legislative goal....

...h Amendment to the federal Constitution." Caldwell, 26 So.2d at 790-91 (quoting State ex rel. Spence v. Bryan, 87 Fla. 56, 99 So. 327, 329-30 (1924)) (citations omitted); accord DeAyala v. Florida Farm Bureau Cas. Ins. Co., 543 So.2d 204 (Fla.1989). Section 627.736(5)(b) treats medical providers that are similarly situated differently without any legitimate reason for the different treatment....

...No valid reasoning has been posited for more seriously abridging those rights of some providers while not others. For that reason, I would find the statute unconstitutional as a violation of the equal protection provision of our constitution. [11] I also agree with Justice Lewis's dissent to the extent that he finds section 627.736(5)(b) unconstitutional as a violation of the right of access to courts....

...These medical providers cannot get the fee from either the insurance company or the patient, thereby rendering any resort to the courts moot. For these reasons, I disagree with the majority's determination that the statute is constitutional. NOTES [1] Section 627.736(5)(b) of Florida's No-Fault Law reads as follows: With respect to any treatment or service, other than medical services billed by a hospital for services rendered at a hospital-owned facility, the statement of charges must be furnishe...

...ed without sale, denial or delay." [4] Although the applicable statute in this case is the statute as it existed in 1999, we note that the statute has undergone amendments since that time. The current version of the applicable statute is codified at section 627.736(5)(c), Florida Statutes (2004). [5] On separate issues, this Court has confronted the constitutionality of section 627.736(5) in Nationwide Mutual Fire Insurance Co....

...ions is met). [9] In 2001, the Legislature added a provision that allows a provider an extra thirty-five days to submit a bill if the provider was given incorrect information by the insured. See ch.2001-271, § 6, Laws of Fla. (currently codified at § 627.736(5)(c)(2), Fla. Stat. (2004)). [10] I recognize that the statute provides health care professionals who notify insurance companies within twenty-one days of the commencement of treatment sixty days to submit bills for payment. See § 627.736(5)(b), Fla....

...Reserve Ins. Co., 299 So.2d 661 (Fla.App. 1st, 1974), cert. den., 308 So.2d 113 (Fla. 1975), this Court held that personal injury protection benefits paid by an insurer to its insured under the Florida Automobile Reparations Reform Act are reimbursable under § 627.736, F.S....

...665, 666. Appellees Stokeley and Graff, citing White , argue that the same reasoning applies here. Their argument, however, overlooks the significant difference between the two types of benefits: personal injury protection benefits are payable under § 627.736 in amounts determinable irrespective of fault in order to compensate the recipient for losses formerly assessable only against the party at fault; on the other hand, disability benefits payable under § 627.727 are not insurance against al...

...laintiff in the eye. Claim was made for PIP benefits under the policy covering the minor plaintiff's father's vehicle. The sole question on this appeal is whether the loss sustained arose out of the ownership, maintenance, or use of a motor vehicle. Section 627.736(1), Florida Statutes (1977). Appellees attempt to sustain the summary judgment on the basis of Section 627.736(4)(d) 1 & 3 which require payment of PIP benefits by the insurer for accidental bodily injury sustained by the owner (or a relative of the owner residing in the same household) while occupying a motor vehicle....

...eview by interlocutory appeal of an order entered on a petition for equitable distribution determining payment to plaintiffs' personal injury protection insurance carrier, Leatherby Insurance Company, under Florida Automobile Reparations Reform Act, Section 627.736, Florida Statutes 1971, F.S.A....

...$1,412.80, which constituted all the personal injury protection benefits it paid the plaintiffs with no proration whatsoever. Pertinent parts of the trial court's order on petition for equitable distribution appear as follows: "The Court finds that Section 627.736(3)(a) provides for subtraction by the insurer before payment, or repayment to the insurer after payment, of the full amount of PIP benefits due or paid the insured, less the insured's attorney's fees and expenses, where the amount of the tort recovery exceeds, exclusive of attorney's fees and expenses, the amount of benefits paid or payable." The trial court interpreted Section 627.736(3)(a), Florida Statutes, F.S.A., to foreclose "equitable distribution" where the plaintiff (the insured under the no-fault policy) settled the tort claim for an amount, exclusive of attorneys' fees and costs, in excess of the dollar amount of no-fault benefits paid. In such circumstances the trial court determined that the carrier is entitled to reimbursement of one hundred per-cent on the dollar out of settlement proceeds. The trial court further determined that § 627.736(3)(b), Florida Statutes, F.S.A., *41 provided for equitable distribution only where the net recovery was less than the no-fault benefits paid. We conclude that the trial court was in error. The applicable sections of F.S. 627.736, F.S.A....

...herefor and notice to the carrier." (Emphasis supplied.) In State Farm Automobile Insurance Co. v. Hauser, 281 So.2d 563 (Fla.App. 1973), our sister court of the third district made the following determination at page 565: "Paragraphs (a) and (b) of § 627.736(3) Fla....

...(less the prorata share of costs), with provision for the `probation of the reimbursement' to be made `by the judge of a trial court handling the suit to recover.'" We agree with our sister court of the third district that paragraphs (a) and (b) of § 627.736(3), F.S.A., resist reconciliation....

...City of St. Petersburg v. Pinellas County Power Co., 87 Fla. 315, 100 So. 509, 510 (1924). Thus the insurer's rights of reimbursement shall be based upon equitable distribution in accordance with paragraph (b). The equitable distribution provisions of § 627.736(3)(b), Florida Statutes, F.S.A., are taken almost verbatim from the equitable distribution provisions of § 440.39(3)(a), Florida Statutes, F.S.A., the Workmen's Compensation Statute....

...Additionally, there is no indication that any party was not "made or joined" in order to invoke diversity jurisdiction. E.g., Ambrosia Coal & Constr. Co. v. Morales, 482 F.3d 1309, 1313-16 (11th Cir.2007). Therefore, § 1359 does not preclude diversity jurisdiction in this case. *1286 Defendants next argue that FLA. STAT. § 627.736 gives Nationwide a right to individually challenge each PIP claim at issue, and that this statute does not allow for the aggregation of claims....

...1827, 104 L.Ed.2d 338 (1989); Brown v. Crawford County, 960 F.2d 1002, 1009-10 (11th Cir.1992). A. Statutory Preemption All defendants argue that plaintiff's causes of action for common law fraud, unjust enrichment, and negligent supervision are preempted by Florida Statute Section 627.736(12), which provides: An insurer shall have a cause of action against any person convicted of, or who, regardless of adjudication of guilt, pleads guilty or nolo contendere to insurance fraud under s....

...ilt, pleads guilty or nolo contendere to insurance fraud under s. 817.234, patient brokering under s. 817.505, or kickbacks under s. 456.054, associated with a claim for personal injury protection benefits in accordance with this section. FLA. STAT. § 627.736(12)....

...Defendants' reliance on Lasky v. State Farm Ins. Co., 296 So.2d 9 (Fla.1974) and Corfan Banco Asuncion Paraguay v. Ocean Bank, 715 So.2d 967 (Fla. 3d DCA 1998) is misplaced, since neither case addresses the statute at issue. The Court finds that the plain language of FLA. STAT. § 627.736(12) does not preempt plaintiff's common law claims, but rather provides a specific remedy under a particular set of facts....

..., and are anticipating submission of additional claims in the future, all of which are false, misleading and deceptive. Nationwide asserts that it is in doubt as to its rights under the terms of the applicable insurance policies and under Fla. Stat. § 627.736 as to whether or not any of the bills submitted by defendants are payable due to the facts and circumstances outlined in paragraphs 16a through 16i of the Complaint, and whether any future claims would be compensable....

...Accordingly, we reverse the trial court's order dismissing the amended complaint with prejudice and remand with instructions to reinstate count I for restitution and count II for fraud. Reversed and remanded. NOTES [1] The PIP lawsuits were brought pursuant to section 627.736, Florida Statutes, which provides personal injury protection benefits from an insurer to an insured. [2] On appeal, United Auto does not seek review of the decision to dismiss its claim for insurance fraud pursuant to section 627.736(4)(h), Florida Statutes.

...Before FLETCHER, SHEVIN and SORONDO, JJ. SHEVIN, Judge. Colonial Penn Insurance Company appeals a class certification order. We affirm. Magnetic Imaging Systems I, Ltd. ["Magnetic"], a medical services provider, brought this action seeking statutory interest under section 627.736(4)(c), Florida Statutes (1995), [1] on behalf of itself and other providers and insureds who have received personal injury protection ["PIP"] benefit payments from Colonial Penn, the insurer, beyond the thirty-day period provided in section 627.736(4)(b), but with no added statutory interest....

...This case presents a question of common or general interest to all class members: statutory interest due on late PIP benefit payments. The class members have a similar interest in the relief sought: statutory interest due on late payments. The claims of class members present a common right of recovery under section 627.736(4)(c) based on Colonial Penn's conduct that raises common issues to all members: whether the statutory interest was paid when due....

...It is highly improbable that the class members would have the resources to challenge, individually, Colonial Penn's failure to pay interest under section 637.736(4)(c). Based on the foregoing reasons, and finding that appellant's remaining points lack merit, we affirm certification. Affirmed. NOTES [1] Section 627.736 provides: (4) Benefits; when due.—......

...In concluding that Allstate had no duty to furnish PIP benefits to Tindall, the trial court found that "[u]nder the totality of the circumstances in this case as a matter of law, the Defendant's failure to undergo two independent medical examinations was unreasonable." Section 627.736(7)(a), Florida Statutes, expressly requires an injured person claiming PIP benefits to accede to an insurer's request that an independent physical examination be undertaken if the insured's mental or physical condition is "material to...

...rement is to provide the insurance company with an opportunity to evaluate whether the benefits should be paid. Thus, an unreasonable refusal of a claimant to submit to an examination alleviates the insurer of any further liability for PIP benefits. § 627.736(7)(b), Fla....

...Finally, Tindall asserts that the trial judge erred when he denied his motion for summary judgment because, as a matter of law, an eligible insured is entitled to PIP benefits until he unreasonably refuses to undergo independent medical examination. Two statutes, read together, provide some support for Tindall's assertion: Section 627.736(4)(b), Florida Statutes, provides in part: Personal injury protection benefits shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same... . However, any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding that written notice has been furnished to the insurer. Section 627.736(7), provides in part: (a) Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury protection insuran...

...Cimino (Cimino) was injured in an automobile accident and sought benefits pursuant to her personal injury protection (PIP) automobile insurance policy with U.S. Security Insurance Company (Security). Security scheduled a medical examination for Cimino. Pursuant to section 627.736(7), Florida Statutes (1997), and as provided for in a provision in the insurance policy, Security chose the physician....

...Security also advised Cimino that failure to attend the scheduled examination or failure to comply with the required *698 conditions would result in termination of her benefits. Cimino filed an action for declaratory judgment, seeking to have the trial court determine her rights under the insurance policy and under section 627.736....

...1st DCA 1994). Relying upon Klipper v. Government Employees Insurance Co., 571 So.2d 26 (Fla. 2d DCA 1990), where the district court found the insured was not entitled to have a court reporter present during a medical examination conducted pursuant to section 627.736, the trial court ordered the temporary injunction dissolved....

...'s attorney from a workers' compensation examination). On the other hand, there has been little litigation on the issue of third-party attendance at a medical examination conducted pursuant to the terms of the insured's contract with the insurer and section 627.736, Florida Statutes. See Cimino; Klipper. The examination requirements contained within section 627.736(7)(a)-(b), Florida Statutes (1997), are, in pertinent part, as follows: (a) Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for...

...A PIP examination is a potential step in the direction of litigation. The insured is claiming an entitlement to continued benefits and the insurer is questioning the necessity for same. In order to continue receiving benefits the insured must comply with the requirements of the insurance contract and section 627.736....

...aking of the examination. On the other hand, Cimino argues there is nothing in the insurance contract or the statute which prevents her from having her attorney present. Cimino's argument is persuasive. The language of the contract at issue here and section 627.736 contemplate a situation, such as this one, where the insured "reasonably refuses to submit" to an examination. By using the term "unreasonably refuses to submit" in both the conditions section of the policy and subsection 627.736(b), it is logical to deduce there are scenarios where the insured "reasonably refuses to submit" to the examination....

...Section 627.737, Florida Statutes (1975) [3] *216 provides tort exemption for damages due to "bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use" of a motor vehicle only to the extent that the benefits described in Section 627.736 [4] (reasonable medical expenses and lost earnings) are payable....

...missions, is hereby exempted from tort liability for damages because of bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use of such motor vehicle in this state to the extent that the benefits described in s. 627.736(1) are payable for such injury, or would be payable but for any exclusion or deductible authorized by ss....

...uffering, mental anguish, and inconvenience because of bodily injury, sickness, or disease arising out of the ownership, maintenance, operation, or use of such motor vehicle only in the event that the benefits which are payable for such injury under s. 627.736(1)(a) or which would be payable but for any exclusion or deductible authorized by ss....

...Any person receiving ordinary and necessary services normally performed by a nurse from a relative or a member of this household shall be entitled to include the reasonable value of such services in meeting the requirements of this subsection. [4] Section 627.736, Florida Statutes, provides in pertinent part: (1) REQUIRED BENEFITS....

...The insured under the PIP policy was driving home when his tire blew out. When he stopped to fix it, he was assaulted by unknown persons. He sued for PIP benefits, claiming that they were due for his injuries "arising out of the ownership, maintenance, or use of a motor vehicle," as required both by the policy and section 627.736, Florida Statutes (1995)....

...5th DCA 1981) (citations omitted)). Noting the inconsistent ways in which these rules had been applied, the Blish court set forth guidelines for the "nexus" standard: First, legislative intent—as always—is the polestar that guides an inquiry under section 627.736(1)....

...treatment was not “lawfully provided” since Silver Star did not comply with the licensing statute. Florida law provides that an insurer is not required to pay for medical treatment that is not “lawfully provided.” See id. §§ 400.9935(3), 627.736(1)(a)1....

...unenforceable.” Id. § 400.9935(3). In addition, Florida’s no fault statute provides that “[a]n insurer . . . is not required to pay a claim or charges . . . [f]or any service or treatment that was not lawful at the time rendered . . .,” id. § 627.736(5)(b)1.b., and it defines “lawful” as “in substantial compliance with all relevant applicable criminal, civil, and administrative requirements of state and federal law related to the provision of medical services and treatment,” id....

...ry decree that its policy did not provide coverage. Each party moved for summary judgment, and the trial court entered summary final judgment in favor of the Burches and against Allstate, determining that the policy did in fact provide for coverage. Section 627.736(1), Florida Statutes (1981), requires that automobile insurance policies provide personal injury protection benefits for any "loss sustained ......

...This instruction assumes that the jury will be asked to decide the total amount of medical charges. It is anticipated that the judge will adjust this award in entering judgment to account for any payments previously made by the insurer, as well as for the effect of the 80% limitation in F.S. 627.736(1)(a), and any deductible....

...It is possible that the parties could agree upon a plainer and simpler definition. 3. The statutory description of what constitutes a reasonable amount may require a supplemental instruction for fee-capped diagnostic testing services as described in F.S. 627.736(5)(b) (2003)....

...after October 1, 1993, arising out of the ownership, operation, use, or maintenance of a motor vehicle, in which evidence is presented that personal injury protection benefits have been paid or are payable, instruction 501.8c should be given. See F.S. 627.736(3); Caruso v....

...Every policy is required to provide for "binding arbitration of any claims dispute involving medical benefits arising between the insurer and any person providing medical services or supplies if that person has agreed to accept assignment of personal injury protection benefits." § 627.736(5), Fla.Stat....

...We hold that the interest claim is arbitrable, pursuant to the recent opinion of this court rendered in the case of U.S. Security Ins. Co. v. Magnetic Imaging Sys., 678 So.2d 872 (Fla. 3d DCA 1996)(holding that a statutory interest claim for late payment under section 627.736(4)(b)(c), Florida Statutes, is arbitrable to the same extent as any other portion of the claims dispute involving medical benefits)....

...insurer and any person providing medical services or supplies if that person has agreed to accept assignment of personal injury protection benefits. The provision shall specify that the provisions of chapter 682 relating to arbitration shall apply. § 627.736(5), Fla.Stat. (1995). It is clear that section 627.736(5) applies to Magnetic and Orion....

...As set forth above, Magnetic's suit for interest due to allegedly late payment of claims is a "claims dispute involving medical benefits." In addition, this claim arises between Orion, the "insurer," and Magnetic, a "person providing medical services." The scenario in this case is precisely what section 627.736(5), Florida Statutes (1995) anticipates....

..."[O]nce a medical provider receives *477 an assignment of benefits from an insured, disputed medical claims between the provider and the insurance company must be resolved by binding arbitration." State Farm Mut. Automobile Ins. Co. v. Gonnella, 677 So.2d 1355 (Fla. 5th DCA 1996). Magnetic concedes in its brief that section 627.736(5) of the Florida Statutes requires that insurance policies for personal injury protection benefits include a provision for arbitration between the medical service provider and the insurance company, but Magnetic contends that the statute does not specifically require arbitration per se. We refuse to hold that the Legislature intended to require specific language in insurance policies which would have no effect or meaning. "The legislative intent is clear. Section 627.736(5) requires arbitration to resolve disputes involving medical benefits." State Farm v. Gonnella, 677 So.2d 1355, 1356 (Fla. 5th DCA 1996). Arbitration is mandatory pursuant to section 627.736(5) even in the event that the insurance policy between the insured and the insurance company does not include an arbitration provision with regard to the medical provider....

...citations omitted). [2] Although arbitration can be waived, or be deemed to have been waived, depending on the facts of a particular case, nothing contained within the record herein suggests such a waiver. Magnetic attempts to escape the dictates of section 627.736(5) by challenging the constitutionality of that statute....

...and the No-Fault scheme may be avoided by refusing to do so. Third, the statutory No-Fault regime provides medical service providers like Magnetic with the ability to collect via assignment statutorily mandated PIP insurance benefits. In this view, Section 627.736(5) creates new rights and may not be challenged as taking away any existing rights which predate the state constitution....

...ellant's motion to compel arbitration. NOTES [1] The Florida Vehicle No-Fault Law also requires that automobile insurance carriers pay personal injury protection claims within thirty days of the date that the carrier is notified of the covered loss. § 627.736(4)(b), Fla.Stat. (1995). If the claim is overdue, the overdue amount bears interest at the rate of ten percent per year. § 627.736(4)(c), Fla.Stat....

...Miller was not one of the doctors listed in Garcia's letter. On that same date, Allstate wrote Graham reserving the right to deny coverage under the PIP policy reciting the language in the Allstate policy that essentially follows the relevant portion of section 627.736(7)(b), Florida Statutes (1985)....

...ounsel. The trial court entered a final summary judgment in favor of Graham on the issue of liability and a subsequent final judgment awarding Graham specified amounts for unpaid medical expenses and lost wages, as well as attorney's fees and costs. Section 627.736(7), Florida Statutes (1985), as did Graham's insurance policy, clearly provided for physical examination by a physician if Graham was claiming PIP benefits under her policy. Section 627.736(7)(b) states in part: "[I]f a person unreasonably refuses to submit to an examination, the personal injury protection carrier is no longer liable for subsequent personal injury protection benefits." The trial court erred in ruling the refusal of Graham to submit to an IME was reasonable based upon the advice of her attorney. As this court stated in Tindall v. Allstate Ins. Co., 472 So.2d 1291 (Fla. 2d DCA 1985), review denied, 484 So.2d 10 (1986): Section 627.736(7)(a), Florida Statutes, expressly requires an injured person claiming PIP benefits to accede to an insurer's request that an independent physical examination be undertaken if the insured's mental or physical condition is "material to...

...rement is to provide the insurance company with an opportunity to evaluate whether the benefits should be paid. Thus, an unreasonable refusal of a claimant to submit to an examination alleviates the insurer of any further liability for PIP benefits. § 627.736(7)(b), Fla....

...In this state, owners of private passenger automobiles are required to obtain "no fault" insurance covering their vehicles as provided in the Florida Automobile Reparations Reform Act, Sections 627.730-627.741, Florida Statutes (1977) (the Act). Under Section 627.736, every insurance policy complying with the Act must provide personal injury protection (PIP) benefits to the extent of $5,000 covering medical expenses, disability (loss of earnings and loss of earning capacity) [1] and $1,000 of funeral expenses....

...Defendants' policies provide PIP benefits. However, if an injured party is the owner of a motor vehicle required to be insured under the Act, he can recover PIP benefits only under his own policy — not the policy of the owner of the motor vehicle in which he is riding when injured. Section 627.736(4)(d) 4....

...orida Statutes (1977): An owner of a motor vehicle with respect to which security is required by this section who fails to have such security in effect at the time of an accident . . shall be personally liable for the payment of [PIP] benefits under Section 627.736....

...Safeco Insurance Company, 144 N.J. Super. 506, 366 A.2d 695 (1976). Reversed with instructions in each case to reinstate plaintiff's complaint and for further proceedings not inconsistent with this opinion. GRIMES, C.J., and BOARDMAN, J., concur. NOTES [1] In 1977, Section 627.736 was amended to reduce PIP benefits to 80% of medical expenses and 80% of disability, subject to the same maximum.

...y the items identified by the insured person were reasonable in amount and medically necessary, together with a sworn statement that the treatment or services rendered were reasonable and necessary with respect to the injury sustained. Id.; see also § 627.736(6)(b), Fla....

...cy for benefits that became due when their insured underwent medical treatment. State Farm's position not only disregards contract law, but also attempts through a policy provision impermissibly to alter Florida's comprehensive PIP statutory scheme. Section 627.736(5), Florida Statutes (2007), contemplates that an insured can authorize the insurer to pay the provider directly. Details of the payment obligation are closely regulated by the statute. Specifically, section 627.736(6)(b), Florida Statutes (2007), provides an elaborate mechanism for insurers to obtain information from health care providers concerning their treatment and expenses: Every physician, hospital, clinic, or other medical institution pro...

...ts; the majority fails to properly distinguish a condition precedent to recovery or suit that must be complied with by a claimant from a contract obligation that an assignee of benefits must otherwise agree to be bound by; the majority misinterprets section 627.736(6), Florida Statutes (2007), to require State Farm to obtain what is in essence a bill of discovery in order to receive information regarding the validity of a claim from the very person or organization making the claim or seeking pay...

...ent. See State Farm Mut. Auto. Ins. Co. v. Hyma Med. Ctr., Inc., 22 So.3d 699, 700 (Fla. 3d DCA 2009); United Auto. Ins. Co. v. Santa Fe Med. Ctr., 21 So.3d 60 (Fla. 3d DCA 2009) ("[T]he thirty-day period for the payment of PIP benefits contained in section 627.736(4)(b) only applies *341 to the payment of benefits that are reasonable, necessary, and related, and the insurer may contest the claim at any time....

...ely within the meaning of the EUO clause provisions. I believe that had the courts in Marlin and Advanced reviewed the policy provision at issue in the instant case, a different decision would have been rendered. Finally, I reject the assertion that section 627.736(6), Florida Statutes (2007), provides the exclusive means for a No-Fault insurer to obtain pre-suit discovery from a medical care provider who is the claimant. There is nothing in the provisions of section 627.736(6) that suggests insurers are prohibited from conducting an EUO of a medical care provider that is a claimant, and there is nothing in the statute that provides that the statute is the sole and exclusive means by which a No-Fault insurer may obtain the pre-suit information requested in an EUO....

...The majority's reliance on Marlin is once again misplaced. The court in Marlin, after holding that the particular provisions of the EUO clause at issue in that case only applied to the insured, simply recognized that the insurance company could acquire the requested information pursuant to section 627.736(6)(b)....

...t be used to create an ambiguity in the policy provisions. Itnor Corp. v. Markel Int'l Ins. Co., 981 So.2d 661 (Fla. 3d DCA 2008); Winter Garden Ornamental Nursery, Inc. v. Cappleman, 201 So.2d 479 (Fla. 4th DCA 1967). [6] "[Florida Statute section] 627.736(6)(c) has long been construed to empower insurers, upon good cause shown, to petition a court for a bill of discovery permitting the insurer to conduct discovery concerning a person's injuries, wages, medical treatment and costs of treatment." 7 Fla....

...McAliley of Brennan, McAliley, Hayskar, McAliley & Jefferson, P.A., West Palm Beach, for appellee. DELL, Judge. Margarita Palma appeals from a decision of the trial court which declared that thermographic examinations do not constitute necessary medical services under the Florida No-Fault Act, section 627.736(1), Florida Statutes (1983)....

...declaratory relief as follows: The action for declaratory relief asked the Court to declare that thermographic examinations in musculoskeletal injuries and nerve root impingement were not necessary medical treatment as defined under Florida Statute 627.736 (Personal Injury Protection) and, therefore, were not reimbursable to the plaintiff, or any plaintiff, under her PIP coverage in the insurance policy issued by State Farm. The policy language tracked F.S. 627.736....

...es" instead of construing it broadly in her favor. She argues that the evidence established that the thermographic examinations performed in her case constituted a necessary medical service, and therefore she is entitled to reimbursement pursuant to section 627.736....

...lue in the diagnosis of musculoskeletal disease or nerve root impingement, and therefore do not constitute necessary medical services. The issue for our determination is whether thermographic examinations constitute a necessary medical service under section 627.736 which provides: (1) REQUIRED BENEFITS....

..." the trial court looked to the Workers Compensation Act, section 440.13, Florida Statutes (1983) and adopted three parts of the definition contained therein. The trial court concluded that a "medically necessary" diagnostic study as contemplated by section 627.736(1) must: 1....

...The broad scope of the medical services covered by the No-Fault Act is highlighted by the inclusion of benefits for remedial treatment and services for an injured person who relies upon spiritual means through prayer alone for healing in accordance with his religious beliefs. § 627.736(1)(a)....

...We disagree with Perez and hold that the thirty-day period for payment in the PIP statute applies only to bills for treatment which is reasonable and necessarily incurred as a result of the accident. Inaction by the insurer does not result in the insurer having to pay a bill which it otherwise would not have to pay. In section 627.736(1)(a), Florida Statutes (1999), medical benefits are defined as follows: (a) Medical benefits. —Eighty percent of all reasonable expenses for necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices, and necessary ambulance, hospital, and nursing services. [emphasis added.] Section 627.736(1) requires insurers to provide these benefits for injury, etc. "arising out of the ownership, maintenance, or use of a motor vehicle." Further on, section 627.736(4), the subsection involved in Perez and this case, provides in part: BENEFITS; WHEN DUE— Benefits due from an insurer ......

...The fifth district reversed the summary judgment in favor of the insurer, finding issues of fact, but made it clear that the insurer did not "lose its right to contest the claim." In Fortune Insurance Co. v. Everglades Diagnostics, Inc., 721 So.2d 384, 385 (Fla. 4th DCA 1998), this court considered the provisions of section 627.736(4)(b) and (c) in determining whether the thirty-day overdue provision applied to demands for arbitration under section 627.736(5)....

...We construed subsection (4)(b) and (c) as "merely" making the insurer liable for interest if payment is not made within 30 days from the notice. We observed that: "the function of the statute is to define when interest begins to accrue on unpaid PIP benefits." Id. at 385. We conclude that the thirty-day period in section 627.736(4) applies only to benefits which are reasonable and necessary as a result of the accident. Section 627.736(4), Florida Statutes begins with the words "benefits due" and states in subsection (b) that "personal injury protection benefits paid pursuant to this section shall be overdue if not paid within thirty days." If an insured submits a b...

...sue: "an insurer is not liable for any medical expense to the extent that it is not a reasonable charge for a particular service or if the service is not necessary." Derius v. Allstate Indem. Co., 723 So.2d 271, 272 (Fla. 4th DCA 1998). We interpret section 627.736(4) to mean that if PIP benefits are payable, they are due within thirty days after notice....

...therefore, it had not yet breached any contractual obligation to the plaintiff. In addition, in the Fladd case, as in the case at bar, the manner in which payments under the policy were to be made was governed by the Florida Statutes. See FLA.STAT. § 627.736(4)(b) and FLA.STAT....

...urance Co.) entered into a stipulation providing that if appellee is entitled to PIP benefits, then each insurer would pay $2,125 and that if appellee is entitled to uninsured motorist coverage, then each insurer will pay $5,000. As to PIP benefits, § 627.736(4)(d), Florida Statutes (1975), provides in pertinent part as follows: *640 "(d) The insurer of the owner of a motor vehicle shall pay personal injury protection benefits for: 1....

...The court entered a final judgment in favor of Carlson in the amount of $3,024.77, the difference between the verdict of $10,543.05 and the net setoff of $7,518.28. The court denied McKenna's motion for attorney fees and her motion to tax costs. In considering the setoff issue the initial question is whether section 627.736(3), [2] Florida Statutes (dealing with setoff of PIP benefits which are "paid or payable") or section 768.76, Florida Statutes, the collateral source rule, applies to the setoff of PIP benefits. Rollins v. Pizzarelli, 761 So.2d 294 (Fla.2000) holds that section 627.736(3) applies to the setoff of PIP benefits....

...Likewise, the amount of PIP benefits actually paid (or submitted and *558 pending payment) were properly ordered set off. The purpose of such setoff is to prevent a plaintiff from obtaining a double recovery, i.e., receiving as damages sums for which PIP benefits were paid. § 627.736(3), Fla....

...ently payable or owed by the PIP carrier as a result of expenses incurred by the plaintiff should be set off from a verdict that, as here, includes an award of future medical expenses. Rollins thus rejects the view that the term "payable" as used in section 627.736(3), includes all remaining PIP benefits that are not currently payable....

...on behalf of the claimant or members of his immediate family to secure his right to any collateral source benefit which he is receiving as a result of his injury. [Emphasis supplied]. McKenna argues that subsection 768.76(1) does not apply and that section 627.736, which is the applicable statute, does not provide for a reduction from any setoff for automobile insurance premiums....

...We have concluded and so hold that the trial court's construction of the Florida Automobile Reparations Reform Act was correct and proper in all respects and, therefore, the judgment appealed herein is affirmed. RAWLS, C.J., and CARROLL, DONALD K., J., concur. NOTES [1] F.S. §§ 627.730-627.741, F.S.A. [2] F.S. § 627.736, F.S.A. [3] F.S. § 627.736, F.S.A. [4] F.S. § 627.736(4), F.S.A....

...Rudnick, 706 So.2d 389 (Fla. 4th DCA 1998), in which the Fourth District certified conflict with the decision in Kokotis v. DeMarco, 679 So.2d 296 (Fla. 5th DCA 1996), review denied, 689 So.2d 1068 (Fla.1997), on the issue of the definition of the term "payable" found in section 627.736(3), Florida Statutes (1993)....

...d owed at the time of trial, the trial court did not err in refusing to set off the remaining personal injury protection benefits and medpay benefits against the verdict. See id. In Rollins v. Pizzarelli, 761 So.2d 294 (Fla.2000), we held that under section 627.736(3), Florida Statutes (1991), an award for future medical damages should not be reduced by the amount of a plaintiff's remaining PIP benefits....

...Because we have jurisdiction in this case on the basis of a certified conflict, we have the discretion to address this issue. See PK Ventures, Inc. v. Raymond James & Assocs., Inc., 690 So.2d 1296, 1297 n. 2 (Fla.1997). [1] Allstate first maintains that the future medpay benefits are the equivalent of PIP benefits for section 627.736(3) purposes, and therefore must be set off from the verdict as "payable." Because we have determined in Rollins that the term "payable" does not include all remaining PIP benefits that are not currently payable, this argument is unavailing. However, even if we were to read "payable" more expansively, we would conclude that medpay benefits should not be treated as PIP benefits. In rejecting Allstate's argument, we need look no further than the actual language of section 627.736(3), which is limited by its express terms to "personal injury protection benefits." Further, while PIP is a statutorily required coverage, see section 627.736(1), medpay coverage is optional. See § 627.736(4)(f), Fla....

...Swearingen, 590 So.2d 506, 508 (Fla. 4th DCA 1991). In State Farm Mutual Automobile Insurance Co. v. Klinglesmith, 717 So.2d 569, 570 (Fla. 5th DCA 1998), the Fifth District addressed this precise issue: The basis for State Farm's equating medpay benefits with PIP benefits, section 627.736(4)(f), actually demonstrates that medpay benefits are a collateral source. That statute provides that if PIP medical benefits have paid 80 percent of an insured's medical expenses, see section 627.736(1)(a), medpay benefits, "if available in a policy of motor vehicle insurance," must be applied to the remaining 20 percent even if PIP benefits have not been exhausted....

...be applied first, rather than other medical insurance the insured may have. (Citations omitted.) We agree with the Fifth District's reasoning on this issue. We thus conclude that medpay benefits are not the equivalent of PIP benefits for purposes of section 627.736(3)....

...the future. We conclude that the trial court was correct in refusing to set off the remaining medpay benefits against the verdict. Accordingly, we approve the Fourth District's decision in Rudnick based on its interpretation of "payable" as found in section 627.736(3) and its interpretation of "available" within the meaning of section 768.76(1)....

...However, I agree with the majority that medpay benefits are a collateral source to which the general collateral source statute is applicable, and therefore I also agree that medpay benefits are not the equivalent of PIP benefits for the purposes of section 627.736(3), Florida Statutes (1993)....

...on benefits because the Fourth District found the record "insufficient to reverse the trial court's ruling." Allstate Ins. Co. v. Rudnick, 706 So.2d 389, 391 (Fla. 4th DCA 1998); see Bell v. U.S.B. Acquisition Co., 734 So.2d 403, 412 (Fla.1999). [2] Section 627.736(4)(f) provides in part: Medical payments insurance, if available in a policy of motor vehicle insurance, shall pay the portion of any claim for personal injury protection medical benefits which is otherwise covered but is not payable...

...Burch, 724 So.2d 1237 (Fla. 1st DCA 1999), addresses the application of this statute. We decline to address this issue because the basis for our jurisdiction in this case is the certification of conflict with Kokotis regarding the definition of the term "payable" in section 627.736(3), and because there is no conflict among the decisions on the application of section 627.727(1)....

...unty. The county court certified the following question as an issue of great public importance pursuant to section 34.017, Florida Statutes (2010): MAY A PIP INSURER NEVERTHELESS ELECT TO USE THE MEDICARE PART B FEE SCHEDULES SET FORTH IN FLA. STAT. § 627.736(5)(a)(2) WHEN THE SUBJECT PIP POLICY SPECIFIES THAT THE PIP INSURER WILL PAY 80% OF MEDICALLY NECESSARY EXPENSES? This court accepted discretionary review pursuant to Florida Rule of Appellate Procedure 9.030(b)(4)(A)....

...After applying the deductible, Kingsway paid the bills for dates of service from April 16, 2008, through June 26, 2008, at 80% of 200% of the Medicare Part B fee schedule. This amount paid was less than payment at 80% of the billed amount. In making payment, Kingsway relied upon subsection 627.736(5)(a)2., Florida Statutes (2008), which went into effect on January 1, 2008....

...ured person: 1. 80% of medical expenses; .... Medical expenses means those expenses that are required to be reimbursed pursuant to Florida Motor Vehicle No Fault Law, as amended, and that are reasonable expenses for medically necessary ... services. Section 627.736, Florida Statutes (2008), sets out the provisions for "[r]equired personal injury protection benefits" and provides in pertinent part: (1) REQUIRED BENEFITS.—Every insurance policy complying with the security requirements of s....

...bulance, hospital, and nursing services. [2] Expanding on the subsection (1) requirement that the statute requires reimbursement of "reasonable expenses," the 2007 version of the statute provided a framework for the concept of "reasonableness" in subsection 627.736(5)(a): (5) CHARGES FOR TREATMENT OF INJURED PERSONS.— (a)1....

...in the community and various federal and state medical fee schedules applicable to automobile and other insurance coverages, and other information relevant to the reasonableness of the reimbursement for the service, treatment, or supply. In 2007, subsection 627.736(5)(a) was amended [3] to add subsections (5)(a)2....

...ly and unambiguously choose and identify its selected payment methodology. The trial court then reviewed the language in the policy and found that the policy established an agreement to reimburse 80% of medically necessary expenses as provided in subsection 627.736(1)(a) rather than the safe harbor amount found in subsection 627.736(5)(a)2.f., which the policy did not mention....

...Trust, 351 So.2d 14, 16 (Fla.1977)) (alteration in Knowles ) (emphasis removed). We agree with the trial court that these statutes are unambiguous and that their plain language allows an insurer to choose between two different payment calculation methodology options. Significantly, subsection 627.736(5)(a)2. provides that the insurer "may limit reimbursement," language that indicates that this option choice is not mandatory; subsection 627.736(5)(a)5. states "[i]f an insurer limits payment as authorized by subparagraph 2.," language that anticipates that an insurer will make a choice. The applicable policy made no reference to the permissive methodology of subsection 627.736(5)(a)2. The policy cites the No-Fault Act, states it will pay "80% of medical expenses," and defines medical expenses as those that it is required to pay "that are reasonable expenses for medically necessary ... services." That is the language of subsection 627.736(1)(a), which is amplified by subsection 627.736(5)(a)1. The policy does not say it will pay 80% of 200% of Medicare Part B Schedule as provided in subsection 627.736(5)(a)2....

...As in Nichols, the insurance policy in this case expressly states that the insurance company will pay for claims pursuant to a particular methodology (80% of incurred medically necessary expenses). The "reasonable amount" methodology corresponds to the mandatory language contained in § 627.736(1)(a) of the new PIP statute. Because the new PIP statute also states that a PIP insurer may apply the new fee schedule listed in [subsection 627.736(5)(a)2,] this provision is permissive, not mandatory, and the policy language that requires payment in accordance with the reasonable amount methodology specified in [subsection 627.736(1)(a)] is "not in conflict with the [permissive methodology set forth in the new] statute and is [therefore] binding on the parties to the insurance *68 contract." Nichols, 21 So.3d at 905....

...when the insurance policy provides greater coverage than the amount required by statute, the terms of the policy will control. The requirement that a PIP policy specify the applicable payment methodology is consistent with the requirement that a subsection 627.736(5)(d) health insurance claim form and subsection 627.736(10)(b)3....

...Such precision is not possible where the payment calculation methodology is in doubt. Affirmed. HAZOURI and CIKLIN, JJ., concur. NOTES [1] See Ch. 2007-324, §§ 20, 23, Laws of Fla. [2] This statutory language existed prior to and after the amendments to section 627.736 created by Chapter 2007-324. See § 627.736(1), Fla....

...provider”). Pursuant to an assignment of benefits from the insured, the provider directly billed State Farm $8,655 for the services. State Farm paid $4,572.75 in PIP benefits, which was 80% of the amount State Farm determined was reasonable. See § 627.736(1)(a), Fla. Stat....

...(2010) (requiring PIP insurers to pay “[e]ighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services”). In calculating the reasonable expenses, State Farm used 200% of the allowable amount under the 2011 Medicare fee schedule. See § 627.736(5)(a)(2)(f) (allowing an insurer to limit reimbursement to 80 percent of “the allowable amount under the participating physicians schedule of Medicare Part B.”). In 2014, the provider filed a breach of contract action in county court seeking the full amount of its charges....

...Appellant then responded in a manner which appellee deemed to be not in compliance with the original order and filed a second motion to compel a better answer. After hearing, a second order was entered requiring an additional answer to the interrogatory, outlining the court's interpretation of the applicable statute, section 627.736(1)(b), Florida Statutes (1979), as it related to loss of earning capacity....

...e legislature's express intent. We question the supreme court's reliance on Rollins v. Pizzarelli, 761 So.2d 294, 300 (Fla.2000), to apply a narrow construction of section 768.76 in Rudnick. See 761 So.2d at 293. Rollins involved the construction of section 627.736(3), Florida Statutes (Supp.1996), which precluded the recovery of damages "for which personal injury protection benefits are paid or payable" from collateral sources and required the jury to be so instructed. The Rollins court did not construe section 768.76. Because it does not appear that section 627.736(3) is also remedial in nature, it was proper to narrowly construe that section....

...accident and total damages amounting to $19,647.71 ($6,247.71 in past medical expenses; $8,400 in future medical expenses; $2,500 for past pain and suffering; and $2,500 for future pain and suffering). The parties agreed at pretrial that pursuant to section 627.736(3), Florida Statutes (2003), the defendant was entitled to a setoff for "damages for which personal injury protection benefits are paid or payable" to the plaintiff, which would be implemented by the trial judge after the jury returned a verdict....

...This Court accepted jurisdiction on the basis of conflict with Assi. [2] ANALYSIS The issue raised in this case involves the calculation of damages when a plaintiff has received PIP benefits but is also comparatively negligent. Thus, we consider the PIP statute and the comparative negligence statute. Section 627.736(3) addresses how recovery in tort claims is to be impacted by an insured plaintiff's receipt of PIP benefits....

...ts paid or payable. In all cases in which a jury is required to fix damages, the court shall instruct the jury that the plaintiff shall not recover such special damages for personal injury protection benefits paid or payable. (Emphasis added.) Thus, section 627.736(3) dictates that an insured plaintiff has "no right to recover" damages paid or payable by PIP benefits....

...(Emphasis added.) A plain reading of section 768.81(2) is that "the amount awarded as economic and noneconomic damages" to the plaintiff is what is to be reduced by the percentage of the plaintiff's comparative fault. Reading these statutes in conjunction, [5] we find that pursuant to section 627.736(3), which bars all recovery of damages paid or payable by PIP benefits, the amount for which PIP benefits have been paid or payable is to be deducted by the trier of fact [6] from the amount awarded as economic damages in the verdict....

...[2] The petitioner alleged in his jurisdictional brief to this Court that conflict exists between the decision below and this Court's decision in Rollins. However, this Court did not accept jurisdiction on that basis because Rollins addressed the issue of whether section 627.736 was properly construed as including only those PIP benefits already paid or also unused benefits believed to be available....

...Law] ... is hereby exempted from tort liability for damages because of bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use of such motor vehicle in this state to the extent that the benefits described in s. 627.736(1) are payable for such injury ......

...of indemnity and provides in pertinent part that in any negligence action the court shall reduce the amount of damages awarded "by the total of all amounts which have been paid for the benefit of the claimant... from all collateral sources." Because section 627.736(3) more specifically addresses PIP benefits, it controls the present case. [5] We find it unnecessary to look to the legislative history of section 627.736 for resolution of this case; rather, we apply a plain meaning reading of these two statutes. [6] See Caruso v. Baumle, No. SC03-127, 880 So.2d 540 at 544, 2004 WL 1403170 (Fla. June 24, 2004) (holding that trier of fact, whether judge or jury, is to offset collateral source amount under section 627.736(3))....

...The issue presented for review is whether an injury sustained by an insured while alighting from an insured motor vehicle is a "bodily injury ... arising out of the ownership, maintenance, or use of a motor vehicle" to which the insured is entitled to personal injury protection benefits under Section 627.736(1), Florida Statutes (Supp. 1976), of the Florida Automobile Reparations Reform Act. We hold that such an injury arises out of the use of such a motor vehicle for which the insured is entitled to personal injury protection benefits under Section 627.736(1), Florida Statutes (Supp....

...We agree that the issue is one of great public import and therefore have en banced this case to settle the law in this district; in so doing, we align ourselves with the First and Fourth districts. The Dade County Court certified the following question: WHETHER § 627.736(4)(B), FLA....

...accident report as specified in Chapter 316 of Florida Statutes; and c) all medical expenses incurred as a result of the accident and all supporting medical records. (Emphasis added.) The trial court entered summary judgment for Pacheco; we affirm. Section 627.736(4), Florida Statutes (1993), provides that PIP benefits "shall be due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered by the policy." (Emphasis...

...By so defining the term, Fortune sought to determine when the thirty-day period to pay the claim would begin to run, and thus circumvent long-established case law that once an insurer receives notice of a loss and medical expenses, it must pay within thirty days, unless, pursuant to section 627.736(4)(b), it has obtained reasonable proof to believe that it is not responsible for the payment....

...SCHWARTZ, C.J., and LEVY, GERSTEN, GODERICH, GREEN, SHEVIN and SORONDO, JJ., concur. COPE, J., specially concurs. COPE, Judge (specially concurring). In my view, the insurer is allowed to include within its insurance policy a definition of the statutory term "reasonable proof of such loss." § 627.736(4), Fla. Stat. (1993). Further, in deciding what is "reasonable" proof of loss, the insurer may consider the fact that benefits must be paid within thirty days after submission of the completed claim. See Id. § 627.736(4)(b)....

...hat a review of medical records is unnecessary in many, or even most, cases. That being so, requiring the submission of complete medical records in all cases is unreasonable, and goes beyond the statutory phrase, "reasonable proof of such loss." Id. § 627.736(4)....

...Govan, 502 So.2d 913 (Fla. 4th DCA 1986), approved, 521 So.2d 1086 (Fla. 1988). The issue presented in Govan was whether the deductible amount was to be deducted from the total medical expenses incurred before or after calculating the eighty percent figure authorized under section 627.736(1)(a), Florida Statutes (1983)....

...In the instant case, believing that this Court approved its construction of the section 627.739(2) when we approved its decision in Govan and disapproved Thibodeau and Cowan, the district court held that the term "benefits otherwise due" relates to the "`Required Benefits' mandated by section 627.736 et seq....

...policy limits mandated by the PIP statute. In Govan, the sole issue with which we were presented was the interrelationship of the deductible amounts authorized under section 627.739(2) and the coinsurance percentages by which eligible benefits under section 627.736(1) are to be reduced....

...ict with Thibodeau and Cowan and we disapproved those cases to the extent they conflicted with our decision, neither of those decisions involved the application of the deductible to eligible benefits after reduction by the coinsurance percentages of section 627.736(1)....

...policy limits. The Department has approved PIP policies, such as those at issue, which provide that the deductible amount authorized under section 627.739(2) is to be deducted from the lesser of the recoverable lost wages and medical expenses under section 627.736(1) or the policy limits....

...reduce coverage." Arnone, 528 So.2d at 919. However, the legislature has prescribed the manner in which deductibles may be utilized in a PIP policy. Under the statutory scheme, the deductible amounts are to be deducted from "benefits otherwise due." Section 627.736(1) defines "Required [PIP] Benefits." Reading these sections in pari materia, it is plain that the statutorily defined "required benefits" are the benefits otherwise due from which the deductible amount is to be subtracted. Section 627.736(1) defines the parameters of the benefits otherwise due under a PIP policy as including eighty percent of certain medical expenses and sixty percent of lost wages "to a limit of $10,000" (emphasis added). [5] In construing the term "benefits otherwise due," the district court below overlooked the fact that "required benefits" are eligible benefits set forth in section 627.736(1) "to a limit of $10,000." Based on the plain language of sections 627.736(1) and 627.739(2), we hold that these provisions provide for the authorized deductible amounts to be subtracted from the lesser of the eligible benefits after application of the coinsurance percentages of sections 627.736(1)(a) and (b) or the statutorily mandated coverage limit of $10,000....

...If the total amount of such loss and expense exceeds such deductible, the total limit of benefits the Company is obligated to pay shall be the difference between such deductible amount and the applicable limit of the Company's liability. (Emphasis added.) [2] Sections 627.736, 627.739, Florida Statutes (1975 and Supp....

...[3] The 1977 personal injury protection scheme at issue in Thibodeau v. Allstate Insurance Co., 391 So.2d 805 (Fla. 1980), disapproved, Govan v. International Bankers Insurance Co., 521 So.2d 1086 (Fla. 1988), provided for a maximum deductible of $4,000 and coverage up a limit of $5,000. §§ 627.736(1), 627.739(1), Fla. Stat. (1977). [4] The coinsurance percentages became part of Florida's PIP scheme in September 1977. Ch. 77-468, § 33, Laws of Fla. Cowan involved the 1975 and 1976 versions of sections 627.736 and 627.739. Although the 1977 scheme was employed in Thibodeau, the relationship between the deductible and the coinsurance percentages was not at issue. [5] Benefits for funeral and burial expenses which are provided for in section 627.736(1)(c) are exempt from application of the deductible, pursuant to section 627.739(2).

...y judgment in an action to recover personal injury protection ["PIP"] benefits. In that judgment the Dade County Court certified the following question of great public importance: IN AN ACTION TO RECOVER MEDICAL BENEFITS IN A LAWSUIT UNDER FLA.STAT. § 627.736 WHERE THE ONLY DEFENSE BY AN INSURER IS THAT THE MEDICAL TREATMENT WAS NOT RELATED, NOT REASONABLE AND/OR NOT NECESSARY, MUST AN INSURER OBTAIN THE REPORT REQUIRED UNDER FLA. *1124 STAT. § 627.736(7) CONSTITUTING "REASONABLE PROOF" WITHIN 30 DAYS OF RECEIVING WRITTEN NOTICE OF THE FACT OF A COVERED LOSS AND OF THE AMOUNT OF SAME BEFORE IT CAN DEFEND ON THE BASIS THAT THE MEDICAL BILLS ARE NOT REASONABLE, NOT RELATED AND/OR NOT NECESSARY? We accept jurisdiction and affirm the judgment....

...On January 16, United Auto submitted Ms. Rodriguez's medical bills for review to a doctor who issued a report to United Auto on January 19, 1998, outside the thirty-day statutory time period. Ms. Rodriguez sued to recover the amount of the unpaid medical bills plus interest. § 627.736(4)(b), (c), Fla.Stat....

...Perez's petition demonstrates that the Appellate Division decision is a "violation of a clearly established principle of law resulting in a miscarriage of justice," Haines City Community Dev. v. Heggs, 658 So.2d 523, 528 (Fla.1995), we grant certiorari and quash the Appellate Division decision. Section 627.736(4)(b), Florida Statutes (1997), provides that PIP insurance benefits "shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." This section als...

...However, this court held that this interpretation would totally obliterate the thirty-day statutory provision. Pacheco goes on to advise that "once an insurer receives notice of a loss and medical expenses, it must pay within thirty days unless, pursuant to Section 627.736(4)(b), it has obtained reasonable proof to believe that it is not responsible for the payment." Pacheco, 695 So.2d at 395 (emphasis added)....

...He appeals a summary final judgment entered for the company upon a holding of the trial judge that the insurance company was entitled to a judgment as a matter of law because the insured had failed to perform a condition precedent to a suit upon the policy. Pursuant to Section 627.736(7)(a), Florida Statutes (1975), the policy includes a provision as follows: "3.) ......

...denied, 279 So.2d 305 (Fla. 1973). In personal injury protection claims, a party must turn over all medical records concerning a specific condition only after requesting and receiving a copy of medical reports from a medical examination requested by the insurer. § 627.736(7)(b), Fla....

...The trial court denied the plaintiff's motion for summary judgment and granted the defendant's motion, declaring that the plaintiff was not entitled to any coverage under the policy. This appeal followed. With regard to the personal injury protection (including the medical benefits), see § 627.736(1), Fla....

...missions, is hereby exempted from tort liability for damages because of bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use of such motor vehicle in this state to the extent that the benefits described in s. 627.736(1) are payable for such injury, or would be payable but for any exclusion authorized by ss....

...Worthy, 447 So.2d 998, 1001 (Fla. 5th DCA 1984), in which that court said that section 627.737(1) exempts "a tortfeasor from tort liability for damages because of bodily injury caused by a motor vehicle only `to the extent that benefits described in section 627.736(1) are payable for such injury, or would be payable but for any [authorized] exclusion.'" That court, as well as the Fourth District Court of Appeal, has also held that, although the exemption applies where there is coverage, the tortfeasor is liable only for medical expenses not payable under the PIP coverage....

...The majority's further attempt to distinguish Purdy by stating that it related only to a discussion of the collateral source rule, contained in section 627.7372, is equally unpersuasive. This is so because it is clear that the PIP coverage encompassed by section 627.736, and at issue in the instant case, is one of the enumerated collateral sources encompassed by the rule....

...For the reasons stated above I find Purdy and Matthews controlling and would affirm the analysis and decision below. BARKETT, C.J., and SHAW, J., concur. NOTES [1] We have jurisdiction. Art. V, § 3(b)(4), Fla. Const. [2] In accordance with sections 627.737(1) and 627.736(1), the Riveros should recover 80% of all their reasonable medical expenses from their own PIP carrier....

...al's decision in Nationwide Mutual Fire Insurance Co. v. Central Florida Physiatrists, P.A., 851 So.2d 762 (Fla. 5th DCA 2003) ( CFP ). [1] The conflict issue is whether a personal injury protection (PIP) insurer must comply with the requirements of section 627.736(10), Florida Statutes (2006), in order to pay PIP benefits based on a reduced rate that a medical provider contractually agreed to accept. The Fourth District aligned itself with the Second District Court of Appeal's decision in Nationwide Mutual Insurance Co. v. Jewell, 862 So.2d 79 (Fla. 2d DCA 2003), which concluded that compliance with section 627.736(10) is not a prerequisite to the payment of PIP benefits at reduced rates that the medical provider contractually agreed to accept....

...ot contracted directly with any health care provider, Allstate could not take advantage of any reduced rates and was required to pay eighty percent of all reasonable medical expenses, i.e., eighty percent of the full bill as charged, as set forth in section 627.736(1)(a), Florida Statutes (2006)....

...hich at that time was the only appellate court to have addressed the issue. [3] The county court also certified the following question as one of great public importance to the Fourth District: "Is an insurer required to comply with the provisions of section 627.736(10), Fla....

...Holy Cross and Allstate, and certified conflict with CFP. See Holy Cross, 895 So.2d at 1244-45. We accepted jurisdiction to resolve the conflict. ANALYSIS The issue we decide is whether an automobile PIP insurer must comply with the requirements of section 627.736(10) in order to pay PIP benefits based on a reduced rate that a medical provider contractually agreed to accept....

...rd to fault"). The No-Fault Law mandates security that can be established by alternative means, one of which is PIP insurance. See § 627.733, Fla. Stat. (2006). The "Required Personal Injury Protection" provision, or the PIP statute, is codified at section 627.736 and is "an integral part of the no-fault statutory scheme." Flores v. Allstate Ins. Co., 819 So.2d 740, 744 (Fla.2002). The statute requires motor vehicle insurance policies issued in Florida to provide PIP benefits for bodily injury "arising out of the ownership, maintenance, or use of a motor vehicle." § 627.736(1), Fla....

...As to medical benefits, which are the subject of this case, insurers must pay "[e]ighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including . . . medically necessary ambulance, hospital, and nursing services." § 627.736(1)(a), Fla. Stat. (emphasis supplied). PIP insurers are required to comply with subsection (1) and cover all medically necessary medical expenses at that percentage, unless one of the specific exclusions set forth in subsection (2) applies. See § 627.736(2), Fla. Stat (2006). Subsections (4) and (5) set forth strict guidelines for both PIP insurers and medical providers, including how and when charges must be submitted and benefits paid. See § 627.736(4)-(5), Fla....

...by [PIP] insurance may charge the insurer and injured party only a reasonable amount pursuant to this section. . . . In no event, however, may such a charge be in excess of the amount the person or institution customarily charges for like services." § 627.736(5)(a), Fla....

...As is evident from the language of subsection (10), the 1992 amendments authorized insurers to issue PPO policies in the context of PIP insurance. [5] Subsection (10) is the sole avenue by which insurers can modify the standard PIP policy as outlined in section 627.736 and when such policies are offered, the insurers clearly must comply with the statutory mandates of subsection (10)....

...Under subsection (10), if an insured purchases a PPO policy and chooses to use a preferred provider, then the PIP insurer may "pay medical benefits in excess of the benefits required [by statute] and may waive or lower the amount of any deductible that applies to such medical benefits." § 627.736(10), Fla....

...This provision allows PIP insurers to enter into contracts with preferred providers, issue PPO policies, and, most importantly, increase the "medical benefits in excess of the benefits required by this section" and "waive or lower the amount of any deductible that applies to such benefits." § 627.736(10), Fla. Stat. However, where the insurer is neither issuing PPO policies nor attempting to modify the standard PIP insurance policy as set forth in section 627.736, we conclude that there is nothing in the language of the statute that requires an insurer to comply with subsection (10)....

...That sentence states that "[a]n insurer may negotiate and enter into contracts with licensed health care providers for the benefits described in this section, referred to in this section as `preferred providers,' which shall include health care providers licensed under chapters 458, 459, 460, 461, and 463." § 627.736(10), Fla....

...ng the types of contractual relationships that Allstate allegedly negotiated in this case. We reject Holy Cross's argument in the alternative that a payment which is eighty percent of a contractually agreed-upon reduced rate is a per se violation of section 627.736....

...ract with a provider to create an agreed-upon fee schedule for reduced rates. See Jewell, 862 So.2d at 83. Second, payment at a reduced rate does not violate subsection (1)(a) so long as the insurer pays "eighty percent of all reasonable expenses. " § 627.736(1)(a), Fla. Stat. (emphasis supplied). What a provider customarily charges or has previously accepted are important factors for determining whether a fee is reasonable. See § 627.736(5)(a), Fla....

...Jewell, 862 So.2d at 86. Accordingly, "[i]f a provider has agreed in a valid and enforceable contract to accept payment for services at a particular rate, that rate would necessarily be a `reasonable amount for the services . . . rendered.'" Id. (quoting § 627.736(5)(a), Fla....

...nsured to use preferred providers, engaged in actions to the detriment of its insureds, or otherwise violated the statutory scheme. [6] CONCLUSION Based on the foregoing analysis, we conclude that an insurer, which neither violates the provisions of section 627.736 nor otherwise attempts to modify its responsibilities under the standard PIP policy, is not required to comply with the requirements of section 627.736(10) in order to pay PIP benefits based on a reduced rate that a medical provider contractually agreed to accept....

...fits set forth in the PIP statute. A PIP insurer that merely enters into a contract with a preferred provider to create an agreed-upon fee schedule for medical services and does not issue PPO policies or amend the standard PIP policy requirements in section 627.736 may do so without complying with the requirements of subsection (10)....

...nt's insurer). No question is presented regarding the form of that judgment. *565 On this appeal by State Farm it is contended the court should have allowed State Farm the amount it had so paid to its insured, as provided for in subsection (3)(a) of § 627.736 Fla. Stat., F.S.A. Instead, as indicated above, the court allowed a smaller sum, on the basis of equitable distribution of the amount recovered, proceeding under subsection (3)(b) of § 627.736....

...is further provided there that the proration of the reimbursement shall be made by the judge of the court handling the suit to recover damages in the third party action, upon application therefor and notice to the carrier. Paragraphs (a) and (b) of § 627.736(3) Fla....

...bation of the reimbursement" to be made "by the judge of a trial court handling the suit to recover." In this case, where there was a suit to recover, we find no reason to fault the trial court for proceeding under paragraph (b) of subsection (3) of § 627.736, rather than by granting full reimbursement under paragraph (a) thereof....

...personal injury protection coverage for material misrepresentation; [and] as such, Defendant's common law right to rescind personal injury *598 protection coverage is abrogated by the Florida Statutes." The trial court further reasoned that, because section 627.736(9)(a), Florida Statutes (2003), mandated United to report cancellation or nonrenewal of PIP coverage to the Department of Highway Safety Motor Vehicles within forty-five days from the effective date of cancellation or non-renewal, Uni...

...As such, we conclude that an insurer's failure to rescind a policy in accordance with statutory cancellation procedures does not preclude or abrogate an insurer's ability to void the policy ab initio pursuant to section 627.409. VI. APPLICATION OF SECTION 627.736(9)(a) We turn now to Salgado's argument that section 627.736(9)(a) abrogates an insurer's right to rescission....

...t of Highway Safety and Motor Vehicles within 45 days from the effective date of the renewal, cancellation, or nonrenewal. *603 Based on the plain and unambiguous language of this section, we find Salgado's argument unpersuasive. First, we find that section 627.736(9)(a) applies only to "renewal[s], cancellation[s] or nonrenewal[s]." While section 627.728(1)(b) defines the term "renewal," [6] which is not applicable in this case, the term "cancellation" is undefined by chapter 627....

...that between divorce and annulment. 2 Lee R. Russ & Thomas F. Segalla, Couch on Insurance § 30:3 (3d ed. 1995). Because "the effect of a rescission is to render the contract abrogated and of no force and effect from the beginning," we conclude that section 627.736(9)(a) does not apply where—as here—the policy was rescinded as opposed to cancelled....

...notice of cancellation accompanied by the reason therefore shall be given. No notice of cancellation of a policy to which this section applies shall be effective unless the reason or reasons for cancellation accompany the notice of cancellation. [5] Section 627.736(9) was amended in 2007 and moved to section 324.0221, Florida Statutes (2008)....

...We find no departure from the essential requirements of the law and thus we deny the petition. However, we write to address the discord that has manifested itself in the county courts relating to the interpretation and application of two portions— sections 627.736(4)(b) and 627.736(7)(a)—of Florida's personal injury protection (PIP) statute....

...easonable proof that United Auto was not responsible for payment of its bills. Partners in Health also argued that Dr. Fleischer's August 23, 2004 report was invalid because Dr. Fleischer had not personally examined Lebrun purportedly as required by section 627.736(7)(a) of the Florida Statutes....

...Summary judgment in Partners in Health's favor was granted without explication. Proceedings in the Appellate Division of the Circuit Court The Appellate Division of the Circuit Court reversed the summary judgment in Partners in Health's favor. It did so for two reasons: first, because it concluded that under section 627.736(4)(b), an insurer does not forfeit the right to challenge whether a claim is reasonable, related or necessary, where it fails to obtain proof of same within thirty days of receipt of a claim; and second because it found that to be valid, a section 627.736(7)(a) physician's report, need not be predicated on a physical examination performed by the physician making the report. While we agree with both conclusions, we write to confirm (1) that in a section 627.736(4)(b) case such as this, section 627.736(7)(a) does not apply to mandate a physician's report; and, (2) that a section 627.736(7)(a) report need not be predicated on a physical examination of the insured by either the reporting physician or by any physician on behalf of the insurance company. Denial of Benefits vs. Withdrawal of Payment to a Treating Physician We begin by drawing a distinction between an outright denial of all or some benefits—which is governed by subsection 627.736(4) of the Florida Statutes—and a withdrawal of payment from a treating physician—which is governed by subsection 627.736(7)....

...If an insurer either denies a claim completely, that is refuses to make any payments whatsoever, or denies one or more discrete charges or claims (whether for a treating physician's services or otherwise), the insurer's actions constitute a "denial" of benefits and section 627.736(4) of the Florida Statutes applies. If, however, the insurer has paid benefits to a treating physician, and then seeks to withdraw or terminate further payment to that physician, the insurer's actions constitute a "withdrawal" of further benefits and section 627.736(7) applies. Because the instant case is a denial case, section 627.736(4) applies. *861 Application of Section 627.736(4)(b) Section 627.736(4) governs when personal injury protection (PIP) benefits must be paid by an insurer such as United Auto....

...the insured's policy: (4) Benefits; when due.—Benefits due from an insurer .... shall be due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered by the policy.... § 627.736(4), Fla....

...t paid within that time: (b) Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a cover loss and of the amount of same. § 627.736(4)(b), Fla....

...In short, an insurer may deny a PIP claim in whole or in part either before or after that claim becomes "overdue [because not paid within thirty days]" provided it has "reasonable proof" that it is not responsible for payment. And, while such proof may come in the form of a report described in section 627.736(7)(a), such a report is not necessary to deny a claim under section 627.736(4)(b): Amici Allstate Insurance Company and Geico Casualty Company point out that [the] requirement of a medical report is not mentioned anywhere in section 627.736(4).... Amici are correct. The statute does not mention "medical report" in this regard; the statute [section 627.736(4)] simply says that the insurer must pay benefits within thirty days unless the insurer "has reasonable proof to establish that the insurer is not responsible for the payment." The statute does not limit "reasonable proof" to a "medi...

...s rewritten the statute. This too was error. United Automobile Ins. Co. v. Rodriguez, 808 So.2d 82, 87 (Fla.2001) (footnotes omitted); Rhodes and Anderson, 18 So.3d at 1064 (holding that denial of a "single claim *862 for payment" does not implicate section 627.736(7)(a) so as to require a report); see also United Automobile Ins. Co. v. Millennium Diagnostic Imaging Ctr., Inc., 12 So.3d 242, 246 (Fla. 3d DCA 2009) (confirming that based on the unambiguous language of section 627.736(4)(b) and applicable case law, an insurer may challenge treatment at any time and may rely on a section 627.736(7)(a) report, even if that report is obtained more than thirty days after the claim is submitted)....

...In Viles, the insurer had made payments for some of an insured's chiropractic services before refusing to pay for the remainder of those services. There, we treated the insurer's action as a withdrawal or refusal to pay further benefits to a treating physician under section 627.736(7)(a) and held that a valid physician's report had to be provided by the insurer before payment could be terminated: [W]e agree with the trial court's well reasoned analysis concluding that United Auto was required to first obtain a physician's report before refusing to pay further medical bills. The statute [section 627.736(7)] plainly provides that an insurer must first obtain the referenced report before electing to withdraw payment. Viles, 726 So.2d at 321 (citation omitted) (emphasis added). Viles does not, therefore, hold that a 627.736(7)(a) report is a condition precedent to a total refusal to pay an insured's bills or claims or to a refusal to pay (denial of) some of an insured's bills or claims....

...wal or termination of payments or to the withdrawal or termination of authorization for treatment" and that "denial of a single claim for payment does not constitute the withdrawal of a physician's `treatment authorization'" which does not implicate section 627.736(7)(a) because that section "does not address situations in which one charge for treatment has been denied by the insurer"). Bermudez also does not stand for the proposition that a 672.736(7) report is a condition precedent to denying or reducing some or all of an insured's bills or claims. Bermudez dealt with a withdrawal of benefits under section 627.736(7)(a) and not with a denial of a claim or claims under section 627.736(4)(b). While dicta in Bermudez appears to suggest that Viles stands for the proposition that section 627.736(7)(a) applies to all reasonable, related, necessary claim denials, it nonetheless re-confirms the holding in Viles....

...Thus, we affirm our holding in Viles that a valid report is required *863 where an insurer attempts to reduce, withdraw, or deny PIP benefits on grounds of reasonableness, necessity, or relationship. Viles, 726 So.2d at 321. Bermudez, 980 So.2d at 1216. Thus, neither Viles nor Bermudez, as these cases now stand, require a 627.736(7)(a) report as a condition precedent to either the complete denial or partial reduction of an insured's bills or claims....

...The Appellate Division of the Circuit Court was, therefore, correct in concluding that United Auto did not have to obtain "reasonable proof" that Partners in Health's claim was not reasonable, related or necessary within thirty days of receipt of that claim. And, because section 627.736(4)(b) requires only "reasonable proof" that a claim is not reasonable, related or necessary, the physician's affidavit provided by Dr. Fleischer satisfied the requirements of section 627.736(4)(b). There was, therefore, no need for the Circuit Court to either look to section 627.736(7)(a) or to determine whether the report submitted by Dr. Fleischer complied with the requirements of that provision. See Santa Fe Medical Center, 21 So.3d 60. Application of Section 627.736(7)(a) We also note that while not necessary to resolution of this case, the Appellate Division also correctly concluded that the section 627.736(7)(a) report prepared by Dr....

...In Bermudez this court addressed this precise issue: We have jurisdiction pursuant to Florida Rule of Appellate Procedure 9.030(b)(4)(A). We rephrase the certified question to read as follows: WHETHER A MEDICAL REPORT ISSUED FOR THE WITHDRAWAL OF PERSONAL INJURY PROTECTION BENEFITS PURSUANT TO SECTION 627.736(7)(a), FLORIDA STATUTES MUST BE BASED UPON A PHYSICAL EXAMINATION OF THE INSURED THAT IS PERSONALLY CONDUCTED BY THE PHYSICIAN ISSUING THE REPORT....

...980 So.2d at 1214. Although the report at issue in Bermudez was premised on a physical examination conducted at the request of the insurer by a physician other than the physician preparing the report, that is, it was premised on an IME, nothing in, section 627.736(7)(a) mandates an IME as a predicate to such a report. While much has been made of recent amendments to this provision purportedly for the purpose of doing away with reports based solely on review of a treating physicians records [1] , section 627.736(7)(a) still expressly defines a "valid report" as "one that is prepared and signed by a physician examining the injured person or reviewing the treatment records of the injured person." § 627.736(7)(a) (emphasis and underline added)....

...Dep't of Health, 898 So.2d 61, 64-65 (Fla.2005)) (citation omitted). Thus, irrespective of the legislature's purported intent to do away with reports based on no more than review of a treating physician's records, the statute in its current state is clear and does not require a valid section 627.736(7)(a) report to be premised on either a physical examination by the reporting physician or an examination conducted on the insurer's behalf (an IME)....

...To summarize: • a claim may be rejected more than thirty days after submission to the insurer notwithstanding being "overdue"; • where no payment whatsoever has been made and the insurer rejects all claims or bills from a particular provider or treating physician as being unreasonable, unrelated or, unnecessary, section 627.736(4)(b) applies; • where some but not all claims or bills from a particular provider or treating physician are being rejected or reduced as unreasonable, unrelated, or unnecessary, section 627.736(4)(b) likewise applies; • Section 627.736(4)(b) requires only that an insurer have reasonable proof that a rejected claim or claims (or bill or bills) are unreasonable, unrelated, or unnecessary; while a section 627.736(7)(a) report may be utilized for this purpose, such a report is not required for this purpose; • where an insurer withdraws (that is, terminates) payments being made to a treating physician or withdraws or terminates authorization for further treatment by a treating physician, a section 627.736(7)(a) report must first be obtained; • such a section 627.736(7)(a) report does not have to be predicated on either a physical examination by the reporting physician or on a physical examination conducted on behalf of the insurer (an IME) but may be premised on review of the records of the insured's treating physician. In this case, the insurer made no payments, claiming that no treatment was reasonable, related or necessary. The Appellate Division therefore correctly concluded that this action was governed by section 627.736(4)(b) and that the trial court erred in refusing to consider either the affidavit or the report submitted by United Auto in support of its denial of Partners in Health's claim. Although United Auto was not obligated to provide a section 627.736(7)(a) report to support its rejection of Partners in Health's claim, the Appellate Division was correct in determining that the report was valid even though not based on a physical examination conducted by the reporting physician. For these reasons, and those stated in this opinion, the petition is denied. NOTES [1] Partners in Health cites to a senate staff analysis accompanying the 2001 amendment to section 627.736(7)(a) which states: The effect of this provision is to help remedy the current practice of PIP insurers utilizing what are termed "paper IME's" in which the insurer's physician merely reviews the medical treatment documents of the inj...

...Mrs. White, and expert testimony to the effect that if the third-party tort-feasor or his insurer had responded for the full value of Mrs. White's claim, she would have received at least $25,000. In the action below Reserve took the position that F.S. 627.736(3)(a), F.S.A., requires that it be reimbursed to the full extent of its payment of PIP benefits. Mrs. White contended that 627.736(3)(a) and (3)(b) require that the insurer receive an equitable distribution of the proceeds of the settlement with the third-party tort-feasor, the amount of the distribution to be determined in the discretion of the lower court. The trial judge entered an order finding that the provisions of F.S. 627.736(3)(a), F.S.A., and F.S. 627.736(3)(b), F.S.A., are in conflict and inconsistent....

...In two paragraphs, the Florida Automobile Reparations Reform Act provides for reimbursement of a "no-fault" insurer (which has paid PIP benefits) from proceeds of a recovery from a tort-feasor. As set forth in the official compiled volume of the Florida Statutes, the first paragraph, numbered 627.736(3) (a), reads as follows: (3) Insurer's rights of reimbursement and indemnity....

...dent after the death, and no recovery by a dependent for loss suffered by the dependent after the death will be subtracted in calculating benefits due the injured person except as provided in paragraph (1)(c). The next succeeding paragraph, numbered 627.736(3)(b), reads as follows: (b) The insurer shall be entitled to reimbursement of any payments made under the provisions of this subsection, based upon such equitable distribution of the amount recovered as the court may determine, less the pro...

...It is pertinent to note that the language set forth in the official compiled volume of the Florida Statutes (and Florida Statutes Annotated) differs from the language actually enacted by the legislature as set forth in Laws of 1971, Ch. 71-252. The paragraph numbered 627.736(3)(b), as actually enacted, reads as follows: "(b) The insurer shall be entitled to reimbursement of any payments made under the provisions of subsection (3) of this section based upon such equitable distribution of the amount recovered as th...

...ss the pro rata share of all court costs expended by the plaintiff in the prosecution of the suit to recover such amount against a third-party tort-feasor, including a reasonable attorney's fee for the plaintiff's attorney. * * *" (Florida Statutes, § 627.736(3)(b), F.S.A.) The language in Florida Statutes substitutes the words "this subsection" in place of the words "subsection (3) of this section." The difference is important because it seems to make clear that the intent of the Legislature,...

...a) and (b) of the statute, nevertheless we find no difficulty in harmonizing the two, and in that regard we differ from our sister courts wherein it was stated, in State Farm Automobile Insurance Co. v. Hauser, supra, that "Paragraphs (a) and (b) of § 627.736(3) Fla. Stat., F.S.A. resist reconciliation." (Page 565 of 281 So.2d) and in Reyes v. Banks, supra, that "We agree with our sister court of the third district that paragraphs (a) and (b) of § 627.736(3), F.S.A., resist reconciliation....

...rer's reimbursement." In the Reyes case the Court found that the requirement of equitable distribution is applicable to both paragraphs (a) and (b) and set forth guide lines to be followed. We too find that there is a remarkable similarity between F.S. 627.736(3)(b), F.S.A., of the "no-fault" statute and F.S. 440.39(3)(a), F.S.A., of the Workmen's Compensation Statute. In that regard the Court in the Reyes case stated: "The equitable distribution provisions of § 627.736(3)(b), Florida Statutes, F.S.A., are taken almost verbatim from the equitable distribution provisions of § 440.39(3)(a), Florida Statutes, F.S.A., the Workmen's Compensation Statute....

...above recited, is rather narrow we expand our decision and hold that in the absence of unusual or unforeseen circumstances not now contemplated by us, "equitable distribution" is applicable to all cases (whether suit be filed or not) arising under F.S. 627.736(3)(a), F.S.A., and F.S. 627.736(3)(b), F.S.A....

...above recited, is rather narrow we expand our decision and hold that in the absence of unusual or unforeseen circumstances not now contemplated by us, `equitable distribution' is applicable to all cases (whether suit be filed or not) arising under F.S. 627.736(3)(a), F.S.A., and F.S. 627.736(3)(b), F.S.A." We did not intend by our opinion, nor do we now intend, to hold that there can be no circumstances under which "equitable distribution" will not result in reimbursement of 100 percent to the carrier of the amount paid by it....

...The respondent's amended answer alleged that the petitioner's policy specifically provided that personal injury protection benefits were reduced by the amount of workmen's compensation benefits received. The trial court accepted the respondent's argument and held that Section 627.736(4), Florida Statutes (1975), only required the respondent to supplement workmen's compensation benefits until the petitioner had received, both from workmen's compensation and from the respondent, a total of $5,000.00....

..., the total aggregate limit of personal injury protection benefits available with respect to such bodily injury shall be reduced by the amount of workmen's compensation benefits received." The question posited by petitioner for our review is whether Section 627.736(4), Florida Statutes (1975), requires an insurer to supplement workmen's compensation benefits until the insurer has, itself, paid the limits of liability under its policy for the required personal injury protection benefits. Section 627.736, Florida Statutes (1975), provides in pertinent part: "627.736 Required personal injury protection benefits; exclusions; priority....

...compensation benefits received. Petitioner asserts that the applicable sections of the policy issued by respondent improperly lay a predicate for the instant construction by the District Court of Appeal, First District, and posits that the intent of Section 627.736(4), Florida Statutes (1975), (which became a part of the insurance contract since the parties are presumed to have entered into the contract with reference to the statute) is to eliminate one from recovering for a loss which is not su...

...benefits. Petitioner contends that respondent is required to supplement workmen's compensation benefits until respondent has paid its limits of liability or the insured has returned to work. Respondent submits that it is unreasonable to assume that Section 627.736(4), Florida Statutes (1975), indicates only a procedural manner of payment when it expressly and unambiguously requires that workmen's compensation benefits shall be credited....

...ne v. Travelers Insurance Co., supra, involved whether workmen's compensation benefits are concurrent and whether exhaustion of workmen's compensation benefits is a prerequisite to receiving personal injury protection benefits. The credit allowed by Section 627.736(4), Florida Statutes (1975), is a setoff against the total aggregate limit available and not just against individual payments, argues respondent....

...liable for any payment until workmen's compensation benefits were exhausted and then only if workmen's compensation payments received for medical benefits were less in amount than the amount payable under the personal injury protection provision of Section 627.736, Florida Statutes (1975)....

...The Travelers Insurance Company, supra, the District Court of Appeal, Third District, relied on its earlier decision in Charter Oak Fire Insurance Co. v. Regalado, supra, and explained: "We stated there that the purpose of the Automobile Reparations Reform Act was to broaden insurance coverage and that pursuant to Section 627.736(4), Florida Statutes (1975), workmen's compensation benefits received by a claimant were therefore to be credited against p.i.p....

...ved. Rather, we hold that an insurer is required to supplement workmen's compensation benefits until the insurer has itself paid the limits of liability under its policy for required personal injury protection benefits. The legislative intent behind Section 627.736(4), Florida Statutes (1975), is that whenever an automobile accident occurs, the personal injury protection benefits are primary and that they are to be paid in full whether or not any other coverage exists....

...lds, P.A., West Palm Beach, for appellee. GROSS, Judge. The county court has certified two questions to this court pursuant to Florida Rule of Appellate Procedure 9.160(d), which we rephrase as follows: TO RECOVER MEDICAL BENEFITS IN A LAWSUIT UNDER SECTION 627.736, FLORIDA STATUTES (SUPP. 1994), MUST THE PLAINTIFF PROVE BY THE GREATER WEIGHT OF THE EVIDENCE THAT THE EXPENSES SOUGHT ARE BOTH REASONABLE AND FOR NECESSARY MEDICAL SERVICES? IN AN ACTION FOR PIP BENEFITS, WHERE A TRIAL COURT CHARGES THE JURY USING THE LANGUAGE OF SECTION 627.736(1)(a), MUST THE COURT FURTHER DEFINE THE *272 TERM "NECESSARY" AS USED IN THE STATUTE? We have accepted jurisdiction pursuant to Rules 9.030(b)(4)(A) and 9.160(d)....

...chiropractic treatment after June 7, 1994. Derius continued to treat with her chiropractor until September, 1994. Derius filed suit under the no-fault statute in the county court seeking, inter alia, to recover for her chiropractic treatments under section 627.736(1)(a), Florida Statutes (Supp.1994)....

...ity Company, for the total amount of those reasonable and necessary chiropractic expenses incurred after June 7, 1994 and for the interim examination dated May 11, 1994. After a lengthy trial, the jury returned a verdict for Allstate on both issues. Section 627.736(1), Florida Statutes (Supp.1994), requires an insurer to provide personal injury protection (PIP) benefits for "loss sustained ......

...as a result of bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle." Personal injury protection benefits include "[e]ighty percent of all reasonable expenses for necessary medical ... services." § 627.736(1)(a), Fla....

...There is nothing in the PIP statute suggesting a legislative intent to alter the normal dynamics of a lawsuit by placing the burden on the defendant in a PIP case to prove that a proposed charge was unreasonable or that a given service was not necessary. *273 Derius points to the language of section 627.736(7)(a), which provides that [a]n insurer may not withdraw payment of a treating physician without the consent of the injured person covered by the personal injury protection, unless the insurer first obtains a report by a physician lic...

...d under the same chapter as the treating physician whose treatment authorization is sought to be withdrawn, stating that treatment was not reasonable, related, or necessary. This language is part of the independent medical examination requirement of section 627.736(7) which is "intended to give insurers an opportunity to determine the legitimacy of a claim so that an appropriate decision can be made as to whether benefits should be paid." U.S. Security Ins. Co. v. Silva, 693 So.2d 593, 596 (Fla. 3d DCA 1997). The quoted language from section 627.736(7)(a) sets up a procedural requirement that an insurer cannot withdraw payment of a treating physician unless the decision is supported by an expert that the treatment does not comply with the statutory criteria....

...relies upon spiritual means through prayer alone for healing in accordance with his religious beliefs. Id. at 149; see also Hunter v. Allstate Ins. Co., 498 So.2d 514, 515-16 (Fla. 5th DCA 1986). Whether a given medical service is "necessary" under section 627.736(1)(a) is a question of fact for the jury....

...On the remaining issues, we find no error in the trial court's rulings on Derius' motions for directed verdict and mistrial. Allstate's reliance on the IME chiropractor's letter to withdraw payment to Derius' chiropractor was in compliance with the requirements of section 627.736(7)(a)....

...Allstate cannot legally, moreover, diminish [2] the extent of its PIP and medpay undertakings by adding or amending policy provisions. See generally Young v. Progressive Southeastern Ins. Co., 753 So.2d 80 (Fla.2000) (holding uninsured motorist policies must conform [3] to statutory requirements). Section 627.736(4), Florida Statutes (1997) makes PIP and medpay benefits "due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered by the policy." As the Ivey court...

...ed insured may get on with his life without undue financial interruption.' Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987)(citing Comeau v. Safeco Ins. Co., 356 So.2d 790 (Fla. 1978))." Ivey, 774 So.2d at 683-84. See § 627.736(4)(b), Fla....

...period. To rule otherwise would render the recently enacted "nofault" insurance statute a "no-pay" plan—a result we are sure was not intended by the legislature. Dunmore v. Interstate Fire Ins. Co., 301 So.2d 502, 502 (Fla. 1st DCA 1974). See also § 627.736(4)(f), Fla....

...ng they were properly due, [5] State Farm had effectively breached their contract with [the Lees]."). While "payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment," § 627.736(4)(b), Fla....

...fails to conform to the requirements of sections 627.730-7405, Florida Statutes (1997), or of article I, section 21 of the Florida Constitution. See generally Nationwide Mut. Fire Ins. Co. v. Pinnacle Med., 753 So.2d 55, 59 (Fla.2000) (holding that section 627.736(5), Florida Statutes (1995), "denies medical providers access to courts" and "arbitrarily distinguishes between medical providers and insureds").

...opedic surgeon. Insured saw the internist as scheduled; however, her attorney notified GEICO that she would not submit to the I.M.E. by the orthopedic surgeon. Thereafter, insured's counsel sent a letter to GEICO [1] stating her position that, under section 627.736(7)(a), Florida Statutes (1987), [2] the medical examination was to be conducted by a physician "under the same licensing chapter as the treating physician whose treating authorization is sought to be withdrawn." Insured, at the time, was under the care of an internist and a chiropractor....

...*103 Considering insured's actions and the clear language of the instant policy, we conclude that the insurer was entitled to the summary judgment ordered in its favor. The requested I.M.E. was in no way unreasonable in terms of location, frequency, or type of examination requested. The limitation imposed by the amendment to section 627.736(7)(a), relied upon by insured's counsel, clearly related only to the type of physician whose report could be used to terminate benefits and placed no limitation on the type of physician an insurer could reasonably choose to perform an I.M.E....

...For the foregoing reasons, the summary judgment is affirmed. NOTES [1] That letter stated: Dear [GEICO representative], Your request for an examination with an orthopedic surgeon is unreasonable in light of the fact that Mrs. De Ferrari has never been examined or treated by an orthopedic surgeon. Section 627.736(7)(a) F.S., specifically states that I.M.E....

...at my position is incorrect, we will gladly submit to an I.M.E. by an orthopedic. Until such time as you can cite such language or case law, we consider the I.M.E. with the orthopedic to be null and void. Very truly yours, [De Ferrari's counsel] [2] Section 627.736(7), Florida Statutes (1987) provided: (a) Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury pr...

...Thompson of Bradford, Williams, McKay, Kimbrell, *349 Hamann & Jennings, Miami, for appellant. Jerry Larotonda, Miami, for appellee. OVERTON, Justice. This cause is before this Court on direct appeal from a summary final judgment of the county court construing and expressly upholding the constitutional validity of Section 627.736(4)(d)(1), Florida Statutes (1975)....

...tered partial summary judgment as to coverage for the appellee, Castagna, ruling that no actual physical contact between the van and the Chevrolet was necessary for PIP coverage under the insurance policy or the statute. The court further ruled that Section 627.736(4)(d)(1), Florida Statutes (1975), did not deny equal protection or due process of law. Several Florida courts have construed Section 627.736(4)(d)(1), Florida Statutes (1975), of the No Fault Act to allow PIP benefits to an insured injured while riding in a commercial vehicle, if the commercial vehicle collides with a "motor vehicle," State Farm Mutual Automobile Insurance *350 Co....

...We think that by inserting the word "caused" in the statute, the legislature plainly intended that it would be a factor to be considered. Id., at 460. The ruling of the Third District on this issue is consistent with our holding in the instant case. The contention of the appellant that Section 627.736(4)(d)(1), Florida Statutes (1975), constitutes a denial of due process and equal protection under the constitutions of this state and of the United States is without merit....

...[2] (d) The insurer of the owner of a motor vehicle shall pay personal injury protection benefits for: 1. Accidental bodily injury sustained in this state by the owner while occupying a motor vehicle, or while not an occupant of a motor vehicle or motorcycle if the injury is caused by physical contact with a motor vehicle. § 627.736(4)(d)(1), Fla....

...An insured appeals a final order denying his claim for attorney's fees in a suit to recover "no-fault" insurance benefits from his insurance company. We reverse because we find that the insurance company failed to pay the insured's medical providers as required by Florida Statutes, Section 627.736(4)(b)....

...of the letter. There is no question that these bills qualified for "nofault" insurance benefits under the State Farm policy. After more than three months had passed without payment, Crooks filed suit against State Farm, pursuant to Florida Statutes, Section 627.736(4)(b), to obtain payment of the bills, to recover interest on the late payments, and to recover attorney's fees for filing the suit....

...*1268 A non-jury trial proceeded on the issue of Crooks's entitlement to attorney's fees for filing the action. The trial court ruled that Crooks was not entitled to attorney's fees even though State Farm had "technically" violated the time requirements of Section 627.736(4)(b). The court reasoned that State Farm had not violated the intent of Section 627.736(4)(b). After the court denied Crooks' motion for rehearing, Crooks filed the instant appeal. Florida Statutes, Section 627.736(4)(b) reads, in pertinent part, as follows: Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of the same ... . However, any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding that written notice has been furnished to the insurer. § 627.736(4)(b), Fla....

...Based on the clear and unambiguous language in this statute, we find that the trial court erred in construing the statute in the manner in which it did, and in entering a judgment in favor of State Farm. Here, State Farm clearly violated the express requirements of Section 627.736(4)(b) by failing to pay Crooks' medical bills within thirty days of being notified, in writing, of these charges. The record indicates that State Farm paid these benefits only after Crooks had initiated the underlying suit, which was over three months after it had been notified of these claims. Section 627.736(4)(b) unambiguously states that an insurer, who fails to pay out benefits within thirty days of receiving proper notice, will be liable to the insured. § 627.736(4)(b), Fla....

...(1993). Here, the trial court correctly acknowledged that State Farm had violated the statute, but then erroneously excused the violation as being merely "technical." By making this ruling, the trial court, in effect, attempted to create an exception to Section 627.736(4)(b) which does not exist....

...of the thirty day payment period under circumstances such as those in this case. As the First District made abundantly clear in Dunmore v. Interstate Fire Ins. Co., 301 So.2d 502 (Fla. 1st DCA 1974): It appears to us that the statutory language [in Section 627.736(4)(b)] is clear and unambiguous....

...State Farm Mut. Auto. Ins. Co., 622 So.2d 135 (Fla. 4th DCA 1993); Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269 (Fla. 3d DCA 1987). By attempting to create an exception to this section, the court erroneously ignored the plain meaning and intent of Section 627.736(4)(b), which is to guarantee swift payment of PIP benefits....

...4th DCA 1995) (same); Powell v. State, 508 So.2d 1307, 1310 (Fla. 1st DCA) (same), review denied, 518 So.2d 1277 (Fla. 1987); National Fed'n of Retired Persons v. Department of Ins., 553 So.2d 1289, 1290 (Fla. 1st DCA 1989) (same). The only provision in Section 627.736 which may arguably provide for a tolling of the thirty day payment period is the provision *1269 which states that an insurer's payments will not be overdue where "the insurer has reasonable proof to establish that the insurer is not responsible for the payment... ." § 627.736(4)(b), Fla....

...rticular in-house claims form. Since State Farm neither alleged nor attempted to prove that it had "reasonable proof" that it was not responsible for the underlying claims, and since the court made a finding that State Farm violated the provision of section 627.736(4)(b), the court's order denying attorney's fees must be reversed....

...ions Reform Act, § 627.730 et seq., F.S. 1975, and State Farm's policy insuring an automobile owned by appellant's father, in whose household she lived. While driving her father's car, appellant was injured in an accident. The trial court held that § 627.736(4)(d)3, F.S....

...1976), that only those motor vehicles which are required by Florida law to be registered are subject to the security requirements of the Automobile Reparations Reform Act. The owners of such vehicles, and those alone, are excluded from the benefits afforded by § 627.736(4)(d)3....

...ompelled transaction. We suspect that in exercising its police powers to dictate state-imposed commerce, the legislature would carefully craft a set of laws to be applied in carrying out its mandate, as it has in other insurance contexts. See, e.g., § 627.736, Fla....

...v. Pacheco, 695 So.2d 394 (Fla. 3d DCA 1997) (en banc), we reverse. United Auto concedes that its requirement for sworn statements, or examinations under oath, does not toll or extend the 30-day period within which the insurer must pay pursuant to section 627.736(4)(b), Florida Statutes....

...We disagree with United Auto's argument. If the insurer does not pay by the statutory 30-day period, on the 31st day, the insurer is itself in violation of the PIP statute and the insured is free to initiate a lawsuit to have the case determined on the merits. § 627.736(4)(b), Fla. Stat. (1997); Fortune v. Pacheco, 695 So.2d at 395; Crooks v. State Farm Mut. Auto. Ins. Co., 659 So.2d 1266, 1268 (Fla. 3d DCA 1995); Dunmore v. Interstate Fire Ins. Co., 301 So.2d 502 (Fla. 1st DCA 1974). Section 627.736(4)(b) provides that an insured's claim is "due and payable as loss accrues, upon receipt of reasonable proof of such loss." The Policy Agreement between United Auto and the insureds provides that "[n]o action shall lie against `us'; u...

...Rodriguez, 746 So.2d 112 (Fla. 3d DCA 1999); Perez v. State Farm Fire and Cas. Co., 746 So.2d 1123 (Fla. 3d DCA 1999). The insurer cannot use its investigative rights to extend the 30-day period without reasonable proof that it is not responsible for the claim. See § 627.736(4)(b), Fla....

...must comply with the requested examinations under oath. However, the instant case, unlike Willis, is governed by Florida's PIP statute which requires United Auto to verify, and pay, an insured's claim within 30 days of receiving notice of the claim. § 627.736(4)(b), Fla....

...rsuant to Florida Rule of Appellate Procedure 9.160, is as follows: In personal injury protection (PIP) claims, is the cost of transportation incurred in connection with reasonable and necessary medical treatment a reimbursable medical benefit under section 627.736(1)(a), Florida Statutes? The question arose before the lower court based on a complaint filed by appellant/plaintiff below, John Hunter, seeking recovery for medical expenses under the personal injury protection provision of a policy with appellee, Allstate....

...automobile accident. The trial court, in addition to certifying the question, granted summary judgment for Allstate on the basis that neither the policy nor the no-fault law could be construed to allow for reimbursement for transportation expenses. Section 627.736(1)(a), Florida Statutes (1985), provides: (1) REQUIRED BENEFITS....

...t in Mobley, we find the legislative intent is to recompense an injured party for his reasonable expenses. The cost of transportation for medical treatment constitutes a "reasonable expense for necessary medical service," thus properly awarded under section 627.736(1)(a)....

...March 26, 1974. Talburt, Kubicki & Bradley, and Robert J. Dickman, Miami, for appellant. Toby, Hyman, North Miami, E. Dennis Brod, Miami, for appellees. Before BARKDULL, C.J., and CARROLL and HENDRY, JJ. PER CURIAM. This appeal involves the construction of § 627.736, Fla....

...State Farm requested full reimbursement of all PIP benefits paid. The trial court entered an order awarding State Farm $150.00 from the settlement proceeds received by Mrs. Mance. State Farm now appeals that order for equitable distribution. An examination of § 627.736(3)(a) and (3)(b), Fla....

...mbursement. This was alluded to in a prior opinion of this court in State Farm Automobile Insurance Company v. Hauser, Fla.App. 1973, 281 So.2d 563 [by Judge Charles A. Carroll], wherein the following is found: * * * * * * "Paragraphs (a) and (b) of § 627.736(3), Fla....

...However, I believe that the Legislature should *54 revisit this subject. It seems that the statute should not encourage litigation, yet the only way a claimant can have equitable distribution under the precise wording of subsections (3)(a) and (3)(b) of § 627.736, Fla....

...ity" under Section 627.737, or to establish medical expense in excess of $1,000. [1] But the Act does not restrict injured persons from receiving treatment by chiropractors. Nor does it limit payment of "medical" expenses to medical doctors. Rather, Section 627.736, Florida Statutes, provides for payment to "any physician, hospital, clinic, or other person or institution lawfully rendering treatment to an injured person for bodily injury ..." "Medical" relates to the science of medicine and the...

...The decedent was killed instantly in an automobile wreck, and appellant contends she is entitled to compensation of loss of earning capacity of decedent under the personal injury protection benefit coverage of an automobile liability insurance policy issued by appellant. Appellant contends that under § 627.736, Florida Statutes, relating to required personal injury protection benefits and under the terms of the aforesaid insurance policy, she is entitled to the claimed benefits up to a limit of $5,000. § 627.736, Florida Statutes provides in pertinent part as follows: "(1) Required benefits....

PARIENTE, J. The issue presented to the Court is whether the Medicare fee schedules set forth in section 627.736(5)(a), Florida Statutes (2008), authorized an insurer to limit reimbursements for medical services rendered to an insured without giving notice in the insurance policy of the insurer’s election to use the Medicare fee schedules as the basis for calculating reimbursements....

...estion of great public importance to this Court. 2 *150 We rephrase the certified question 3 as follows: WITH RESPECT TO PIP POLICIES ISSUED AFTER JANUARY 1, 2008, MAY AN INSURER LIMIT REIMBURSEMENTS BASED ON THE MEDICARE FEE SCHEDULES IDENTIFIED IN SECTION 627.736(5)(a), FLORIDA STATUTES, WITHOUT PROVIDING NOTICE IN ITS POLICY OF AN ELECTION TO USE THE MEDICARE FEE SCHEDULES AS THE BASIS FOR CALCULATING REIMBURSEMENTS? We have jurisdiction....

...For the reasons more fully explained below, we agree with all of the appellate court decisions that have addressed this issue, and we therefore answer the rephrased certified question in the negative. We conclude that notice to the insured, through an election in the policy, is necessary because the PIP statute, section 627.736, requires the insurer to pay for “reasonable expenses ... for medically necessary ... services,” § 627.736(l)(a), Fla. Stat., but merely permits the insurer to use the Medicare fee schedules as a basis for limiting reimbursements, see § 627.736(5)(a)2., Fla....

...Because the GEICO policy has since been amended to include an election of the Medicare fee schedules as the method of calculating reimbursements, and the Legislature has now specifically incorporated a notice requirement into the PIP statute, effective July 1, 2012, see § 627.736(5)(a)5., Fla....

...et. In response to the $3600 charges submitted by Virtual Imaging, GEICO paid the bill on December 14, 2008, but limited its reimbursement to eighty percent of 200% of the applicable Medicare fee schedule, in accordance with the formula described in section 627.736(5)(a), Florida Statutes, which provides as follows: 1....

...The insurer may limit reimbursement to 80 percent of the following schedule of maximum charges: [[Image here]] f. For all other medical services, supplies, and care, 200 percent of the allowable amount under the participating physicians schedule of Medicare PartB. § 627.736(5)(a), Fla....

...ty court issued an order granting Virtual Imaging’s motion for final summary judgment and certifying the following question to the Third District: MAY AN INSURER LIMIT PROVIDER REIMBURSEMENT TO 80% OF THE SCHEDULE OF MAXIMUM CHARGES DESCRIBED IN F.S. 627.736(5)(a) IF ITS POLICY DOES NOT MAKE A SPECIFIC ELECTION TO DO SO? On appeal and in reliance on its previous decision in Virtual I, the Third District affirmed the county court’s order....

...The No-Fault Law’s stated purpose is “to provide for medical, surgical, funeral, and disability insurance benefits without regard to fault, and to require motor vehicle insurance securing such benefits.” See § 627.731, Fla. Stat. (2008). The PIP statute, codified in section 627.736, is “an integral part of the no-fault statutory scheme.” Flores v....

...This statutory provision “requires motor vehicle insurance policies issued in Florida to provide PIP benefits for bodily injury ‘arising out of the ownership, maintenance, or use of a motor vehicle.’ ” Holy Cross, 961 So.2d at 332 (quoting § 627.736(1), Fla....

...Co., 774 So.2d 679, 683-84 (Fla.2000) (quoting Gov’t Emps. Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987)). Since its inception in 1971, the PIP statute has required insurers to provide coverage for reasonable expenses for necessary medical services. See § 627.736(l)(a), Fla....

...beginning November 1, 2001, “allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services shall not exceed 175 percent of the allowable amount under Medicare Part B.” § 627.736(5)(b)5., Fla....

...Stat. (2008) (emphasis supplied). For emergency services and care provided by a licensed hospital, for instance, the 2008 amendments provided that an insurer could limit reimbursement to “75 percent of the hospital’s usual and customary charges.” § 627.736(5)(a)2.b., Fla. Stat. (2008). With respect to other medical services and care, such as the MRIs that are the focus of this case, the 2008 amendments provided that an insurer “may limit reimbursement” in accordance with the Medicare fee schedules. See § 627.736(5)(a)2.f., Fla....

...es specified in this paragraph. A policy form approved by the office satisfies this requirement. If a provider submits a charge for an amount less than the amount allowed under subparagraph 1., the insurer may pay the amount of the charge submitted. § 627.736(5)(a)5., Fla....

...cal benefits. — Eighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices, and medically neces *155 sary ambulance, hospital, and nursing services. § 627.736, Fla....

...nd rules adopted thereunder which are in effect at the time such services, supplies, or care is provided. Services, supplies, or care that is not reimbursable under Medicare or workers’ compensation is not required to be reimbursed by the insurer. § 627.736, Fla....

...ayments accepted by the provider involved in the dispute, and reimbursement levels in the community,” as well as “various federal and state medical fee schedules” and “other information relevant to the reasonableness of the reimbursement.” § 627.736(5)(a)l., Fla....

...This provision, adopted in the 2008 amendments, states that an insurer “may limit reimbursement” for certain services rendered, such as MRIs, to “200 percent of the allowable amount under the participating physicians schedule of Medicare Part B.” § 627.736(5)(a)2.f., Fla....

...medical expenses coverage mandate, but did not set forth the only methodology for doing so. The 2008 fee schedule amendments used the word “may” to describe an insurer’s ability to limit reimbursements based on the Medicare fee schedules. See § 627.736(5)(a)2., Fla....

...that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services shall not exceed 175 percent of the allowable amount under the participating physician fee schedule of Medicare Part B.” *157 § 627.736(5)(b)5., Fla....

...insureds as to whether to limit reimbursements based on the Medicare fee schedules or whether to continue to determine the reasonableness of provider charges for necessary medical services rendered to a PIP insured based on the factors enumerated in section 627.736(5)(a)l. In other words, we do not conclude that payment under section 627.736(5)(a)2. could never satisfy the PIP statute’s basic “reasonable expenses” coverage mandate, set forth in section 627.736(1). 8 Instead, what we conclude is that the fee schedule payment calculation methodology in section 627.736(5)(a)2....

...benefits in the insured’s policy— regarding the amount of PIP coverage the insurer will provide. Judge Gross cogently articulated this reasoning in Kingsway as follows: The applicable policy made no reference to the permissive methodology of subsection 627.736(5)(a)2....

...The policy cites the No-Fault Act, states it will pay “80% of medical expenses,” and defines medical expenses as those that it is required to pay “that are reasonable expenses for medically necessary ... services.” That is the language of subsection 627.736(l)(a), which is amplified by subsection 627.736(5)(a)l. The policy does not say it will pay 80% of 200% of Medicare Part B Schedule as provided in subsection 627.736(5)(a)2....

...s of the Florida Motor Vehicle No-Fault Law, as revived and amended by this act. § 627.7407(2), Fla. Stat. (2008). We disagree and adopt the reasoning set forth by the Fourth District in Kingsway. Because the fee schedule provision of sec *159 tion 627.736(5)(a)2.f....

...statute alters the fact that the insurer cannot take advantage of the Medicare fee schedules to limit reimbursements without notifying its insured by electing those fee schedules in its policy. In other words, the Medicare fee schedules set forth in section 627.736(5)(a)2. provide an option for insurers, not the method of how the insurer exercises this option. In order to exercise the option, the insurer must provide notice in the policy of its election to use the fee schedules. Subsection 5 of section 627.736(5)(a), Florida Statutes (2008), further supports this conclusion....

..., or care may not bill or attempt to collect from the insured any amount in excess of such limits, except for amounts that are not covered by the insured’s personal injury protection coverage due to the coinsurance amount or maximum policy limits. § 627.736(5)(a)5., Fla....

...to describe an insurer’s ability to limit reimbursements in accordance with the Medicare fee schedules indicates that an insurer is not required to use those schedules. As the Fourth District explained in Kingsway, 63 So.3d at 67 , the language in section 627.736(5)(a)5....

...Pete, Inc. (a health care services provider). . The question certified by the Third District was 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, *150 EVEN IF THE POLICY DOES NOT CONTAIN A PROVISION SPECIFICALLY ELECTING THOSE SCHEDULES RATHER THAN "REASONABLE MEDICAL EXPENSES” COVERAGE BASED ON SECTION 627.736(l)(a)? Virtual II, 90 So.3d at 324 ....

...ical expenses" coverage, as the question certified by the Third District frames the issue, but whether the insurer can use the Medicare fee schedules as a method for calculating the "reasonable medical expenses” coverage the insurer is required by section 627.736 to provide, when the policy does not provide notice of the insurer’s election to use the fee schedules. . See ch.2012-197, § 10, Laws of Fla. . The Legislature subsequently amended section 627.736(5)(a)2.f....

...limit reimbursement according to the parameters of subsection (5)(a)(2).” Although we agree that there are two payment methodologies for satisfying the PIP statute’s coverage mandate, we emphasize that we do not conclude that limiting reimbursement pursuant to section 627.736(5)(a)2....

...United Automobile Insurance Company ("United Auto") petitions for a writ of certiorari, pursuant to Article V, section 4(b) of the Florida Constitution and Florida Rule of Appellate Procedure 9.030(b)(2)(B), to quash a decision of the Circuit Court Appellate Division holding that a medical report, produced in accordance with section 627.736(7)(a), Florida Statutes (2005), as a precondition to withdrawal of PIP benefits, must be based on a physical examination performed by a physician, other than the treating physician, who conducts an independent medical examination....

...Davis was treated at the Metro Injury & Rehab *899 Center ("Metro"), and she assigned to Metro her right to benefits under the policy. On September 15, 2005, United Auto notified Ms. Davis that it was denying payment of Metro's bills on the authority of section 627.736(7)(a), based on a report of Dr....

...A valid report is one that is prepared and signed by the physician examining the injured person or reviewing the treatment records of the injured person and is factually supported by the examination and treatment records if reviewed and that has not been modified by anyone other than the physician. § 627.736(7)(a), Fla....

...United Auto filed a motion for summary judgment based on an affidavit of Dr. Goldberg, which it attached in support of its motion. The trial court granted Metro's motion for summary judgment concluding that Dr. Goldberg's peer review report was not a "valid report" under section 627.736(7)(a) because it was neither based upon nor factually supported by an independent medical examination. The circuit court affirmed the summary judgment in favor of Metro holding that "[a] report based only upon a review of the records of the insured's treating physician is not a valid report within the meaning of section 627.736(7)(a)." United Auto petitions this Court for a writ of certiorari reversing the holding of the circuit court....

...rly established law by refusing to follow United Automobile Insurance Co. v. Bermudez, 980 So.2d 1213 (Fla. 3d DCA 2008), and instead applied incorrectly rules of statutory *900 construction to interpret the meaning of the term, "valid report" under section 627.736(7)(a)....

...Metro argues that the holding in Bermudez does not apply to the facts before us, and, therefore, the circuit court applied the correct law. We agree with United Auto and follow our holding in Bermudez, wherein we interpreted the meaning of "valid report" under section 627.736(7)(a). Bermudez, after being involved in a car accident, sought medical treatment for her injuries. After bills had been submitted to United Auto for payment, United Auto obtained a report from Dr. Peter Millheiser in accord with section 627.736(7)(a)....

...In construing whether this was a "valid report" under the statute, we found that a "valid report" for the withdrawal of PIP benefits does not have to be based upon a physical examination conducted by the actual physician preparing the report. Instead, we held that, under section 627.736(7)(a), a "valid report" for the withdrawal of PIP benefits "may be based on a physical examination of the insured that is conducted by either the physician preparing the report or another physician's examination." Bermudez, at 1215 (emphasis added)....

...the insured. He or she may base the report on another physician's examination whether an IME or an examination conducted by the treating physician. We follow our prior holding in Bermudez, and hold that, in order to constitute a "valid report" under section 627.736(7)(a), the physician who issues the report must be a physician who examines the insured or, excluding the treating physician, a physician who reviews the examination and treatment records of the insured....

...Goldberg's opinion that a battery of x-rays, a series of physical therapy and an office visit were unreasonable, unnecessary, or unrelated to the accident. [2] At oral argument, this Court raised the question of whether, in fact, instead of being a question of the interpretation of the "valid report" provision of section 627.736(7)(a), the proper analysis should have been pursuant to section 627.736(4)(b). Neither party raised this issue below or in their briefs and the opinion of the Appellate Division of the Circuit Court addressed the issue as a 627.736(7)(a) question. Thus, we will issue this opinion based on an analysis of the 627.736(7)(a) issue presented....

...The force of the impact caused the parked car to collide with the bus bench, pinning Ms. Rowell between the bus bench and the second car. The plaintiff brought suit against both the insurance carriers involved in this appeal seeking PIP benefits under the provisions of Fla. Stat. § 627.736(4)(d)(4), F.S.A., which reads: "(d) The insurer of the owner of a motor vehicle shall pay personal injury protection benefits for: "4....

...3d DCA 1993), mistakenly conducted its analysis under the PIP statutory scheme. This is significant, because the PIP statute contains a penalty for an unreasonable refusal to attend a CME. It imposes a bar on the recovery of "subsequent personal injury protection benefits." § 627.736(7)(b), Fla....

...and I hardly think there is any insurer that would. The concurring opinion misreads the decision in Custer Medical Center v. United Automobile Insurance Co., 62 So.3d 1086 (Fla.2010). In that case, the court was concerned with a PIP statute found in section 627.736(4)(b) that states PIP payments for bills submitted become overdue after 30 days....

...The requested examination in Custer was not scheduled until long after this period had expired and the bills were overdue. The PIP statute further provides that refusal to attend an examination eliminates the insurer's liability "for subsequent ... benefits." § 627.736(7)(b), Fla....

...he Majority's Misreading Of Those Opinions I disagree with the majority's reading of the cases relied upon by State Farm and cited in the original panel opinion. The majority primarily argues that they were decided based on the PIP provision in *829 section 627.736(7)(b), which states that failure to attend a physical or mental examination may prevent further payment of PIP benefits....

...The court in Custer discussed the forfeiture provisions in the PIP statute, which provide that "[i]f a person unreasonably refuses to submit to an examination, the personal injury protection carrier is no longer liable for subsequent personal injury protection benefits." Id. at 1096 (emphasis in original) (quoting § 627.736(7)(b), Fla....

...central to the claims," id. ( citing Brooks v. Blue Cross & Blue Shield of Fla., Inc. , 116 F.3d 1364 , 1369 (11th Cir. 1997) ). III. Discussion This case presents a question of interpretation of the Florida No-Fault ("PIP") Statute, Fla. Stat. § 627.736 (2012 to date). Fla. Stat. § 627.736 sets forth a basic coverage mandate which requires every PIP insurer to reimburse 80% of reasonable expenses for medical services....

...reimbursements to satisfy the PIP mandate: (1) the "reasonableness is a fact dependent inquiry" methodology prescribed under Florida Statutes subsection § 627.726(5)(a); 2 and (2) the "schedule of maximum charges" provided under Florida Statutes subsection 627.736(5)(a)1....

...properly elected the "schedule of maximum charges." The parties agree that Progressive is entitled to limit reimbursement for medical expenses based on the "schedule of maximum charges" contained in Section (5)(a) of the PIP Statute. See Fla. Stat. § 627.736 (5)(a)....

...under CPT code 98940. The "schedule of maximum charges" limits payment for the chiropractic services rendered by Plaintiff to "200 percent of the allowable amount under" the "participating physicians fee schedule of Medicare Part B." See Fla. Stat. § 627.736 (5)(a) 1.f.(I)....

...Plaintiff asserts that the Defendant misinterpreted what is the Medicare Part B Physicians Schedule and misapplied the CMS Payment Files instead, which resulted in improper, unauthorized reductions by 2% for each unit of a chiropractic manipulation. The Court agrees. Notwithstanding that no provisions of Fla. Stat. § 627.736 (5)(a) 1 nor of the relevant portions of the federal regulations permit private payers, such as Defendant Progressive, to reduce payment to chiropractors treating under chiropractic fee codes 98940, 98941 and 98942 by two percent (2%), Def...

...ction because those values were calculated into the CMS payment files. Regardless of whether it was easier for a private payer to use those values rather than calculate the formula once a year, such reduction is contradicted by the plain language of § 627.736(5)(a) 1, which clearly allows an insurer to limit reimbursement to medical care to the treating chiropractor to "200 percent of the allowable amount under" the "participating physicians fee schedule of Medicare Part B." See Fla. Stat. § 627.736 (5)(a) 1.f.(I)....

...Goldstein , No. 15-CV-62113, 2015 WL 10324134 , at *3 (S.D. Fla. Dec. 21, 2015) (citations omitted). Finally, Defendant claims that Plaintiff has failed to allege class-wide compliance with the PIP statute's pre-suit notice requirement. See Fla. Stat. § 627.736 (10) ("As a condition precedent to filing any action for benefits under this section, written notice of an intent to initiate litigation must be provided to the insurer.")....

...ims. See Bristol W. Ins. Co. v. MD Readers, Inc. , 52 So.3d 48 , 51 (Fla. 4th DCA 2010). See also A&M Gerber Chiropractic LLC v. Geico Gen. Ins. Co. , No. 16-CV-62610, 2017 WL 850177 , at *2 (S.D. Fla. Mar. 3, 2017) (statutory notice pursuant to § 627.736(10) not required in action for declaratory relief). Additionally, as to the claim for breach of contract, Plaintiff has adequately pled compliance. See [DE 1] at ¶ 88 ("The Plaintiff and the Class members satisfied the pre-suit requirements of Fla. Stat. § 627.736 (10) because Plaintiff and the Class members sent Defendant pre-suit demand letters prior to instituting this action.")....

...DONE AND ORDERED in Chambers in Fort Lauderdale, Broward County, Florida this 3rd day of April, 2018. All facts set forth in the background are according to the allegations of the Complaint [DE 1], which the Court assumes as true for purposes of this Motion. Formerly subsection 627.736(5)(a)(1) under the 2008 version of the PIP statute. Formerly subsection 627.736(5)(a)(2) under the 2008 version of the PIP statute....

...The trial court granted Barth's motion for summary judgment, determining her injuries arose out of the operation, maintenance, or use of her vehicle, and State Farm appealed. We agree with the trial court finding sufficient connection between the vehicle and the injury and therefore affirm. Pursuant to section 627.736(1), Florida Statutes (1987), State Farm's policy provides personal injury protection benefits "for loss sustained ......

...The attack on Barth arose out of the use of the vehicle. AFFIRMED. GRIFFIN, J., concurs. COWART, J., dissents with opinion. COWART, Judge, dissenting. THE QUESTION IS: Does an insurance policy, providing personal insurance protection (PIP) coverage pursuant to section 627.736(1), Florida Statutes, for bodily injury "arising out of the ownership, maintenance or use of a motor vehicle" apply to personal injuries to a person seated in the driver's seat of a vehicle parked with its engine off when the injuries resulted solely from a criminal assault by a third person? In Reynolds v....

...Novak held that this required causal nexus is not "proximate cause" but the opinion in Novak failed to articulate the exact nature of the required nexus, in theoretical terms, helpful in resolving other cases as distinguished from the facts in Novak. Surely a proper understanding and analysis of the reason for the statute (§ 627.736(1), Fla....

...mobile and that the stepfather had failed to procure no-fault insurance coverage on his own car. It argues that since the stepfather's vehicle was not so insured Farley was required to look to his stepfather as an "insurer" under the provisions of §§ 627.736(4)(d) 4. and 627.733(4), F.S. 1971. Following a non-jury trial, the court entered judgment for Gateway. We reverse. As material here, § 627.736(4)(d) 4., supra, reads in part as follows: "(d) [Gateway] [t]he insurer of [Hamilton] the owner of a motor vehicle shall pay personal injury protection benefits for: * * * * * * 4....

...person [Farley] while occupying the owner's motor vehicle ... provided the injured person is not himself: a. The owner of a motor vehicle with respect to which security is required ... or b. Entitled to personal injury benefits from the insurer of [Ryan] the owner of such a motor vehicle." Section 627.736(4)(d) 3., F.S....

...1971, is relevant; and that, as applied here, provides: "(4) An owner [Ryan] of a motor vehicle with respect to which security is required ... who fails to have such security in effect at the time of an accident shall have no immunity from tort liability, but shall be personally liable for the payment of benefits under § 627.736....

...sonably limiting the amount of damages which could be claimed. The interpretation placed upon the act by the court below in the factual context of this case had the effect of reducing the scope of insurance coverage. Secondly, the obvious reason for § 627.736(4)(d) 4.b., supra, relating to coverage under another owner's policy, is to prevent an injured party from receiving a windfall by collecting benefits from the insurance carrier for the owner of the vehicle in which he is riding at the time...

...This may in some cases be a distinction without a difference, but nevertheless the fact that because of his failure to buy insurance one may be liable under the act for the payment of benefits does not make him an "insurer" as such under the provisions of § 627.736(4)(d) 4., first hereinabove set forth....

...is his. On June 14, 1982, plaintiff's attorneys notified Bankers that plaintiff was requesting that the entire $10,000 no-fault insurance benefits available to him be reserved to pay disability benefits, rather than medical benefits, as provided by section 627.736(1)(b), Florida Statutes (1981)....

...From the undisputed facts as presented, the trial court found that State Farm owed the Plaintiff a total amount of $20,000 in PIP benefits ($5,000 for each automobile) and medical payments coverage of $3,000 ($1,000 for each of three vehicles). Florida Statutes § 627.736(2)(a) provides in pertinent part: "Required personal injury protection benefits; exclusions; priority * * * * * * (2) Authorized exclusions....

...Respondent Amy Walden was injured in an automobile accident in November 1996. She made a claim for personal injury protection (PIP) benefits under the policy issued by Peachtree. Peachtree paid the medical bills submitted by Walden, but later scheduled her for an independent medical examination as permitted under section 627.736(1)(a) and (7)(a), Florida Statutes....

...f action then the unintended result may be that some insurance companies will cancel benefit payments to their PIP insured and only resume making payments to those who question the denial." Peachtree timely filed its petition for writ of certiorari. Section 627.736(4)(b), Florida Statutes, provides in part: "Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered...

...tate Farm was not legally liable to *1001 the insured in any manner and that State Farm never paid the insured anything. Nevertheless, because of our disposition of this case, those matters are moot. The original 1972 "no-fault" statutes provided in section 627.736(1), Florida Statutes, for PIP benefits of 100 percent of medical expenses and 100 percent of lost earnings up to a limit of coverage of $5,000. Section 627.737, Florida Statutes, gave exemption from tort liability to the extent of the PIP benefits payable under section 627.736(1), Florida Statutes, and provided that if certain thresholds relating to permanency and seriousness were met the injured party could recover from the tortfeasor for pain, suffering, mental anguish and inconvenience....

...ing suit for the remainder. (emphasis supplied) Section 627.737(1), Florida Statutes, undertakes to exempt a tortfeasor from tort liability for damages because of bodily injury caused by a motor vehicle only "to the extent that benefits described in s. 627.736(1) are payable for such injury, or would be payable but for any [authorized] exclusion......

...." Therefore, under the statutes cited and Lasky and Chapman, without meeting the thresholds in section 627.737(2), Florida Statutes, the tortfeasor and his liability carrier, here State Farm, is liable to the injured party for the 20 percent of medical expenses not payable under the PIP coverages provided by section 627.736(1)(a) and the 40 percent of lost gross income and earning capacity not payable under the PIP coverage provided by section 627.736(1)(b), Florida Statutes, and for 100 percent of those damages as exceeds the applicable policy limits....

...Liberty Mutual Insurance Co., 152 N.J. Super. 371, 377 A.2d 1234, 1237-1238 (N.J.Law Div. 1977). We reverse the judgment and remand for entry of judgment in favor of the insurer. REVERSED AND REMANDED. SHARP, J., and WOLFMAN, STANLEY, Associate Judge, concur. NOTES [1] See § 627.736(1), Fla. Stat. (1983). [2] See § 627.736(1)(a), Fla. Stat. (1983). [3] See § 627.736(1)(b), Fla....

...g that she was entitled to be paid more than 34.5 cents per mile for medical transportation costs. Malu sought declaratory relief and damages for breach of contract based upon a violation of the PIP statute of the Florida Motor Vehicle No-Fault Law, section 627.736, Florida Statutes (2001)....

...rt, the Fourth District could apply the tipsy coachman rule. [3] Petitioners next argue that even if the tipsy coachman rule was properly invoked, the alternative theory upon which *74 the district court justified affirmance was incorrect. We agree. Section 627.736(1)(a), Florida Statutes (2003), states: Medical benefits....

...However, in light of the statute's wording calling for reimbursement of " all reasonable expenses" and its stated purpose to provide insurance benefits covering a broad range of medically necessary services, we conclude that the inclusion of ambulance expenses in section 627.736(1)(a) should not be read to exclude other reasonable travel expenses incidental to the medically necessary services set out in the statute....

...Interpreting the statutory language to include such travel expenses is consistent with effectuating this legislative purpose. This same question was answered seventeen years ago by the Fifth District Court of Appeal in Hunter under a previous version of section 627.736(1)(a)....

...On the basis of Mobley's rationale and the principle that such provisions should be construed broadly in favor of coverage, the Hunter court held that the cost of transportation to medical providers constitutes a "reasonable expense for necessary medical service," properly reimbursable under section 627.736(1)(a)....

...r changes. [5] The Legislature is presumed to be acquainted with judicial constructions of a statute when it subsequently reenacts the statute. Collins Inv. Co. v. Metro. Dade County, 164 So.2d 806, 809 (Fla.1964). Thus, when the Legislature revised section 627.736, it presumably was aware of the Fifth District's decision in Hunter....

...I cannot agree that a plain reading of the PIP statute at issue requires reimbursement of transportation costs incurred in connection with medical treatment that is reasonably medically necessary. Therefore, I would affirm the results in Malu and Padilla and disapprove the decision in Hunter. Section 627.736(1)(a) specifically provides for the payment of "reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices, and medically necessary ambulance, hospital, and nursing services." § 627.736(1)(a), Fla....

...medically necessary service), the majority's interpretation necessarily reads the statute to require payment of any other reasonable expenses incurred to obtain services expressly covered under the statute. In other words, the majority's reading of section 627.736(1)(a) does not limit the duty to pay expenses incurred "in connection with medical treatment" to transportation expenses....

...However, I cannot agree with Justice Lewis's suggestion that my interpretation of the plain meaning of the statute would encourage citizens to use ambulance services or other medical transportation systems instead of their *78 own vehicles. The statute plainly addresses this situation. Section 627.736(1)(a) only authorizes payment for "medically necessary ambulance" services....

...The medically unnecessary use of ambulances would not be reimbursable. Accordingly, I would affirm the result of the decisions in Malu and Padilla and hold that payment of transportation costs incurred in connection with obtaining reasonably necessary medical treatment is not mandated by section 627.736, Florida Statutes....

...s were compensable under the statute. Hunter, 498 So.2d at 516. The trial court was bound to follow Hunter since it was the only district court decision that had pronounced a ruling on the issue. Pardo v. State, 596 So.2d 665, 666-67 (Fla.1992). [4] Section 627.736(1)(a) was amended in 2001 to include the word "medically" before the word "necessary" in two places and to add the final clause that now appears in the statute. See ch.2001-271, § 6, at 2929, Laws of Fla. At the time Hunter was decided, section 627.736(1)(a), Florida Statutes (1985), provided: (a) Medical benefits....

...ured person who relies upon spiritual means through prayer alone for healing, in accordance with his religious beliefs. [5] See supra note 4. [6] Respondents argue that the addition of the word "medically" before "necessary" in the 2001 revisions to section 627.736 refutes the argument that the Legislature approved of the Fifth District's interpretation of the statute....

...rsonal injury protection benefits under Caldwell's policy on the ground that the passenger (appellant), as the owner of an automobile in respect to which security was required, was made ineligible for benefits under Caldwell's policy by operation of § 627.736(4)(d) 4a, F.S....

...t: (a) Appellant's vehicle shall have been one "required to be registered and licensed in Florida" (see F.S. 320.35), and (b) appellant shall have been the owner of a motor vehicle "with respect to which security is required under [this Act]" (see F.S. 627.736(4)(d) 4 a.) Had appellant's motor vehicle been inoperable or had it been in storage it would not have been a vehicle required to be registered and licensed in Florida....

...Further, had appellant's motor vehicle been one operated exclusively on private property (as distinguished from "over the public streets or highways of this state") it would not have come within the definitional requirement of F.S. 320.35 as being required to be registered and licensed in the State. However, F.S. 627.736(4)(d) 4 a unambiguously denies to an injured passenger in an insured car the personal injury protection benefits otherwise afforded by the owner's policy if the injured passenger himself owns a motor vehicle which is required to be registered and licensed in Florida. The Act remits the injured passenger to benefits afforded by the policy which he necessarily obtained to satisfy Act requirements in respect to his own motor vehicle. Sec. 627.736(4)(d) 1, F.S....

...Co., Fla.App.2d 1974, 302 So.2d 177, relied on by appellant, interpreted a materially different provision of the Act and cannot be applied to govern the decision in this case. There, the injured passenger to whom the owner's insurer wished to deny personal injury protection benefits by virtue of § 627.736(4)(d) 4 b was held entitled to the payment of such benefits by the owner's insurer notwithstanding that the passenger was conceivably "entitled to collect personal injury benefits from" his stepfather, who owned an uninsured motor vehicle and therefore became a self insurer....

...the examination was scheduled to occur in Daytona Beach, even though the statute provides that "[s]uch examination shall be conducted within the municipality of residence of the insured or in the municipality where the insured is seeking treatment." § 627.736(7)(a), Fla....

...d from all liability for PIP payments; rather, the statute provides that "[i]f a person unreasonably refuses to submit to an examination, the personal injury protection carrier is no longer liable for subsequent personal injury protection benefits." § 627.736(7)(b), Fla....

...Maldonado for injuries sustained when he was struck by a vehicle that Allstate insured. The county court certified as a question of great public importance whether a person's status as an illegal alien should be admissible in this context. We conclude that the residence requirement in section 627.736(4)(d)(4), Florida Statutes (1993), is intended by the legislature as a pure residence requirement, and not as a requirement for domicile, legal residence, or citizenship....

...rtify the admissibility of illegal alien status to this court. II. THE TERM "RESIDENT" AND ITS RELATIONSHIP TO CITIZENSHIP AND DOMICILE DEPEND UPON THE CONTEXT IN WHICH THE TERM IS USED The residency requirement at issue in this case is contained in section 627.736(4)(d)(4)....

...sed. III. FLORIDA'S MOTOR VEHICLE NO FAULT LAW In this case, the term "resident" is used to accomplish the purposes and goals of the Florida Motor Vehicle No-Fault Law, which is codified at sections 627.730 through 627.7405, Florida Statutes (1993). Section 627.736(1) requires that virtually every insurance policy issued in Florida provide personal injury protection benefits for (a) the named insured, (b) relatives residing in the household of the named insured, (c) passengers in the insured automobile, and (d) "other persons struck by such motor vehicle." Thus, subsection (1) of this statute places no Florida residency restriction upon the receipt of these benefits. The residency requirement contained in subsection 627.736(4)(d)(4) is primarily intended to determine which insurance company should pay personal injury benefits *469 to injured claimants and their health care providers....

...sehold with the owner of a Florida automobile. In our motorized society, subsection (4)(d) addresses a small fraction of the people who live in Florida. To understand why the legislature placed any state residency requirement in subsection (4)(d) of section 627.736 in 1971, one must look at the overall operation of the no-fault law....

...Indeed, a no-fault threshold for property claims was found to be unconstitutional by the supreme court. See Kluger v. White, 281 So.2d 1 (Fla.1973). The quid pro quo that allowed the nofault statute to survive this constitutional challenge was found both in the payment of personal injury benefits under section 627.736 and in the immunity provided under section 627.737....

...Unless a car is already registered in another state, even a nonresident often must register a car in Florida. See §§ 320.37, 320.38, Fla. Stat. (1993). *470 In this context, the legislature's creation of a residency requirement in subsection (4)(d)(4) of section 627.736 must be read narrowly as a pure residency requirement and not a requirement that includes elements of either domicile or citizenship....

...Bailey's claim did not trigger a duty to investigate by Liberty. On its face, her initial claim demonstrated that Ms. Bailey was not entitled to premium waivers. Furthermore, Liberty had no statutory obligation to investigate the facially insufficient claim. See § 627.425; cf. § 627.736(4)(b); Ivey v....

...policy did not provide personal injury protection benefits to the named insured, i.e., appellee, while occupying a motor vehicle of which he was the owner and which was not the insured motor vehicle under the policy. This exclusion is authorized by § 627.736 (2), Fla....

...As the truck picked up speed, the wind velocity accelerated and Douglas and the mattress were lifted by the wind out of the truck onto the roadway. Douglas was injured as a result of his body coming into contact with the surface of the roadway. Sections 627.736(1) and 627.736(4)(d)(1) and (3), Florida Statutes (1977), govern the disposition of this appeal....

...t of the ownership, maintenance or use of a motor vehicle." The latter provides benefits if one is injured "while occupying a motor vehicle" or "if the injury is caused by physical contact with a motor vehicle." We have previously held that Sections 627.736(4)(d)(1) and (3) must be read in conjunction with Section 627.736(1)....

...The causal connection here was the same as that in National Indemnity Co. v. Corbo, 248 So.2d 238 (Fla. 3d DCA 1971), where the plaintiff, while a passenger, was bitten by a watchdog being transported from a residence to a place of business. The next issue to be considered is the applicability of Sections 627.736(4)(d)(1) and (3), Florida Statutes....

...Iowa Mutual Insurance Company, 163 Mont. 82, 515 P.2d 362 (1973); Whitmire v. Nationwide Mutual Insurance Company, 254 S.C. 184, 174 S.E.2d 391 (1970). See also, Annot., 42 A.L.R.3d 501 (1972); 19 A.L.R.2d 513 (1951). It seems to be an illogical interpretation of Sections 627.736(4)(d)(1) and (3) to afford the protection of occupancy to one who is alighting but has left the vehicle and to deny it to another whose ejection from the vehicle has been involuntary and accidental....

...CURRED? We rephrase the certified question as follows: WHEN A PIP INSURER'S LIABILITY FOR "SUBSEQUENT PERSONAL INJURY BENEFITS" IS DISCHARGED DUE TO THE INSURED'S FAILURE TO ATTEND AN INDEPENDENT MEDICAL EXAMINATION (I.M.E.), UNDER THE PROVISIONS OF SECTION 627.736(a) and (b), FLORIDA STATUTES, DOES THE TERM "SUBSEQUENT PERSONAL INJURY BENEFITS" REFER TO BENEFITS SUBSEQUENTLY PAYABLE UPON THE INSURER'S RECEIPT OF REASONABLE PROOF OF LOSS AND THE AMOUNT OF EXPENSES AND LOSS INCURRED? Pursuant to...

...Security again sent letters to Silva and her attorney rescheduling her appointment for the I.M.E for September 2, 1993. Both letters contained the following language: "Failure to attend this examination could jeopardize your client's eligibility for future benefits in accordance with Florida Statute 627.736 Section 7(b)." Silva did not appear for the September 2 examination....

...of August 27 and that she would not be claiming payment for any medical services rendered after September 2. The Final Judgment awards Silva six-thousand twenty four ($6,024) dollars. The independent medical examination requirement contained within Section 627.736(7)(a)-(b), Florida Statutes (1993), reads, in pertinent part, as follows: Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for p...

...hat it was in doubt about its legal rights and obligations under the contract. The trial court ultimately ruled that Allstate was justified in refusing to pay Tindall because of his refusal to submit to the I.M.E. Addressing the I.M.E requirement of Section 627.736(7)(b), the court stated: [T]he unmistakable intent behind the independent medical examination requirement is to provide the insurance company with an opportunity to evaluate whether the benefits should be paid....

...rther liability for PIP benefits. Id. at 1292 (emphasis added). Finally, in Klipper v. Government Employees Ins. Co., 571 So.2d 26 (Fla. 2d DCA 1990), the Second District Court of Appeal again spoke to this issue: The medical examination provided by 627.736(7), which arises from the contractual relationship between a consumer and the insurer of his choice, is designed to assist the insurer in evaluating whether it is obligated to pay benefits under its policy. Id. at 26 (emphasis added). It is clear to us that the word "benefits" as used in the statute, and in the insurance contract herein, means payments, and not medical treatment as Silva suggests. It is equally clear that the I.M.E. requirement of Section 627.736(7)(b) is intended to give insurers an opportunity to determine the legitimacy of a claim so that an appropriate decision can be made as to whether benefits should be paid....

...ility in favor of Pridgen against his "no-fault" insurer. In view whereof, the partial summary judgment as to liability should be, and the same is hereby, affirmed. BOARDMAN and SCHEB, JJ., concur. NOTES [1] Sec. 627.730, et seq., Fla. Stat. [2] See § 627.736(4)(d)(1), Fla....

...United Automobile Insurance Company ("United") appeals the trial court's order granting summary judgment in favor of the insured, Piedad Bermudez ("Bermudez"). The trial court certified the following question as one of great public importance: IS AN INSURER REQUIRED BY SECTION 627.736(7)(a), FLORIDA STATUTES TO OBTAIN A MEDICAL REPORT BASED UPON A PHYSICAL EXAMINATION OF AN INSURED BEFORE IT MAY WITHDRAW PERSONAL INJURY PROTECTION BENEFITS? We have jurisdiction pursuant to Florida Rule of Appellate Procedure 9.030(b)(4)(A). We rephrase the certified question to read as follows: WHETHER A MEDICAL REPORT ISSUED FOR THE WITHDRAWAL OF PERSONAL INJURY PROTECTION BENEFITS PURSUANT TO SECTION 627.736(7)(a), FLORIDA STATUTES MUST BE BASED UPON A PHYSICAL EXAMINATION OF THE INSURED THAT IS PERSONALLY CONDUCTED BY THE PHYSICIAN ISSUING THE REPORT....

...ds, including physical therapy visits, office visits, ultrasound testing, x-rays, an MRI, and the independent medical examination conducted at the request of United. Based upon Dr. Millheiser's report, United withdrew Bermudez's benefits pursuant to section 627.736(7)(a), Florida Statutes (2006), which provides, in pertinent part: An insurer may not withdraw payment of a treating physician without the consent of the injured person covered by the personal injury protection, unless the insurer first obtains a valid report by a Florida physician licensed under the same chapter as the treating physician whose treatment authorization is sought to be withdrawn, stating that treatment was not reasonable, related, or necessary. § 627.736(7)(a), Fla. Stat. (2006). The trial court granted Bermudez's motion for summary judgment on the basis that United did not satisfy the requirements for withdrawing benefits as set forth in section 627.736(7)(a). Specifically, the trial court found that Dr. Millheiser's report did not constitute a "valid report" under section 627.736(7)(a) because it was *1215 based solely on Dr. Millheiser's review of Bermudez's medical records and was not supported by his own physical examination. Section 627.736(7)(a) provides that a "valid report" is: [P]repared and signed by the physician examining the injured person or reviewing the treatment records of the injured person and is factually supported by the examination and treatment records if reviewed and that has not been modified by anyone other than the physician....

...on or review of the treatment records the physician must have devoted professional time to the active clinical practice of evaluation, diagnosis, or treatment of medical conditions. . . . Id. This language was inserted in the 2001 amended version of section 627.736(7)(a) in an effort to clarify the requirements of physician reports created for the purpose of withdrawing PIP benefits....

...We disagree with the trial court's interpretation of the Senate Staff Analysis and find that a "valid report" for the withdrawal of PIP benefits does not have to be based upon a physical examination conducted by the actual physician preparing the report. Instead, we hold that under section 627.736(7)(a) a medical report issued for the withdrawal of PIP benefits may be based on a physical examination of the insured that is conducted by either the physician preparing the report or another physician's examination. [1] The parties have also alerted us to a recent case from the Second District Court of Appeal, which held that when an insurer seeks to deny a payment for treatment on the basis that the tests were unreasonable and medically unnecessary, section 627.736(7)(a) does not apply and, therefore, a valid report by a reviewing physician is not required. State Farm Mut. Auto. Ins. Co. v. Rhodes & Anderson, D.C., P.A., ___ So.2d ___, ___, 2008 WL 786856 *1 (Fla. 2d DCA Mar. 26, 2008). State Farm held that section 627.736(7)(a) is applicable only in "circumstances involving the complete termination of payments to a physician" rather than the denial of a single claim as was presented in State Farm. Id. at *3, at ___. Instead, according to State Farm, section 627.736(4) is the applicable statute for situations involving a challenge to a claim on the basis that it is unreasonable, unnecessary, or unrelated. Id. at *5, at ___. Both parties believe State Farm's holding is incorrect. We agree. In United Automobile Insurance Co. v. Viles, 726 So.2d 320 (Fla. 3d DCA 1998), a case decided *1216 prior to the 2001 amendment of section 627.736(7)(a), we considered the following certified question as being one of great public importance: In any claim for personal injury protection benefits in which the insurance carrier has withdrawn, reduced benefits[,] or denied further benefits, is it a condition precedent pursuant to Section 627.736(7)(a), Florida Statutes, that an insurer obtain a report by a physician licensed under the same chapter as the treating physician stating that the treatment was not reasonable, related or necessary in order for the insurance carrier t...

...Viles asserted no such limitation. Thus, we reaffirm our holding in Viles that a valid report [2] is required where an insurer attempts to reduce, withdraw, or deny PIP benefits on grounds of reasonableness, necessity, or relationship. Viles, 726 So.2d at 321. Section 627.736(4), which State Farm relied on, entitled "BENEFITS; WHEN DUE," deals with timing as to when PIP benefits that are properly due must be paid by an insurer before they are considered overdue. [3] Contrary to the holding in *1217 State Farm, section 627.736(4) does not deal with challenges to medical treatment on the basis that the treatment is unrelated, unnecessary or unreasonable. [4] Indeed, section 627.736(4) expressly provides that "[t]his paragraph does not preclude or limit the ability of the insurer to assert that the claim was unrelated, was not medically necessary, or was unreasonable. . . ." § 627.736(4), Fla. Stat. (2006). Instead, we find that a withdrawal of PIP benefits on the basis that the medical treatment received was unrelated, unnecessary, or unreasonable is properly dealt with in accordance with section 627.736(7)(a)....

...econd District's opinion in State Farm, and reverse and remand for further proceedings. NOTES [1] The parties agree and we concur that this case involves the withdrawal of PIP benefits and not denial of PIP coverage. [2] Prior to the 2001 amendment, section 627.736(7)(a) did not include any reference to a "valid report" and only required that prior to an insurer "withdraw[ing] payment of a treating physician without the consent of the injured person," the insurer obtain "a report by a physician licensed under the same chapter as the treating physician whose treatment authorization is sought to be withdrawn, stating that treatment was not reasonable, related, or necessary." § 627.736(7)(a), Fla. Stat. (2000). There was no provision stating that the report must rely upon a physical examination of the insured. Id. The 2001 amendment required that an insurer's withdrawal of payment be preceded by the procurement of a "valid report." § 627.736(7)(a), Fla....

...As clearly set forth in the amendment, a "valid report" must be "factually supported by the examination and treatment records if reviewed." Id. As such, a "valid report" requires reliance on a physical examination of the insured prior to an insurer's withdrawal of payment. [3] Section 627.736(4)(b) states, in pertinent part: Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same....

...he charge was in excess of that permitted under, or in violation of, subsection (5). Such assertion by the insurer may be made at any time, including after payment of the claim or after the 30-day time period for payment set forth in this paragraph. § 627.736(4)(b), Fla. Stat. (2006). [4] In AIU Insurance Co. v. Daidone, 760 So.2d 1110 (Fla. 4th DCA 2000), the court found "that the thirty-day period in section 627.736(4) applies only to benefits which are reasonable and necessary as a result of the accident." AIU, 760 So.2d at 1112. Therefore, section 627.736(4) is not applicable if the medical treatment is not reasonable and necessary as a result of the accident and, as such, a claim for unrelated, unreasonable, or unnecessary treatment may be challenged subsequent to the thirty-day time period set forth in section 627.736(4)....

...Prior to trial, Travelers, pursuant to Rule 1.442, RCP, made a timely offer of judgment [2] in the amount of $600 to allow *331 judgment to be taken against it "in favor of plaintiff(s) Maria T. Hernandez, and her attorney, Jerold Hart." This was refused by Hernandez. Pursuant to §§ 627.428 and 627.736(4)(b) and (c), Fla....

...must pay the costs incurred after the making of the offer..." [3] Section 627.428, Fla. Stat., provides for an award of attorneys fees upon the rendition of a judgment or decree in a Florida State Court against an insurer and in favor of an insured. Section 627.736(4)(b), sets out the time period within which personal injury protection benefits must be paid, and if not paid, when they become overdue. Section 627.736(4)(c) provides that all overdue payments shall bear simple interest at the rate of 10 percent per annum....

ch. 2012-197, Laws of Fla. As codified in section 627.736(8), Florida Statutes, this legislative change

...Rehearing, Certification, and Rehearing En Banc Denied January 7, 1997. PER CURIAM. This is an appeal from a final judgment of the county court passing on the following question certified by the county court, albeit restated, to be one of great public importance: WHETHER SECTION 627.736(4)(b), FLORIDA STATUTES, REQUIRES A PIP INSURER TO PAY THE CLAIMED BENEFITS WITHIN THIRTY DAYS OF RECEIPT OF THE CLAIM RATHER THAN WITHIN THIRTY DAYS OF RECEIPT OF MEDICAL VERIFICATION OF THE CLAIM....

...Appellee paid on the wage loss claim on June 7, 1994, which was within thirty days of receiving the disability report. Appellant argues that he is entitled to statutory interest and attorney's fees because appellee made late payment on the wage loss claim. We agree. The relevant statute, section 627.736(4), Florida Statutes (1993), states: BENEFITS; WHEN DUE.—Benefits due from an insurer under ss....

...the insurer, and noted that the plain meaning and intent of the statute "is to guarantee swift payments of PIP benefits." Id. The section of the statute now under consideration is identical to the section that was in effect when Dunmore was decided. § 627.736(4), Fla. Stat. (1973). The legislature has amended section 627.736 twenty-five times since the opinion in Dunmore was released....

...aning. In the absence of any authority on the meaning of subsection (4), the implied adoption by the legislature of the interpretation established in Dunmore is the most persuasive evidence of what the legislature intended. Accordingly, we hold that section 627.736(4)(b), Florida Statutes, requires a PIP insurer to pay the claimed benefits within thirty days of receipt of written notice of the claim....

...ha[s] reduced, omitted, or declined to pay"—denominated by the parties in this case as an "Explanation of Benefits" (EOB)—"within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same," under section 627.736(4)(b), Florida Statutes (2004)....

...policy. Thirteen months later, on April 12, 2005, United Auto responded to A 1st Choice's request for payment with a form EOB in which two boxes were checked, the first stating "Bill(s) Not Submitted to Our Company in Accordance with Florida Statute 627.736(5)," and the second stating, "Other: SEE PEER REV[IE]W ATTACH[ED]. " No attachment accompanied the submission. Two years later, on February 1, 2007, A 1st Choice filed a two-count complaint against United Auto. Count I sought damages for non-payment of benefits required to be paid under section 627.736(4)(b)....

...'s deductible, A 1st Choice voluntarily dismissed that Count. Proceeding on Count II, the trial court granted summary judgment to A 1st Choice and, in its Order Denying Defendant's Motion for Rehearing, recited, "United Auto violated Florida Statute § 627.736(4)(b), and in turn, breached the contract at issue in this matter" by failing to respond to A 1st Choice's request for payment within thirty days....

...On March 23, 2009, the circuit court appellate division affirmed the decision of the trial court without an opinion. ANALYSIS The petition in this case seeks our consideration of two interrelated questions: (1) whether there exists a firm deadline for the provision of an EOB to an insured (or his or her assignee) under section 627.736(4)(b); and (2) if so, whether section 627.736(4)(b) affords the insured (or assignee) a private right of action against his or her insurer for an insurer's failure to meet the deadline....

...In its final judgment, the county court answered both questions in the affirmative, and the circuit court appellate division per curiam decision without opinion necessarily affirmed each of those determinations. On the first question, A 1st Choice urges that section 627.736(4)(b) must be read to require a personal injury protection insurer to respond to any request for payment of benefits under a personal injury protection policy of insurance within thirty days after receiving "written notice... of a covered loss" and "the amount due of same." See § 627.736(4)(b)....

...paid within thirty days]' provided it has `reasonable proof' that it is not responsible for payment."); United Auto. Ins. Co. v. Millennium Diagnostic Imaging Ctr., Inc., 12 So.3d 242, 246 (Fla. 3d DCA 2009) ("The thirty-day time period set forth in section 627.736(4)(b) does not apply to claims for unrelated, unreasonable or unnecessary treatment.")....

...onal injury protection insurance policy and, as well, medically reasonable, related, and necessary—is "overdue" if not paid within thirty days of submission to the insurer of "written notice of the fact of a covered loss and of the amount of same." § 627.736(4)(b); Partners in Health, 21 So.3d at 60....

...Such a loss, by definition, will not be later challengeable. See Santa Fe, 21 So.3d 60. In such a circumstance, the insured is entitled by law to an award of interest on the overdue payment and potentially an award of attorney fees for non-payment if counsel is involved. See § 627.736(4)(c), Fla. Stat. (2004); United Auto. Ins. Co. v. Rodriguez, 808 So.2d 82, 87 (Fla.2001) ("[T]he plain language of section 627.736 provides that an insurer is subject to specific penalties for an `overdue' payment: ten percent interest and attorneys' fees."); Millennium Diagnostic Imaging Ctr., Inc., 12 So.3d at 245....

...This is the manner in which the legislature has chosen to regulate insurers in matters of this type. [1] The failure of the circuit court *128 appellate division to provide relief to United Auto in this case based upon the trial court's misinterpretation of the plain language of section 627.736(4)(b) constitutes a clear departure from the essential requirements of law for which the exercise of our jurisdiction is warranted....

...grant relief in this case, namely that the statutory provision in question does not afford a private right of action. By awarding A 1st Choice one dollar in nominal damages, the county court and circuit court appellate division implicitly found that section 627.736(4)(b) affords a private right of action against an insurer for the insurer's failure to meet the thirty-day deadline for submission of an EOB....

...This paragraph does not preclude or limit the ability of the insurer to assert that the claim was unrelated, was not medically necessary, or was unreasonable or that the amount of the charge was in excess of that permitted under, or in violation of, subsection (5). § 627.736(4)(b)....

...Prudential Health Care Plan, Inc., 843 So.2d 842, 852 (Fla.2003) (emphasis added). See generally *129 Fla. Jur.2d, Actions, § 37; City of Sarasota v. Windom, 736 So.2d 741, 742 (Fla. 2d DCA 1999) ("[W]e must ascertain whether the legislature intended to create a private cause of action...."). There is nothing in the text of section 627.736(4)(b) from which one can deduce that the legislature intended an insured have a private right of action against an insurer for failure to provide an EOB. In fact, the statute only authorizes one cause of action: a cause of action for personal injury protection benefits. See § 627.736(11)....

...exhausted and then only if the workmen's compensation *278 payments received for medical benefits were less in amount than the amount payable under the personal injury protection provision of the Automobile Reparations Reform Act, Florida Statutes, § 627.736....

...be held to cover all medical expenses where applicable and that the insured should be held to a recovery of medical expenses at the rate, and according to the schedule, set out in the workmen's compensation statute. Appellant bases his argument upon Section 627.736(4), Florida Statutes, which reads as follows: "BENEFITS; WHEN DUE....

...Credit is provided for workmen's compensation benefits actually paid primarily because these benefits become payable and collectable in the ordinary course of events earlier than other types of benefits. Inasmuch as the language of the statute (see Section 627.736, Florida Statutes) requires the payment of all reasonable expenses incurred for necessary medical and surgical expenses, we reach the conclusion that the appellant is correct in conceding that workmen's compensation benefits need not be exhausted, but that his position that medical payments should be restricted to those proscribed by the workmen's compensation schedule is not well-taken. There is some ambiguity in Section 627.736(4), Florida Statutes, in that it states that PIP insurance is primary except that benefits received under workmen's compensation shall be "credited" against benefits "provided" under the no-fault law....

...November 12, 1998. Diane H. Tutt of Diane H. Tutt, P.A., Plantation, for petitioner. Laurie S. Moss of Law Offices of Laurie S. Moss, P.A., Davie, and Alan K. Marcus of Law Offices of Alan K. Marcus, P.A., Miami, for respondents. FARMER, Judge. In section 627.736(4)(b), the legislature has provided that personal injury protection (PIP) benefits are "overdue" if they are not paid within 30 days after notice of the loss and the amount of the claim is given to the insurer....

...tration of any claims dispute between the insurer and any provider of medical services who has agreed to accept an assignment of the insured's benefits. The question raised in this petition for certiorari is whether the "30-day overdue" provision of section 627.736(4)(b) is applicable to demands for arbitration under section 627.736(5)....

...ght to benefits under the PIP policy. The providers then sent claims to the insurer. Through its attorney, the *385 insurer denied the claims within 30 days by letter to the providers in which the insurer also demanded arbitration in accordance with section 627.736(5) and named an arbitrator....

...Given the pervasiveness of automobiles and PIP coverage in this state, we deem an erroneous interpretation of this law to be important enough for certiorari. Turning to the substantive issue, it is difficult to understand the plausibility of a holding that arbitration under section 627.736(5) is lost unless a PIP insurer demands it within 30 days of receiving the unpaid bills. The supposed time limitation for demanding arbitration is based on an interpretation of section 627.736(4)(b)'s provision that bills are overdue if unpaid within 30 days of notice of the loss and amount. We think, however, that the providers have simply read too much into the 30-day overdue provision. Section 627.736(4)(b) says that PIP benefits paid under this section "shall be overdue if not paid within 30 days...." Section 627.736(4)(c) says that "[a]ll overdue payments shall bear simple interest at the rate of 10 percent per year." As we understand these two provisions, they merely make the PIP insurer liable for interest on such claims if payment is not made within 30 days from the notice....

...4th DCA 1996) (statute makes claims for PIP benefits overdue when not paid within 30 days from receipt; failure of insurer to pay claim within 30 days subjects insurer to interest on claim). Hence, appropriately read, the function of the statute is to define when interest begins to accrue on unpaid PIP benefits. The text of section 627.736(4) certainly does not mention the arbitration provision in section 627.736(5), which itself also fails to mention the 30 day provision in section 627.736(4)(b)....

...[2] While we are required to read statutes in their entirety, we are not free to add provisions to parts of a statute under the guise of such reading. Consequently, we are unable to agree that there is any 30-day requirement on the enforcement of the subsection (5) arbitration provision. We also note that neither section 627.736(5) nor the policy in question contain any provision as to the time for demanding *386 arbitration....

...Pacheco merely holds that the insured could not be required to submit all supporting medical records before 30 day period for payment began to run. [3] Neither party raised a constitutional question in the trial court, so we have no occasion to pass upon the validity of the arbitration provision in section 627.736....

...State Farm’s insured received medical treatment from Northwoods in September of 2008 and assigned the PIP benefits under her policy, which had an effective date of January 1, 2008, to North-woods. Northwoods billed State Farm, but State Farm reduced the bills to 80% of 200% of the Medicare fee schedule pursuant to section 627.736(5)(a)2., Florida Statutes (2008)....

...granting the motion based *1052 on exhaustion of benefits. In a later final judgment, the court found: In this matter no determination has been made regarding the legal issue of whether [State Farm] was permitted to apply a fee limitation under F.S. § 627.736(5)(a)(2)(f)....

...V RAY, 556 So.2d 811 (Fla. 5TH DCA 1990)? 2. DOES AN INSURER’S RELIANCE ON AN INTERPRETATION OF THE NO-FAULT STATUTE WHICH IS LATER DETERMINED TO BE AN INCORRECT INTERPRETATION CONSTITUTE THE “REASONABLE PROOF” REFERENCED IN THAT PORTION OF F.S. SECTION 627.736(4)(b) WHICH STATES THAT “HOWEVER, NOTWITHSTANDING THE FACT THAT WRITTEN NOTICE HAS BEEN FURNISHED TO THE INSURER, ANY PAYMENT SHALL NOT BE DEEMED OVERDUE WHEN THE INSURER HAS REASONABLE PROOF TO ESTABLISH THAT THE INSURER IS NOT RES...

...its under his policy, which was in effect through March 2008, to Wellness. Wellness submitted a claim to USAA for PIP benefits, but USAA failed to pay the full claim within thirty days. Instead, it reduced the claims using the payment methodology of section 627.736(5)(a)2., Florida Statutes (2008)....

...ad faith claim. Finally, the trial court acknowledged Kings-way Amigo Insurance Co. v. Ocean Health, Inc., 68 So.3d 68 (Fla. 4th DCA 2011), which held that an insurance company must give notice in its policy prior to using the payment methodology in section 627.736(5)(a)2., but noted that Kingsway had not been decided at the time USAA made its payments to Wellness and thus was not controlling....

...Therefore, we continue to adhere to Simon and its progeny. 2. DOES AN INSURER’S RELIANCE ON AN INTERPRETATION OF THE NO-FAULT STATUTE WHICH IS LATER DETERMINED TO BE AN INCORRECT INTERPRETATION CONSTITUTE “REASONABLE PROOF” REFERENCED IN THAT PORTION OF F.S. SECTION 627.736(4)(b) WHICH STATES THAT “HOWEVER, NOTWITHSTANDING THE FACT THAT WRITTEN NOTICE HAS BEEN FURNISHED TO THE INSURER, ANY PAYMENT SHALL NOT BE DEEMED OVERDUE WHEN THE INSURER HAS REASONABLE PROOF TO ESTABLISH THAT THE INSURER IS NOT RES...

...In contrast, under PIP, disputes commonly arise as to the amount due to the provider assignee, based on the policy language or the PIP statutory provisions. The insurance company has the duty to pay only the reasonable expenses for medically necessary care. See § 627.736(l)(a), Fla. Stat. (2008). A medical provider may charge only a reasonable amount for services provided under section 627.736(5)(a), Florida Statutes (2008). Even the assignment executed by USAA’s insured to Wellness limits the assignment to amounts which would be allowed under PIP and section 627.736, when it states that the assignment is “for services rendered to me covered by Personal Injury Protection (PIP) coverage ......

...have been determined to be reasonable and necessary. When the insurance company denies or reduces payment, a dispute arises as to whether the additional amounts are covered by the statute as being either medically necessary or reasonable in amount. Section 627.736(4) sets forth very specific requirements on how the insurance company must treat claims of providers. Even after a claim is denied or reduced, an insurance company may still defend a suit by the provider claiming additional amounts on the grounds that the service was not medically necessary or that the amount was not reasonable. See § 627.736(4)(b), Fla....

...The respondent filed motions for summary judgment in each of the cases, arguing that State Farm was precluded from defending against the respondent's claims for PIP benefits because State Farm denied payment for diagnostic tests before obtaining a valid report under section 627.736(7)(a), Florida Statutes (2003), which requires a valid report based on a physical examination conducted by a similarly licensed physician before payment can be withdrawn. Concluding that the denials of payment in these three cases constitute withdrawals of payment as contemplated by section 627.736(7), the county court entered summary judgment against State Farm....

...State Farm appealed the orders of summary judgment to the circuit court, and the cases were consolidated on appeal. State Farm argued in the circuit court—as it had in the county court—that the denials of payment in the instant cases did not constitute withdrawals of payment under section 627.736(7). State Farm asserted that the denial of payment for a particular bill or service is governed by section 627.736(4)(b), which does not require a physical examination before payment is denied. The circuit court agreed with the county court that section 627.736(7)(a) applies and that State Farm did not obtain valid reports before withdrawing payment to the provider. In its petition for writ of certiorari, State Farm argues that the circuit court's opinion finds no support in section 627.736(7)(a). It claims that State Farm never withdrew payment to the provider or contested the authorization to continue treatment of the insureds and that, therefore, section 627.736(7)(a) was not implicated....

...2d DCA 2007); State Farm Fla. Ins. Co. v. Lorenzo, 969 So.2d 393, 398 (Fla. 5th DCA 2007). B. The Appropriateness of State Farm's Denials of Payment To determine whether State Farm is entitled to relief, we begin by examining the relationship between section 627.736(7)(a)'s specific restriction on "withdraw[ing] payment of a treating physician" and section 627.736(4)(b)'s general provisions regarding payment of PIP benefits. In examining this relationship, we consider one case— United Automobile Insurance Co. v. Viles, 726 So.2d 320 (Fla. 3d DCA 1999)—which applied section 627.736(7)(a), and another case— Allstate Indemnity Co. v. Derius (Derius II ), 773 So.2d 1190 (Fla. 4th DCA 2000)—which declined to apply it. Section 627.736(7)(a) provides: Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury protection insurance benefit...

...lls were fraudulent and not reasonably related to the accident. The insurer had paid a portion of the bills but denied payment on outstanding bills. The insured sought a directed verdict on the basis that the insurer must obtain a valid report under section 627.736(7)(a) before withdrawing payment....

...The county court certified the following question of great public importance: In any claim for personal injury protection benefits in which the insurance carrier has withdrawn, reduced benefits or denied further benefits, is it a condition precedent pursuant to Section 627.736(7)(a), Florida Statutes, that an insurer obtain a report by a physician licensed under the same chapter as the treating physician stating that the treatment was not reasonable, related or necessary in order for the insurance carrier t...

...sician's report before refusing to pay further medical bills." Id. at 321. In Derius II, the court considered the following question of great public importance: Must an insurance company, who seeks to reduce bills for medical treatment[] pursuant to Section 627.736(1)(a), first obtain a report from a physician licensed under the same licensing chapter as the treating physician stating that the bills for treatment are not reasonable, pursuant to Section 627.736(7)(a), Florida Statutes? 773 So.2d at 1191....

...withheld, or reduced." Id. The court stated that the issue on appeal was "whether a PIP insurer must first obtain a report from a like-licensed physician in order to contest the reasonableness of a treating physician's bill." Id. The court held that section 627.736(7)(a) does not "requir[e] a written report as a condition precedent to reducing payment of a bill for treatment on the grounds of reasonableness, necessity or relationship." 773 So.2d at 1191....

...ation of payments or to the withdrawal or termination of authorization for treatment. The court in Viles quoted Derius v. Allstate Indemnity Co. (Derius I ), 723 So.2d 271, 273 (Fla. 4th DCA 1998), which characterized the withdrawal of payment under section 627.736(7)(a) as the "termination of payment." The court in Viles went on to hold that "because [the insurer] failed to comply with the statutory condition precedent, its termination of PIP benefits was ineffective." 726 So.2d at 321 (emphasis added). This supports the conclusion that the denial of one charge is not within the scope of section 627.736(7)(a). Instead, section 627.736(7)(a) covers circumstances involving the complete termination of payments to a physician. This conclusion flows from the relevant language of section 627.736(7)(a), which states that "[a]n insurer may not withdraw payment of a treating physician ..., unless the insurer first obtains a valid report by a Florida physician licensed under the same chapter as the treating physician whose treatm...

...ay (something bestowed or possessed)." Webster's 3d New International Dictionary 2626 (1993). The denial of a single claim for payment does not constitute the withdrawal of a physician's "treatment authorization." By its plain and unambiguous terms, section 627.736(7)(a) does not address situations in which one charge for treatment has been denied by the insurer. The fact pattern presented by the instant case is covered not by section 627.736(7)(a) but by section 627.736(4), which is titled, "BENEFITS; WHEN DUE." Subsection (4)(b) provides: Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same....

...proof that the insurer is not responsible for the claim. It does not require that the insurer obtain a valid report based on an actual examination by a physician. III. Conclusion Here, the circuit court incorrectly interpreted the plain language of section 627.736(7)(a) and failed to apply the correct law, which is set forth in section 627.736(4)....

...However, the PIP statute does not deprive the PIP carrier of its defenses. Indeed, a PIP carrier may dispute a claim based on a coverage defense or on grounds that the medical treatment was not reasonable, necessary or related to the automobile accident. See § 627.736, Fla....

...[9] The legislature did not state that section 627.428 was the only fee authorizing statute which applies in PIP cases, it merely provided that section 627.428 applies in any dispute between an insured and insurer under the Florida Motor Vehicle No-Fault Law. [10] § 627.736(8), Fla....

...I hold the view that the matter is far less complicated, and dissent from the majority opinion. I would affirm the county court's final order denying an award of attorney's fees to U.S. Security. The legislature has spoken clearly and emphatically [15] through section 627.736(8), *1108 Florida Statutes (1997), that a specific treatment will be given to attorney's fees in PIP cases: "Applicability of provision regulating attorney's fees.—With respect to any dispute under the provisions of ss....

...of the insured or beneficiary a reasonable sum as fees or compensation for the insured's or beneficiary's attorney prosecuting the suit in which recovery is had." Conspicuously absent is any provision for attorney's fee awards for insurers. Sections 627.736(8) and 627.428(1) provide a mandatory one-way street for attorney's fee awards in PIP cases....

...take any action to enforce the contract, the court may also allow reasonable attorney's fees to the other party when that party prevails in any action, whether as plaintiff or defendant, with respect to the contract...." No language which would make section 627.736(8) a two-way street for attorney's fees appears in any statute. The majority opinion simply engrafts general language from other statutes onto section 627.428(1), and thus ultimately onto section 627.736(8)....

...e certainty of monetary assistance in a time of an insured's real need. The majority opinion blithely downgrades the value to the insured of the exchange, arguing that because PIP insurers still (after the swap) have some defenses, then, ipso facto, section 627.736(8) is amended sub silencio by section 768.79, the offer of judgment statute....

...e suit in which the recovery is had. § 627.428, Fla. Stat. (1997). [6] In Silva v. U.S. Security Insurance Co., 734 So.2d 429 (Fla. 3d DCA 1999), this Court accepted the certified question: "Does section 768.79 conflict with sections 624.428(1) and 627.736(8)?" The procedural posture of that case, however, precluded us from reaching the question on the merits. [7] The "part" referred to in the statute refers to Part II of chapter 768, Negligence part II is entitled "Damages" and consists of sections 768.71-.81. [8] Section 627.736(8) of the PIP statute provides: Applicability of provision regulating attorney's fees.—With respect to any dispute under the provisions of ss. 627.730-627.7405 between the insured and the insurer, the provisions of s. 627.428 shall apply. § 627.736, Fla....

...[14] Florida Rule of Civil Procedure 1.442(B) provides that a defendant may not serve an offer of judgment/proposal of settlement earlier than 90 days after service of process. [15] Section 627.428(1) by its own terms would apply to PIP cases in the absence of section 627.736(8), as it does in any other dispute between an insured and an insurer. Hence the emphatic nature of 627.736(8).

...thopedic cases in Dade County over a three month period. Moreover, the particular doctor bill herein cannot by statute be "in excess of the amount the person or institution customarily charges for like services ... in cases involving no insurance. " Section 627.736(5), Florida Statutes (1975) [emphasis added]....

...hen it entered the judgment appealed created question of material fact about appellee's bad faith arbitrary refusal to pay; and (2) *1104 that appellee's conduct coupled with appellant's requests for payment constituted bad faith, as contemplated by Section 627.736, Florida Statutes (1977), which entitled him to punitive damages in tort....

...ellee for its alleged bad faith refusal to pay. Under these circumstances, the parties were more in the nature of a debtor-creditor or adversary relationship than in a fiduciary relationship. See Baxter v. Royal Indemnity, 285 So.2d 652 (Fla. 1975). Section 627.736, among other things provides for interest and attorney's fees for an insurance company's failure to pay, but, in our opinion, it does not create a cause of action for punitive damages....

...eclare the rights of the respective parties by construing the insurance coverage question presented by the petition. On remand, the court below should consider, but is not limited to, the following authorities in declaring the rights of the parties: Section 627.736(4)(d)4 a, Florida Statutes (Supp....

...At the time of trial in July 1996, appellant (plaintiff below), argued that section 627.7372, Florida Statutes (1991), which has since been repealed, was applicable to the 1992 incident which was the subject of the trial below. Appellee, to the contrary, maintained that section 627.736, Florida Statutes (1991), was controlling....

...the jury to deduct from its verdict the value of all benefits received by the claimant from any collateral source. (2) For purposes of this section, "collateral sources" means any payments made to the claimant, or on his behalf. (Emphasis supplied). Section 627.736 (3), Florida Statutes (1991), reads in pertinent part: An injured party who is entitled to bring suit ......

...d future benefits is strained. Id. at 1153 (emphasis supplied)(footnote omitted). In the present case we must review our interpretation of the applicability of section 627.7372 to PIP benefits payable upon future claims in light of the more specific section 627.736. This issue came directly before the fifth district in Kokotis v. DeMarco, 679 So.2d 296 (Fla. 5th DCA 1996). There the court found that section 627.736 applies....

...The Kokotis court provides no authority for its broad interpretation of "payable". Without even a dictionary's definition to guide it, the court took an uncharted approach to allow set-offs of future benefits. We find that the Kokotis court was correct to apply section 627.736(3) to the PIP collateral source issue. It relates more specifically to PIP set-offs. While this court was correct in White, when it held that between sections 768.76 and 627.7372, the latter was more applicable, a comparison of section 627.7372 and section 627.736(3) now leads us to the conclusion that section 627.736(3) is the more specific applicable statute....

...In this case there is no reason to either make a decision contrary to the legislature's clear intent or to alter our prior well founded interpretation of the term "payable" in the statute. In summary, we find that the trial court correctly found that section 627.736(3), Florida Statutes (Supp.1992), applies to the facts of this case....

...issues before this court were clearly not frivolous. Finally, because our holding directly conflicts with the fifth district's opinion in Kokotis, we certify to the Florida Supreme Court the following question: WHETHER THE TERM "PAID OR PAYABLE" IN SECTION 627.736(3), FLORIDA STATUTES (SUPP.1996), SHOULD BE DEFINED AS "THAT WHICH HAS BEEN PAID, OR PRESENTLY EARNED AND CURRENTLY OWING" SO THAT THE STATUTORY LANGUAGE OF SECTION 627.736 WILL NOT BE INTERPRETED TO PERMIT ANY REMAINING PERSONAL INJURY PROTECTION BENEFITS TO BE USED FOR SET-OFFS FOR FUTURE COLLATERAL SOURCES....

...DeMarco urges that section 627.7372, the collateral source setoff statute which was in effect at the time of the accident, should control. Kokotis, on the other hand, contends that the case is controlled by section 627.737, Florida Statutes (1991), the tort exemption statute. Section 627.736(3) provides that an injured party shall have no right to recover any damages for which PIP benefits are "paid or payable." Since DeMarco had PIP benefits which were and are available to cover his medical expenses associated with this...

...asor for damages for bodily injury." Id. at 632, 633. The cause of action in this case is a first party claim in contract for failure to pay the contractual obligation for personal injuries sustained, regardless of fault. The coverage is mandated by section 627.736(1), Florida Statutes (1981), in all policies complying with the security requirements of section 627.733, Florida Statutes. With regard to the payment of PIP benefits, section 627.736(4)(b) provides: Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same....

...The insured thereafter filed an action seeking proper payment for the additional injury, and Allstate subsequently agreed to pay the proceeds. Id. Because Allstate conceded that it had initially denied the benefits in error, the insured then requested attorney’s fees pursuant to sections 627.736 and 627.428. Id. The county court denied the fees because, pursuant to section 627.736, the insurance company paid the balance within thirty days of learning it had denied coverage in error....

...Accordingly, Felgenhauer did not waive the set-off of the settlement by failing to raise the issue in a pleading prior to trial. On cross-appeal, Bonds argues that the trial court erred in granting Felgenhauer's motion to set off $10,000 PIP benefits. Section 627.736(3), Florida Statutes (2001), provides for a set-off of PIP benefits as follows: (3) INSURED'S RIGHTS TO RECOVERY OF SPECIAL DAMAGES IN TORT CLAIMS....

...rding the set-off of benefits paid. Caruso v. Baumle, 880 So.2d 540, *1046 542 (Fla.2004). Thus, evidence of PIP benefits must be presented to the jury, and the jury must be instructed to set off the PIP benefits. Id. This implies that set-off under section 627.736(3) must be asserted as an affirmative defense prior to trial....

...ckness or disease. Section 627.737(1), Florida Statutes, provides that no action may be brought to recover damages for bodily injury, sickness or disease to the extent the damages are covered by the insurance (Personal Injury Protection) required by section 627.736(1), Florida Statutes....

...e ownership, maintenance, or use of such motor vehicle ... within the United States or the Dominion of Canada. ..." (emphasis supplied). [2] A provision of the Florida Automobile Reparations Reform Act concerning personal injury protection benefits, § 627.736(4)(d)2., Fla....

...agreed that there were no material facts in dispute and that the issue presented was one of law. The trial court granted Exilus' motion for summary judgment and held that there was PIP coverage. LAW The parties agree that the controlling statute is section 627.736(1), which requires that automobile insurance policies, such as the one involved herein, provide PIP benefits for any "loss sustained ......

...The cases make it clear that some connection or nexus between the injury and the use of the vehicle is required. In Government Employees Insurance Co. v. Novak, 453 So.2d 1116 (Fla. 1984), the Florida Supreme Court stated that the term "arising out of the use of a motor vehicle," as used in section 627.736(1) should be construed liberally because its function is to extend coverage broadly....

...5th DCA 1991). Barth allows for a more liberal interpretation of the court's holding in Novak v. Government Employees Insurance Co., 453 So.2d 1116 (Fla. 1984), than did Reynolds. In Novak the Florida Supreme Court stated that "arising out of" as used in section 627.736(1) did not mean "proximately caused by," but rather had a much broader meaning: "All that is required is some nexus between the motor vehicle and the injury." Novak, 453 So.2d at 1119 (emphasis added)....

...Millennium Diagnostic performed an MRI on Perez, and Perez assigned her right to personal injury protection ("PIP") benefits to Millennium Diagnostic. Millennium Diagnostic, as assignee, sought PIP benefits from United Auto. After payment was not received, Millennium Diagnostic, pursuant to section 627.736(11), Florida Statutes (2003), sent a demand letter notifying United Auto of its intent to initiate litigation....

...Chilito's examination and x-ray reports, and the independent medical examination ("IME") reports prepared by Dr. Pedro Musa-Ris, M.D. and Dr. Michael Weinreb, D.C. On Millennium Diagnostic's motion, the trial court struck Dr. Millheiser's affidavit and report, finding that, within the meaning of section 627.736(7)(a), the report was not a "valid report" because it was not obtained within thirty days of United Auto's receipt of Millennium Diagnostic's claim....

...thereafter entered final judgment in favor of Millennium Diagnostic. The trial court denied United Auto's motion for reconsideration, but certified the following two questions as being of great public importance: *244 (1) AFTER THE 2001 AMENDMENT TO SECTION 627.736(4)(b), FLORIDA STATUTES, MAY TREATMENT BE DENIED BY AN INSURER, PURSUANT TO SECTION 627.736(7)(a), ON THE GROUND THAT THE TREATMENT WAS NOT REASONABLE, RELATED OR MEDICALLY NECESSARY BASED ON A MEDICAL REPORT THAT WAS OBTAINED BY THE INSURER MORE THAN THIRTY (30) DAYS AFTER RECEIVING NOTICE OF A CLAIM BASED ON THAT TREATMENT? (2) IS AN INSURER REQUIRED BY SECTION 627.736(7)(a), FLORIDA STATUTES, TO OBTAIN A MEDICAL REPORT FROM A PHYSICIAN WHO HAS PERSONALLY EXAMINED THE INSURED BEFORE IT MAY WITHDRAW OR DENY PERSONAL INJURY PROTECTION BENEFITS? II. ANALYSIS A. First Certified Question The first certified question addresses whether, following the 2001 amendment to section 627.736(4)(b), a "report," obtained by the insurer pursuant to section 627.736(7)(a) to deny benefits on the ground that the treatment was not reasonable, related, or necessary, is a "valid report" if it was not obtained by the insurer within thirty days of receipt of the claim. [1] In United Automobile Insurance Co. v. Rodriguez, 808 So.2d 82 (Fla.2001), which interprets the 1997 version of section 627.736, the Florida Supreme Court addressed whether an insurer that fails to pay a PIP claim within the thirty-day time period set forth in section 627.736(4)(b), is "forever barred from contesting the claim." Id....

...ent of PIP benefits and prevails, the insured is entitled to attorneys' fees. Id. at 86 (footnotes omitted). Moreover, the Court clarified that the "reasonable proof" referred to in subsection (4)(b) does not "mean only a medical report." Id. at 87. Section 627.736(4)(b), Florida Statutes (2003), which is at issue in the present case, provides in relevant part as follows, with the underscored text indicating language that was added in the 2001: Personal injury protection insurance benefits paid...

...as unreasonable .... Such assertion by the insurer may be made at any time, including after payment of the claim or after the 30-day time period for payment set forth in this paragraph. (Emphasis added). See Ch. 2001-271, § 6, at 2930, Laws of Fla. Section 627.736(4)(b) imposes on the insurer a thirty-day time period to pay PIP benefits that are "due" under section 627.736, and if these PIP benefits are not paid within the thirty-day time period, the benefits are deemed "overdue." If a PIP payment is "overdue," the "overdue payment[] shall bear simple interest." § 627.736(4)(c), Fla....

...(2003). Further, if an insured (or an assignee of the insured's rights under the PIP policy) files an action against the insurer for payment of PIP benefits, and the insured/assignee prevails, the insurer must pay the insured/assignee's attorney's fees. § 627.736(8), Fla. Stat. (2003). Thus, there are statutory penalties for not paying "due" PIP benefits within the thirty-day time period. The language in section 627.736(4)(b) pertains to PIP benefits that are "due" under the policy. If a medical bill is submitted for treatment that is not reasonable, related, or necessary, there can possibly be no benefits "due" under the policy, and therefore, that claim cannot be deemed "overdue." Section 627.736(4)(b) provides that the insurer can assert, "at any time, including ... after the 30-day time period for payment," that "the claim was unrelated, was not medically necessary, or was unreasonable." As articulated by this Court in United Automobile Insurance Co. v. Bermudez, 980 So.2d 1213 (Fla. 3d DCA 2008): Section 627.736(4), [Florida Statutes (2006),] ... deals with timing as to when PIP benefits that are properly due must be paid by an insurer before they are considered overdue.... [S]ection 627.736(4) expressly provides that "[t]his paragraph does not preclude or limit the ability of the insurer to assert that the claim was unrelated, was not medically necessary, or was unreasonable." ... Instead, we find that a withdrawal of PIP benefits on the basis that the medical treatment received was unrelated, unnecessary, or unreasonable is properly dealt with in accordance with section 627.736(7)(a). *246 Id. at 1216-17. Moreover, the Bermudez court relied on AIU Insurance Co. v. Daidone, 760 So.2d 1110 (Fla. 4th DCA 2000), which held "that the thirty-day period in section 627.736(4) applies only to benefits which are reasonable and necessary as a result of the accident." Bermudez, 980 So.2d at 1217 n. 4 (quoting AIU Ins., 760 So.2d at 1112). Based on the unambiguous language of section 627.736(4)(b) and applicable case law, we answer the certified question, as phrased by the trial court, in the affirmative, and conclude that the thirty-day time period set forth in section 627.736(4)(b) does not apply to claims for unrelated, unreasonable, or unnecessary treatment. Therefore, an insurer may challenge such treatment at any time, and is permitted to rely on a report, obtained pursuant to section 627.736(7)(a), even if the report is obtained more than thirty days after the claim was submitted. The insurer, however, must keep in mind that if its challenge fails, it will be liable for interest and attorney's fees. B. Second Certified Question The second certified question addresses whether the report, obtained by the insurer pursuant to section 627.736(7)(a) to deny PIP benefits on the ground that the treatment was not reasonable, related, or necessary, was a "valid report," as the reviewing physician's report was not based on his personal physical examination of the insured, but in...

...s. This issue has been directly addressed by this Court in Bermudez. [2] In Bermudez, the trial court granted the insured's motion for summary judgment based on its finding that the report obtained by the insurer to withdraw PIP benefits pursuant to section 627.736(7)(a) was not a "valid report" because the report was based solely on the reviewing physician's review of the insured's medical records, including an IME report, and was not based on the reviewing physician's physical examination of the insured....

...This Court reversed the order granting final judgment in favor of the insured, finding as follows: [A] "valid report" for the withdrawal of PIP benefits does not have to be based upon a physical examination conducted by the actual physician preparing the report. Instead, we hold that under section 627.736(7)(a) a medical report issued for the withdrawal of PIP benefits may be based on a physical examination of the insured that is conducted by either the physician preparing the report or another physician's examination. Id. at 1215 (footnote omitted). As noted in Bermudez, the language defining a "valid report" was added in the 2001 amendment to section 627.736(7)(a), "in an effort to clarify the requirements of physician reports created for the purpose of withdrawing benefits." Id. Thus, based on our holding in Bermudez, we answer the certified question, as phrased by the trial court, in the affirmative, and conclude that the medical report issued by Dr. Millheiser constitutes a "valid report" under section 627.736(7)(a), even though the report was not based on his physical examination of Perez. III. CONCLUSION We answer the first certified question in the affirmative, and the second certified question in the negative. We hold that (1) an insurer, in challenging a PIP claim under section 627.736(7)(a) on the ground *247 that the treatment was not reasonable, related, or necessary, may rely on a report obtained more than thirty days after the claim was submitted; and (2) under section 627.736(7)(a), the reviewing physician's report issued to deny PIP benefits may be based on either a physical examination of the insured by the physician submitting the report or a physical examination of the insured by "another physician," such as an IME physician....

...[3] Based on our holding, we reverse the trial court's order entering final summary judgment in favor of Millennium Diagnostic, and upon remand, the trial court is instructed to consider the report and affidavit submitted by Dr. Millheiser. Reversed and remanded. NOTES [1] Section 627.736(7)(a), Florida Statutes (2003), provides in relevant part as follows, with the language added in 2001 printed in underscored type: (7) Mental and physical examination of injured person; reports....

...Pekaar reveals that appellant's chest problem related solely to his heart condition and had no relation to the accident. This after-the-fact determination, however, does not absolve appellee from liability under its insurance policy for this expense. § 627.736, Florida Statutes, requires that every insurance policy for personal injury protection benefits provide payment for "......

...care provider bars this action. We conclude that the assignment either bars the lawsuit or renders it premature. II. THE LAW This case involves the controversial statutory mechanism created to streamline the resolution of disputed PIP claims. Under section 627.736(5), Florida Statutes (1993), a health care provider may "charge only a reasonable amount" for its services....

...Livingston owed $100 as her share of the reasonable bill or whether the chiropractor could sue her for the entire $600 remaining unpaid on the original bill. We are inclined to agree with the First and Fifth Districts that the assignment discussed in section 627.736 is unqualified and irrevocable....

...ssigned to a health care provider. Affirmed. FULMER and DAVIS, JJ., Concur. NOTES [1] Personal injury protection benefits do not cover 100% of medical expenses. By statute, such policies are required to cover only 80% of the reasonable expenses. See § 627.736(1)(a), Fla....

...read in context with the rest of the Florida Automobile Reparations Reform Act. In this context, the purpose of the required security is clearly to provide financial responsibility to pay any "no fault" personal injury protection benefits due under Section 627.736....

...edical bills of $5,887.45. The respondent, International Bankers Insurance Company, had issued Govan an insurance policy which covered eighty percent of his medical expenses up to the maximum amount of $10,000 for any single accident, as mandated by section 627.736(1)(a), Florida Statutes (1983)....

...the widow of the decedent and the second count by the Plaintiff in her capacity as administratrix of the estate of the decedent. The trial judge dismissed both counts with prejudice, in his order of dismissal reciting: "In construing Florida Statute 627.736(b) and the coverage thereunder provided for by Section 1 (Personal Injury Protection (b)) of the insurance contract herein sued upon, the Court rules that the only benefits provided for under either the aforesaid statute or the aforesaid prov...

...work and the right to recover for loss of income from that day forward. It is necessary that we consider the statutory provisions pursuant to the mandate of which the policy was issued as well as the provisions of the policy itself. Florida Statute § 627.736, F.S.A, provides as follows: "627.736....

...In response to those bills, State Farm sent document requests to Tampa Chiropractic, requesting, among other things, documents relating to the ownership and management of the clinic, tax information, and copies of the clinic’s leases. State Farm claimed that its request for such documents was authorized by section 627.736(6)(b), Florida Statutes (2010)....

...1 The document request went on to state, in essence, that State Farm would not pay the claims until Tampa Chiropractic complied with the document requests. Another document request advised Tampa Chiropractic that “[f]ailure to comply with this request may place you in violation of [section 627.736(6)(b)] and we may choose to seek an order from the court to allow the release of such information to us, and seek 1 In pertinent part, section 627.736(6)(b) provides that a physician or medical institution that treats an insured after bodily injury upon which a claim for PIP benefits is claimed shall, if requested by the insurer against whom the claim has...

..., and allow the inspection and copying of, his or her or its records regarding such history, condition, treatment, dates, and costs of treatment if this does not limit the introduction of evidence at trial. § 627.736(6)(b), Fla....

...(2010). 2 reimbursement of our cost in attorney fees as permitted by law.” Soon thereafter, Tampa Chiropractic’s attorneys responded to State Farm, maintaining that the requests were outside the scope of documents that were required to be furnished under section 627.736(6)(b), because they did not seek information regarding the insureds’ medical treatment. State Farm instituted a declaratory judgment action on a matter not relevant to the issue addressed in this opinion. Tampa Chiropractic later filed an amended counterclaim seeking a declaratory judgment stating that State Farm’s document requests were outside the scope of section 627.736(6)(b), and that State Farm could not predicate payment of the subject claims on Tampa Chiropractic’s response to such requests. In its answer to the amended counterclaim, State Farm requested a declaration that its document requests were proper under section 627.736(6)(b) and asked the trial court to order Tampa Chiropractic to produce the documents. Tampa Chiropractic moved for summary judgment....

...Instead, the court should have applied the confession of judgment doctrine if State Farm, in fact, paid the claims after Tampa Chiropractic filed the amended counterclaim. At the outset, State Farm not only unreasonably withheld payment based on its contention that the scope of its document requests was proper under section 627.736(6)(b), 3 but it also threatened litigation in the event that Tampa Chiropractic refused to comply with its document requests....

...s counterclaim, this constitutes a confession of judgment, entitling Tampa Chiropractic to attorney’s fees. Cf. Bassette v. Standard Fire Ins. Co., 803 So. 2d 744 (Fla. 2d DCA 2001) (holding that attorney’s fees were properly 3 While section 627.736(6)(b) allows the insurer to request a “written report of the history, condition, treatment, dates, and costs of such treatment of the injured person and why the items identified by the insurer were reasonable in amount and medically...

...ds regarding such history, condition, treatment, dates, and costs of treatment,” it does not permit the insurer to request records regarding the ownership and management of the medical provider, or the medical provider’s tax documents or leases. § 627.736(6)(b), Fla....

...and medical payments insurance. Their policies require State Farm to pay "80% of the reasonable charges incurred for necessary" medical procedures because of "an accident resulting from the ownership, maintenance or use of a motor vehicle." See also § 627.736(1)(a), Fla....

...services" within thirty days of being furnished with written notice of a covered loss and the amount of the loss). Sestile and Barrett filed a declaratory action asking the circuit court to find that State Farm's use of a computer-generated database to determine the reasonableness of medical bills violated section 627.736 and the insurance contract....

...The court ruled that State Farm could not decline to pay less than the full amount of a healthcare provider's bill based solely on the computer database, but could consider the database together with other appropriate facts. In so ruling, it determined that relying solely on the database would violate section 627.736 and the insurance contract. For the reasons explained below, we reverse the declaratory judgment. [1] As noted, both section 627.736 and State Farm's policy use the terms "reasonable" expenses or charges for "necessary" medical services....

...he mark. But this is the insured's burden to prove. Presumably, insurance companies will be deterred from making inaccurate assessments of reasonableness by the penalty they face if they lose in court—payment of their policyholders' legal fees. See § 627.736(8), .428....

...reasonableness, that decision was error. Sestile and Barrett admit that they did not seek this relief and that the judgment does not grant it. Therefore, we need not address this issue. [2] Because the terms of the policy are basically identical to section 627.736, Florida Statutes (1995), we will confine our discussion to whether use of the computer database violates the statute.

...Ethel P. Kish; Bethesda Baptist Retirement Home; and Hanover Ins. Co. COWART, Judge. This case involves the validity in Florida of a subrogation lien contained in a policy of personal injury protection insurance issued in a foreign state in view of section 627.736(3), Florida Statutes (1981), which prohibits such liens in insurance policies issued in Florida and the effect of a subrogation lien where an insured is denied recovery from a tortfeasor for insurance benefits by the collateral source rule, section 627.7372(1), Florida Statutes (1981)....

...All parties agree that the issue in count IV of the amended complaint was one of law appropriate for summary judgment but Amica argues that the trial court erred when it adjudicated that the subrogation claim and lien and agreement were invalid and unenforceable under Florida law. The basis for the summary judgment is section 627.736(3), Florida Statutes (1981), which provides in part: No insurer shall have a lien on any recovery in tort by judgment, settlement, or otherwise for personal injury protection benefits, whether suit has been filed or settlement has been reached without suit....

...rovision in the insurance policy and the subrogation agreement, Amica would not be entitled to recover from Mrs. Gifford for such benefits. Therefore while we hold that Amica's subrogation lien and agreement are valid and enforceable notwithstanding section 627.736, Florida Statutes (1981), nevertheless if under the "significant relationships test" Florida law is applied in the trial of the tort counts in this case and section 627.7372(1), Florida Statutes (1981) (the collateral source rule), is applied at trial to prevent Mrs....

...ral, and disability insurance benefits without regard to fault, and to require motor vehicle insurance securing such benefits." § 627.731, Fla. Stat. (2006).... The "Required Personal Injury Protection" provision, or the PIP statute, is codified at section 627.736 and is "an integral part of the no-fault statutory *5 scheme." Flores v. Allstate Ins. Co., 819 So.2d 740, 744 (Fla.2002). Allstate Ins. Co. v. Holy Cross Hosp., Inc., 961 So.2d 328, 331-32 (Fla.2007). Under section 627.736(1)(a), PIP benefits are required to be paid to the injured insured's health care providers at 80% of their submitted bills for "all reasonable expenses for necessary medical, surgical, X-ray, dental, and rehabilitative services" until the coverage of $10,000 is exhausted....

...sity cannot be established for the services billed." Denial was also based on the terms of Isaac's policy of insurance. After its claim for the lesser charges was denied, Stand-Up MRI mailed Progressive American a 15-day "demand letter pursuant to F.S. 627.736(11)," demanding that its bills, interest, postage and a 10% penalty be paid....

...Air Metal Indus., Inc., 176 So.2d 94, 96 (Fla.1965)). However, the situation in the present case does not violate the English Rule because it is first come-first served, for medical providers as long as their PIP claim is deemed to be compensable. See § 627.736(5)(a); see also Farinas v....

...fore Progressive American was served with the complaint. The circuit court concluded that, because of Progressive American's "disregard" of Stand-Up MRI's "priority claim," "it appears that the benefits are overdue." This was based upon a portion of section 627.736(4), Florida Statutes (2004), which provides in part: (4) Benefits; when due.—Benefits due from an insurer under ss....

...tion shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same.... In making the assessment that payment was overdue, the circuit court overlooked the portion of section 627.736(4)(b), which specifically contemplates the reduction or denial of claims and provides for exceptions to the thirty-day time limit: When an insurer pays only a portion of a claim or rejects a claim, the insurer shall provide at the tim...

...Rodriguez, 808 So.2d 82, 86 (Fla.2001) ("[A]ny payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding that written notice has been furnished to the insurer," quoting section 627.736(4)(b), Florida Statutes); State Farm Mut....

...1st DCA 2001) (if benefits were not actually due, they could not be overdue); see also United Auto. Ins. Co. v. Bermudez, 980 So.2d 1213, 1217 n. 4 (Fla. 3d DCA 2008) citing AIU Ins. Co. v. Daidone, 760 So.2d 1110, 1112 (Fla. 4th DCA 2000) ("the thirty-day period in section 627.736(4) applies only to benefits which are reasonable and necessary as a result of the accident, and, as such, a claim for unrelated, unreasonable, or unnecessary treatment may be challenged subsequent to the thirty-day time period set forth in section 627.736(4).")....

...We therefore GRANT the Writ of Certiorari and QUASH the circuit court's decision. PLEUS, MONACO, and COHEN, JJ., concur. NOTES [1] Actually, Progressive American paid $10,236 from bills totaling $12,907. [2] Filing a "demand letter" does not require an insurer to hold funds in a reserve fund. It merely satisfies section 627.736(11)'s condition precedent that such a letter be sent before filing suit against the insurer....

...tomobile accident. McElroy introduced into evidence the written reports of two medical experts. One of the experts, Dr. Phillips, performed a medical examination of Perry at the request of Perry's personal injury protection (PIP) carrier pursuant to section 627.736(7), Florida Statutes (1995)....

...ck of trustworthiness." Dr. Phillips was hired by Perry's insurance carrier to examine her for the purpose of assisting the carrier in its determination of whether the treatment Perry was obtaining was "reasonable, related, or necessary" pursuant to section 627.736(7)....

...On June 3, 1994, United Auto issued a timely payment on the resubmitted 867 claim. In February 1995, Diagnostics filed a class action complaint on behalf of a plaintiff class of medical providers and insureds who are allegedly owed statutory interest pursuant to section 627.736(4), Florida Statutes (1994), on PIP benefits not timely provided by United Auto. Section 627.736(4) provides, in pertinent part: (4) BENEFITS; WHEN DUE....

...made more than thirty (30) days after receipt of a notice of loss and a demand for payment), from February 15, 1990 through June 18, 2001, but who were not paid the ten percent (10%) statutory *25 penalty interest as prescribed by law at Fla. Stat. § 627.736(4)(c)....

..., the class should not be certified. Neighborhood Health, 913 So.2d at 706. United Auto contends that Diagnostics does not have standing to bring the class action. Specifically, United Auto asserts that it does not owe statutory interest pursuant to section 627.736(4) because United Auto timely submitted its payment to Diagnostics within thirty (30) days of receipt of the resubmitted 867 claim dated May 19, 1994....

...tal vehicle owned by the United States Government and used in the course and scope of United States Postal service business entitled to personal injury protection benefits under a policy of insurance written on his private automobile under Sections [627.736(4)(d)(1)] *29 and [627.736(4)(d)(4)] of the Florida Automobile Reparations Reform Act?" Since these questions appear to be within the scope of the rule and no objection has been made thereto, we have heard oral argument thereon....

...such that the tractor-trailor here involved would not be considered a "motor vehicle" for the purpose of the Florida Automobile Reparations Reform Act. Turning to the second question, we think that it must be answered in the affirmative. Fla. Stat. § 627.736(4)(d), F.S.A., provides as follows: "(d) The insurer of the owner of a motor vehicle shall pay personal injury protection benefits for: "1....

...8 vehicle parked across the sidewalk. O'Kelley claimed personal injury protection benefits from his insurer, State Farm. State Farm denied such benefits were available on the ground the child was an occupant of a motorcycle and thus was precluded by Section 627.736, Florida statutes (Supp....

...Accordingly we feel the only logical interpretation which can be accorded to the word "motorcycle" is that the motor minibike involved in the accident is a motordriven cycle as defined under Section 316.003(23), and is not a motorcycle as contemplated by Section 627.736....

...ct in favor of Pate by $10,000, the amount of Pate's PIP coverage. The trial court determined that Pate was liable for fees and costs under the offer of judgment statute and granted Renfroe's motion for a $10,000 set-off for PIP benefits pursuant to section 627.736, Florida Statutes (1995)....

...f Pate in the amount of $17,000 ($20,000 in damages reduced by $3000 for Pate's comparative negligence), we turn to the final issue. That issue is whether the trial court erred in granting Renfroe's motion for a $10,000 PIP set-off pursuant to *1098 section 627.736....

...injury protection benefits paid or payable. In all cases in which a jury is required to fix damages, the court shall instruct the jury that the plaintiff shall not recover such special damages for personal injury protection benefits paid or payable. Section 627.736(3), Florida Statutes (1995) (emphasis added)....

...Accordingly, we affirm in part, and reverse in part the trial court's decision to grant Renfroe a set-off for PIP benefits in the amount of $10,000. We remand with directions to enter final judgment for Renfroe in the amount of $31,695.20, based upon the trial court's award of costs and fees pursuant to section 627.736 in the amount of $48,695.20, *1100 less the jury award to Pate of $17,000....

...Perez assigned his PIP medical benefits to Millennium. A claim for PIP benefits under Security National's policy was submitted by Millennium totaling $2,178.00. Security National paid Millennium $903.68 for the services. Millennium claimed that pursuant to section 627.736(5)(b)5, Fla. Stat. (2001), it should have been paid $987.21 and therefore it had been underpaid by $83.53. Thereafter, Millennium filed a putative class action against Security National claiming that an MRI provider's charges, according to section 627.736(5)(b) 5, should be based on the highest of the three available ("participating", "nonparticipating" or "limiting charge") Medicare Part B rate schedules, the "limiting charge" schedule....

...allowable" amount upon which MRI service charges may be based. We disagree and affirm. In 2001, the Florida Legislature enacted a fee schedule regulating, among other things, the amount MRI providers could charge PIP insurers and their insureds. See § 627.736(5)(b)5, Fla....

...This paragraph does not apply to charges for magnetic resonance imaging services and nerve conduction testing for inpatients and emergency services and care as defined in chapter 395 rendered by facilities licensed under chapter 395. Soon after the trial court entered its order in this case, the legislature amended section 627.736(5)(b)5 to explicitly provide that "the participating physician fee schedule" controls the amounts payable to MRI service providers....

...er the original statute. See Gay v. Canada Dry Bottling Co., 59 So.2d 788, 790 (Fla.1952) (holding that the interpretation of a statute by a legislative department goes far to remove doubt about the meaning of the law). Because the 2003 amendment to section 627.736(5)(b)5 confirms that the trial court's interpretation of the 2001 statute was correct, we affirm....

...0 of that year. This paragraph does not apply to charges for magnetic resonance imaging services and nerve conduction testing for inpatients and emergency services and care as defined in chapter 395 rendered by facilities licensed under chapter 395. § 627.736(5)(b)5, Fla....

...§ 95.11(2)(b), Fla. Stat. (1981). On appeal, appellant contends that the trial court erred in dismissing her complaint with prejudice because appellant timely filed her breach of contract action within five years of the accrual of the cause of action. Citing section 627.736(4)(b), Florida Statutes (1981), which provides: "Personal injury protection insurance benefits shall be overdue if not paid within thirty days after the insurer is furnished written notice of the fact of a covered loss and of the amou...

...right of action stems from the plaintiff's right of action against the tortfeasor... . State Farm Mutual Automobile Insurance Co. v. Kilbreath, 419 So.2d 632, 633-34 (Fla. 1982). The Kilbreath rationale applies to a cause of action for a PIP claim. Section 627.736(4)(d)4, Florida Statutes (1981), specifically provides that the insurer of the owner of the motor vehicle must pay PIP benefits for accidental bodily injury sustained in this state by any other person while occupying the owner's motor vehicle. Section 627.736(3), Florida Statutes (1981), *391 provides that the injured party, or his legal representative, may not recover any damages for which PIP benefits are paid or are payable....

...payable." [2] Every owner [of a motor vehicle with respect to which security has been provided pursuant to the statute] is "exempted from tort liability for damages because of bodily injury, sickness,... to the extent that the benefits described in s. 627.736(1) are payable for such injury." [3] Since Assi had such insurance in this case and since the defendants also had the required statutory insurance coverage, the full amount of the defendants' tort liability found by the jury was entitled to the full amount of the statutory exemption....

...The calculation used by the trial court properly encompassed these objectives. AFFIRMED. HARRIS and ANTOON, JJ., concur. NOTES [1] These kinds of damages are encompassed in the required personal injury protection benefits of Florida's no-fault law. § 627.736(1), Fla. Stat. [2] § 627.736(3), Fla....

...fendants applied to the $10,000 PIP payment ($5,500.00), equals $6,060.58. [5] § 627.737, Fla. Stat. [6] § 737.736(4)(d), Fla. Stat. See Mansfield v. Rivero, 620 So.2d 987 (Fla.1993); Lasky v. State Farm Ins. Co., Inc., 296 So.2d 9 (Fla.1974). [7] § 627.736(4), Fla....

...Charles McClellan, plaintiff below, complains that the court erred in submitting this verdict form to the jury. We agree and reverse the lower court's judgment for the defendants. Upon a finding that there is no permanent injury, a plaintiff is precluded from any recovery only to the extent that the benefits described in s. 627.736(1) are payable for such injury, or would be payable but for any exclusion authorized by ss. 627.730-627.7405... . § 627.737(1), Fla. Stat. (1983). The benefits described in section 627.736(1) are limited to 80% of medical expenses incurred, 60% of lost gross income, and death benefits. § 627.736(1), Fla. Stat. (1983). McClellan correctly argues that even though he did not suffer a permanent injury, he may still sue the tortfeasor for benefits not payable under section 627.736(1) (i.e., 20% of his medical expenses and 40% of his lost gross income)....

...5th DCA 1984), the fifth district discussed the pertinent sections of our no-fault insurance law. The court stated: Section 627.737(1), Florida Statutes, undertakes to exempt a tortfeasor from tort liability for damages because of bodily injury caused by a motor vehicle only "to the extent that benefits described in s. 627.736(1) are payable for such injury, or would be payable but for any [authorized] exclusion......

...." Therefore, under the statutes cited and Lasky and Chapman, without meeting the thresholds in section 627.737(2), Florida Statutes, the tortfeasor and his liability carrier, here State Farm, is liable to the injured party for the 20 percent of medical expenses not payable under the PIP coverages provided by section 627.736(1)(a) and the 40 percent of lost gross income and earning capacity not payable under the PIP coverage provided by section 627.736(1)(b), Florida Statutes, and for 100 percent of those damages as exceeds the applicable policy limits....

...filed by the injured party. We further note that the Legislature amended the statute to provide for just such a physical medical examination, as requested of the injured party in the trial court in this matter, when it related to PIP benefits. See: Section 627.736(7)(a), Florida Statutes (1976)....

...e patient to St. Mary's. This form is insufficient to constitute an assignment, as it was not signed by Garcia. Garcia did not countersign an invoice, bill or claim form, as required for an enforceable assignment pursuant to Florida's No Fault laws, section 627.736(5)(a), Florida Statutes (1999), nor did he sign any other written assignment of right to benefits. Section 627.736(5)(a), provides: Any physician, hospital, clinic, or other person or institution lawfully rendering treatment to an injured person for a bodily injury covered by personal injury protection insurance may charge only a reasonable amount...

...Mark Tischhauser, Tampa, for Appellee M & M Diagnostics, Inc., et al. EN BANC DAUKSCH, Judge. This is a consolidated appeal. Appellants, insurance companies, timely appeal the county court's orders denying their motions to dismiss and compel arbitration and declaring a portion of section 627.736(5), Florida Statutes (1995) to be unconstitutional as violative of Article I, Section 9 of the Constitution of the State of Florida. In Pinnacle Medical, Inc. v. Delta Casualty Co., the first case before the county court, the court certified the following question to be of great public importance: Does the arbitration requirement of section 627.736(5) violate Article I, Section 9, of the Florida Constitution? The county court's order in Delta sets forth the factual basis and the court's reasoning for declaring section 627.736(5) to be unconstitutional in each of these cases as follows: In this action plaintiff, Pinnacle Medical, Inc....

...Pinnacle submitted his medical bills to Delta, which refused to pay them. Pinnacle, as Raymond's assignee, now brings this action for breach of the insurance contract. Delta asserts that this action must be referred to binding arbitration in accordance with section 627.736(5), Florida Statutes....

...Most owners of a motor vehicle required to be registered in Florida must buy PIP insurance. § 627.733, Fla. Stat. Under the statutory PIP scheme, the insured is assured *323 of receiving certain medical, disability, and death benefits, but loses the common law right to sue a negligent party for those same damages. § 627.736(3), Fla. Stat. To further the purpose of the law, section 627.736(5) requires that a medical provider charge only a reasonable amount for services rendered to an insured and that those benefits are to be paid directly to the provider if the insured so directs on a form approved by the Department of Insurance....

...ot be considered a legitimate one. Therefore, the act violates the parties' substantive due process rights under Article I, Section 9, of the Florida Constitution. [1] For the forgoing reasons, Chapter 90-119, Section 42, Laws of Florida codified in section 627.736(5), Florida Statutes, is hereby declared unconstitutional and unenforceable as being in violation of the due process provision of the Florida Constitution....

...In doing so, a court should focus on whether the means chosen are constitutional rather than the legislature's wisdom in choosing the means used or whether the chosen means will accomplish the intended goals. Id. at 15-16. Conceding that there is an absence of legislative history pertaining to section 627.736(5), appellants contend that the legislature's dual classification scheme, consisting of the insured, who is allowed to sue the insurance company in court, and the medical providers accepting an assignment of benefits, who are provided...

...ndividual personal injury protection costs would escalate. Accordingly, this court concluded that the statute bore a reasonable relation to the legitimate state interest of insurance regulation. Appellees, medical providers, contend in response that section 627.736(5) is unconstitutional because it improperly discriminates between two classes of similarly situated litigants—medical providers and everyone else....

...hed legal principles; and 3) judicial review. Appellees maintain that these safeguards are protected by the due process clause of the Constitution of the State of Florida. Appellees contend further that the mandatory binding arbitration procedure in section 627.736(5) is unconstitutional because they were not a party to the agreements compelling arbitration. Section 627.736(5) provides that the provisions of chapter 682 are applicable....

...ent. It is not binding upon successors in interest. [3] In Orion, a case directly on point, the court recently decided the issue on appeal. The court's reasoning is set forth as follows: Magnetic [medical provider] attempts to escape the dictates of section 627.736(5) by challenging the constitutionality of that statute....

...and the No-Fault scheme may be avoided by refusing to do so. Third, the statutory No-Fault regime provides medical service providers like Magnetic with the ability to collect via assignment statutorily mandated PIP insurance benefits. In this view, Section 627.736(5) creates new rights and may not be challenged as taking away any existing rights which predate the state constitution....

...Diagnostics, Inc., 697 So.2d 560 (Fla. 3d DCA 1997); Liberty Mut. Ins. Co. v. Magnetic Imaging Systems I Ltd., 696 So.2d 1302 (Fla. 3d DCA 1997). We disagree with the reasoning in Orion. We agree with the county court below that the compulsory arbitration clause in section 627.736(5), Florida Statutes (1995) violates the due process rights guaranteed to medical providers under Article I, Section 9 of the Florida Constitution....

...nments from insureds. Acceptance of such assignments may well be an economic necessity for the medical provider to engage in medical practice. Appellees also raise an additional argument which was not raised in Orion. Specifically, they contend that section 627.736(5) penalizes medical providers compelled to arbitration because it substitutes the prevailing party standard for obtaining attorney's fees in place of section 627.428(1), Florida Statutes (1995) which controls attorney's fees awards in litigation between insurance companies and their insureds in court....

...those attorney's fees incurred when compelled to defend or sue to enforce their insurance contracts. Insurance Co. of North America v. Lexow, 602 So.2d 528 (Fla.1992). See State Farm Fire & Cas. Co. v. Palma, 629 So.2d 830 (Fla.1993). We agree that section 627.736(5) arbitrarily discriminates against medical providers by subjecting them to a prevailing party test of attorney's fee recovery when insureds enjoy the benefits of section 627.428(1). Accordingly, the county courts' orders denying appellants' motions to compel arbitration and declaring the compelled arbitration clause in section 627.736(5), Florida Statutes (1995) to violate Article I, Section 9 of the Florida Constitution are affirmed....

...ue process protection to the litigants. And because the legislature has the constitutional authority to require binding arbitration of third-party claims to PIP benefits so long as the procedure provides adequate due process protection, I would hold section 627.736(5) constitutional....

...ssued by appellee, Florida Farm Bureau, which included coverage for PIP benefits available to "a relative of the owner residing in the same household", who is "not himself the owner of a motor vehicle with respect to which security is required ...". Section 627.736(4)(d)3, Florida Statutes (1975)....

...u, which denied coverage. Appellant filed suit against the appellee-insurer, and summary judgment of nonliability was entered in appellee's favor upon its contention that appellant's ownership of an uninsured automobile prevented his recovery, under Section 627.736(4)(d)3, Florida Statutes (1975)....

...t: (a) Appellant's vehicle shall have been one `required to be registered and licensed in Florida' (See F.S. 320.35), and (b) Appellant shall have been the owner of a motor vehicle `with respect to which security is required under [this act]' (See F.S. 627.736(4)(d)4 a.) " Had appellant's motor vehicle been inoperable or had it been in storage it would not have been a vehicle required to be registered and licensed in Florida....

...[3] Section 627.733(1) Florida Statutes (1975) provides: "(1) Every owner or registrant of a motor vehicle required to be registered and licensed in this state shall maintain security as required by subsection (3) in effect continuously throughout the registration or licensing period." [4] Section 627.736(4)(d)3, Florida Statutes (1975) provides as follows: "(d) The insurer of the owner of a motor vehicle shall pay personal injury protection benefits for: * * * * * * "3....

...personal injury protection provision of an automobile insurance policy issued by the defendant. The plaintiff purchased an automobile insurance policy from the defendant, which contained a $5,000.00 personal injury protection provision, pursuant to Section 627.736, Florida Statutes (1975 and 1976)....

...red dollars, or one thousand dollars, again as the policyholder elects, said amount to be deducted from the amounts otherwise due each person subject to the deduction. * * *" [emphasis added] The amount "otherwise due" under the policy is $5,000.00. Section 627.736(1), Florida Statutes (1975)....

...61-175, Laws of Fla. (now codified at § 627.727, Fla. Stat. (2000)). The shift was even more pronounced when the legislature introduced no-fault concepts by passing the Florida Automobile Reparations Reform Act in 1971. See ch. 71-252, Laws of Fla. (now codified at § 627.736, Fla....

...Whereas, in the cause sub judice the appellee/defendant could not be considered a possible tortfeasor, and it has a legal, contractual obligation to its insured to pay medical expenses under the separate and distinct P.I.P. provisions of its policy with appellant. See, § 627.736, Florida Statutes (1975)....

...The amended complaint effectively alleged a cause of action against the defendant under the "uninsured motorist" coverage (which was barred by the release, as aforesaid) but there are no allegations in the amended complaint, nor elsewhere in the record, sufficient to support a claim under the "no-fault act." Florida Statute 627.736, F.S.A., clearly reflects that an insurer is not required to pay until receipt of reasonable proof of the loss and the amount of injuries sustained by a claimant under that act; and the record in this case is devoid of any showing that any "no-fault" benefits were due to the plaintiff....

...Issues relating to splitting causes of action, estoppel by judgment, etc. are not before us. We therefore express no view at this time as to whether the plaintiff may now furnish appropriate written notice in accordance with the requirements of Florida Statute 627.736(4)(b), F.S.A., and furnish the proof required by Florida Statute 627.736(4), F.S.A., and thereby perfect his claim and recover under the "no-fault" provisions of the policy under which he was clearly covered as a passenger. (F.S. 627.736(1), F.S.A.) Affirmed....

...Florida's Automobile Reparations Reform Act requires the insurer of the owner of a motor vehicle to pay personal injury protection benefits for the accidental bodily injury sustained in this state by the owner while he is occupying a motor vehicle. § 627.736(4)(d)1, Fla....

...State Farm refused and the insureds filed suit. We held, in a case of first impression, that an insured has the right to have benefits so allocated upon request. We did not go so far as to hold that State Farm had a duty to do so automatically, because the PIP statute, section 627.736(4), Florida Statutes (1975), made PIP coverage "primary," as did State Farm's policy....

...r highway; in or about private hospitals, sanitariums, or any private institution; or upon private property of any character whatsoever for the purpose of making motor vehicle tort claims or claims for personal injury protection benefits required by § 627.736....

...sts (CFP). The judgment required that Nationwide pay CFP the reasonable and necessary medical expenses incurred by Nationwide's PIP insured, not the reduced PPO amount for such services, because Nationwide had failed to comply with the provisions of section 627.736(10) of the Florida Statutes (1999) which authorized the payments of PPO amounts. The court also certified the following question to this court as being of great public importance: IS AN INSURER REQUIRED TO COMPLY WITH THE PROVISIONS OF SECTION 627.736(10), FLA....

...Nationwide defended, alleging that since CFP was a participating medical provider in the Beech Street PPO (a health care management provider), CFP was only entitled to be reimbursed at agreed PPO rates (not the PIP statutory rate of 80% of the usual, customary and related charges as set forth in section 627.736(1) of the Florida Statutes) because Nationwide was also a member of the Beech Street PPO. CFP moved for summary judgment, alleging that since Nationwide had not directly contracted with CFP to be a part of a PPO, had not complied with the requirements of section 627.736(10)of the Florida Statute (1999), and had not sold Jivoin a PPO policy, Nationwide was not entitled to pay at the reduced PPO rate. In entering summary judgment in favor of CFP, the trial court concluded that section 627.736(10) of the Florida Statutes (1999) provides the exclusive means by which an insurance company can pay PPO rates for PIP benefits, and that since Nationwide had failed to comply with the terms of the statute, it was not entitled to pay CFP at the reduced PPO rate. We agree. Section 627.736 of the Florida Statutes (1999) provides, in pertinent part, as follows: *765 627.736....

...The insurer shall provide each policyholder with a current roster of preferred providers in the county in which the insured resides at the time of purchase of such policy, and shall make such list available for public inspection during regular business hours at the principal office of the insurer within the state. § 627.736(1)(a)(10), Fla. Stat. (1999). Section 627.736(10) provides the sole language relating to the availability of PPO benefits in PIP cases....

...Nationwide contends that CFP lacks standing to assert a claim against Nationwide because no standing is granted to medical providers by the PIP statutes. Nationwide also argues that the *766 trial court erred in permitting CFP to invoke the terms of section 627.736(10) to void its agreement with Beech Street since the statute contains no private right of enforcement....

...As such, CFP possessed the same rights as Jivoin possessed vis a vis Nationwide, including the right to institute suit to enforce the terms of Jivoin's PIP contract. Similarly, it is clear from the record that CFP has not sought to invoke the terms of section 627.736(10), but rather is merely suing for recovery of benefits under the standard PIP statute, section 627.736(1), Florida Statutes (1999). Accordingly, it is irrelevant that section 627.736(10) does not contain a private right of enforcement. In summary, Nationwide was required to comply with the provisions of section 627.736(10) in order to take advantage of the option of paying reduced PPO rates for payment of PIP benefits....

...3d DCA 1979), has interpreted "contracting insured" to include "claimants who have a direct first party contractual relationship with the carrier." But this interpretation does not aid plaintiffs because they have no contractual relationship at all with the defendant carrier. Affirmed. NOTES [1] See § 627.736(4)(d)(4)(a), Fla....

...The Fifth District Court of Appeal certified a question of great public importance. Caruso v. Baumle, 835 So.2d 276, 281 (Fla. 5th DCA *542 2002). [1] We have jurisdiction. See art. V, § 3(b)(4), Fla. Const. For ease of resolution, we restate and number the questions as follows: (1) IN AN AUTOMOBILE ACCIDENT CASE, DOES SECTION 627.736(3) REQUIRE THAT EVIDENCE OF PIP BENEFITS FOR PURPOSES OF SETOFF BE PRESENTED TO THE TRIER OF FACT, BE IT JUDGE OR JURY? (2) IF THE EVIDENCE OF PIP BENEFITS MUST BE PRESENTED TO A JURY, MUST THE JURY BE INSTRUCTED THAT THE PLAINTIFF SH...

...Plaintiffs appealed, arguing that the trial court should not have allowed post-trial discovery and should not have considered evidence regarding the defense of PIP setoff benefits presented after the jury trial. The Fifth District affirmed. Caruso, 835 So.2d at 280. Although the court agreed that section 627.736(3), Florida Statutes (2001), required a defendant to present evidence of PIP benefits at trial, not after trial, the court felt bound by its prior decision in Allstate Insurance Co....

...Must evidence of PIP benefits for purposes of setoff be presented to the trier of fact? The first certified question asks whether, in an automobile accident case, evidence of PIP benefits must be presented to the trier of fact—be it a judge or jury—for purposes of a setoff defense. The simple answer is yes. In such cases, section 627.736(3) governs the setoff of PIP benefits....

...to any action for damages, whether in tort or in contract." § 768.71(1), Fla. Stat. (2001). The statute clarifies, however, that "[i]f a provision of this part is in conflict with any other provision of the Florida Statutes, such other provision shall apply." § 768.71(3), Fla. Stat. (2001). Another provision, section 627.736(3), is in conflict....

...he plaintiff shall not recover such special damages for personal injury protection benefits paid or payable. (Emphasis added.) Thus, in contrast to the procedure under section 768.76(1), in which the court offsets the collateral source amount, under section 627.736(3), the trier of fact—whether judge or jury—is to offset the amount. As noted, section 768.71(3) provides that any conflicting statute governs over section 768.76. Therefore, in lawsuits concerning motor vehicle accidents, section 627.736(3), not section 768.76(1), applies. [2] *545 PIP benefits are collateral sources; "that is, first-party benefits for which the insured has paid a separate premium." Rollins, 761 So.2d at 300. Section 627.736(3) provides that a plaintiff "shall have no right to recover any damages for which [PIP] benefits are paid or payable." Therefore, we answer the first question in the affirmative: in automobile accident cases, evidence of PIP benefits must be presented to the trier of fact....

...Must the jury be instructed on the plaintiff's PIP benefits? The second question asks whether, in cases where the jury is the trier of fact, the jury must be instructed that the plaintiff shall not recover special damages for PIP benefits. Again, the statute answers this question. Section 627.736(3) provides that "if special damages are introduced in evidence, the trier of facts, whether judge or jury, shall not award damages for personal injury protection benefits paid or payable....

...The statutory language quoted above implies, of course, that only when the plaintiff introduces evidence of damages that would be covered by PIP benefits must evidence of the PIP benefits be introduced as well. [3] The purpose of the setoff provision in section 627.736(3) "is to prevent a plaintiff from obtaining a double recovery, i.e., receiving as damages sums for which PIP benefits were paid." McKenna, 771 So.2d at 558....

...When must evidence of PIP benefits be introduced? The third question asks whether, absent a waiver or an agreement by the parties, a party may introduce evidence of PIP benefits requiring a setoff to the judge after a jury trial. Because we have already determined that in a jury trial, under section 627.736(3), evidence of PIP benefits for purposes of setoff must be presented to the jury, we find the answer to the third question must be no; if the jury is required to hear evidence of PIP benefits for purposes of a setoff, then a party would have nothing to present to the judge after trial....

...The parties apparently operated under the assumption that section 768.76(1) applied and that the judge would determine the setoff issue. (In fact, after trial, the plaintiffs specifically argued that section 768.76(1) applied.) Neither party even mentioned section 627.736(1)....

...efits to the judge during the trial (plaintiffs) or after the trial (Baumle). See Caruso, 835 So.2d at 280-81 (Harris, J., concurring specially). Therefore, to resolve this case, we must determine whether, when both parties waive the requirements of section 627.736(3) and agree to submit the PIP setoff issue to the trial court, the court abuses its discretion by (A) considering the issue after trial instead of during trial, and (B) ordering post-trial discovery on the issue....

...In such circumstances, the court did not abuse its discretion. III. CONCLUSION We answer questions number one and two in the affirmative, the third question in the negative, and approve the decision of the district court. We disapprove Scott, 773 So.2d at 1290, to the extent that, contrary to section 627.736(3), it requires the judge to hold a post-trial hearing to determine the PIP setoff....

...In particular, I agree that in automobile accident cases, evidence of PIP benefits that have been paid or are payable must be presented to the trier of fact. I write separately because a review of the current jury instructions on collateral sources reveals that there is no instruction that specifically pertains to section 627.736(3), Florida Statutes (2003), the PIP setoff statute at issue in this case....

...ruction 6.13, the collateral source rule. [4] In addition the Committee should consider changes to Paragraph 2 of this jury instruction's "Notes on Use." Currently, as pointed out by the majority, there are two applicable collateral source statutes: section 627.736, which governs setoffs for PIP benefits in automobile accident cases, and section 768.76(1), Florida Statutes (2003), which governs setoffs in all other negligence cases....

...The omission of the PIP setoff statute from the jury instructions and notes has the potential to cause confusion rather than assisting judges and litigants. Accordingly, a specific jury instruction, with accompanying explanatory notes on use, should be added to correspond to the PIP setoff statute, section 627.736(3)....

...October 1, 1993. These changes are necessary in order to accurately instruct the jury on the PIP setoff statute. ANSTEAD, C.J., and CANTERO, J., concur. NOTES [1] The actual question certified was the following: IN AN AUTOMOBILE ACCIDENT CASE, DOES SECTION 627.736(3) REQUIRE THAT EVIDENCE OF PIP BENEFITS FOR PURPOSES OF SETOFF BE PRESENTED TO THE TRIER OF FACT, BE IT JUDGE OR JURY, AND IF A JURY, MUST THE JURY BE INSTRUCTED THAT THE PLAINTIFF SHALL NOT RECOVER SPECIAL DAMAGES FOR PERSONAL INJUR...

...E FOR A FACT FINDING OF AMOUNTS INVOLVED, AND FOR PURPOSES OF REDUCING THE PLAINTIFF'S RECOVERY? Caruso, 835 So.2d at 281. [2] In Garcia v. Arraga, 872 So.2d 266 (Fla. 4th DCA 2004), the Fourth District recently found that both section 768.76(1) and section 627.736(3) apply simultaneously "regardless if [ sic ] the case is a personal injury case or a general tort case." 872 So.2d at 269....

...The district court concluded that "both provisions provide the trial court with the authority to reduce damage awards by the value of collateral sources payments as a post-verdict procedure." Id. We disagree with this position and, as explained above, find that in motor vehicle accident cases, section 627.736(3) controls. [3] The Fifth District refers to this as the " obvious assumption in section 627.736(3) that the `trier of fact' will hear evidence of the PIP setoffs, be it judge or jury, and that the jury will be instructed plaintiffs cannot recover such PIP benefits paid or payable." Caruso, 835 So.2d at 280 (emphasis added)....

...tance: Whether a corporation that is not a physician, hospital, clinic or other person or institution lawfully rendering treatment to an insured person for bodily injury covered by personal injury protection benefits, as set forth in Florida Statute § 627.736(5)(a), is entitled to recover *447 PIP benefits for services provided by a healthcare provider pursuant to a valid assignment of benefits from the insured under Florida Statute § 627.736....

...The complaint stated that Professional had accepted an assignment of PIP benefits from Berlinghoff, which was given "for the purpose of billing [Hartford] for treatment rendered to [Berlinghoff] by Bartholomew Care Chiropractic and Jeffrey J. Gibson, D.O." Hartford moved to dismiss, contending that section 627.736(5), Florida Statutes (2000), prevented Professional from making claims under Hartford's PIP policy....

...Hartford maintained that it was only required to make payment to four entities: a physician, a hospital, a clinic, or another person lawfully rendering treatment. See id. No one disputed that Professional was not one of these. The county court expressed its belief that section 627.736 does not prevent an insured from assigning her rights to a non-medical assignee, who could then collect the PIP benefits, because the statute is silent on the right to assign....

...(2000) (stating that firefighters' pensions, annuities, and benefits "shall be unassignable"); § 440.22, Fla. Stat. (2000) (stating that no assignment of workers' compensation benefits, except as provided in the statutes, shall be valid). But nothing in section 627.736(5) addresses assignments. When construing statutes, "[i]nference and implication cannot be substituted for clear expression." Carlile v. Game & Fresh Water Fish Comm'n, 354 So.2d 362, 364 (Fla.1977). Thus, we cannot infer that section 627.736(5) prohibits an assignment of benefits to a non-medical third party when the legislature has not specifically spoken on that issue. We hold that Berlinghoff's assignment to Professional was not prohibited by the language of section 627.736(5). Our conclusion is borne out by a 2001 amendment to section 627.736 that provides "an insurer or insured is not required to pay a claim made by a broker or by a person making a claim on behalf of a broker." § 627.736(5)(b)(1), Fla. Stat. (2001). [1] This 2001 amendment illustrates that section 627.736 does not, as Hartford argues, prevent a PIP insurer from paying claims to anyone other than the four entities mentioned in the statute....

...services provided to accident victims which will, in turn, increase insurance premiums. Hartford notes that controlling the cost of insurance premiums is a stated policy objective of the Florida Legislature. Along similar lines, Hartford claims that section 627.736 does not require it to pay for billing services. As it points out, section 627.736(4)(b) requires an insurer only to pay "eighty percent of all reasonable expenses for medically necessary" medical procedures....

...Both of these arguments address the reasonableness of the charge, not whether a claim is assignable. If Hartford believes a portion of charges submitted by Professional are not reasonable or medically necessary, it may seek to avoid paying on that basis. § 627.736(4)(b); Rodriguez, 808 So.2d at 85-6....

...se resolved by virtue of this assignment. Further, Ms. Berlinghoff's assignment to Professional Consulting Services does not eliminate her obligation to cooperate with Hartford Life and Accident Insurance Company in the processing of this claim. See § 627.736(7), Fla....

...NOTES [1] This amendment applies to treatment and services occurring on or after October 1, 2001, so it is not applicable to this case. See ch.2001-271, § 11, at 2948, Laws of Fla. [2] Certainly the amount Medical Management attempted to bill State Farm was egregious. In that regard, we note that the 2001 amendment to section 627.736, adding the provision that neither an insured nor an insurer was required to pay the claim of a broker, may have been designed to prevent the sort of evils presented in Medical Management. See § 627.736(5)(b)(1), Fla....

...e serious concerns as to whether such a statute would violate access to courts because it would diminish the right to have the ultimate decision in a case made by a court. "[The PIP statute] does not provide for a trial de novo in the circuit court. Section 627.736(5) states that the provisions of chapter 682, Florida's Arbitration Code, shall apply....

...The circuit court agreed with the county court that the peer review report United Auto furnished to defend the summary judgment motion was not valid because it did not state that the doctor either physically examined the insured or that his opinion was based on an independent medical examination as required by section 627.736(7)(a), Florida Statutes....

...We find a departure based on the law as explained by this court in the recent decision of Cent. Magnetic Imaging Open MRI of Plantation, Ltd. v. State Farm Fire & Cas. Ins. Co., 22 So.3d 782 (Fla. 4th DCA 2009). As this court noted, a "valid report" as anticipated by section 627.736(7)(a), Florida Statutes, does not require an insurer to order an IME before denying a claim for PIP benefits....

...We grant the petition for *745 writ of certiorari, quash the circuit court's order, and remand for proceedings consistent with this opinion. TAYLOR, HAZOURI and CIKLIN, JJ., concur. NOTES [1] As in Central Magnetic, we note that other districts have held that the valid report requirement of section 627.736(7)(a) does not apply at all in a case such as this. See State Farm Mut. Auto. Ins. Co. v. Rhodes & Anderson, D.C., P.A., 18 So.3d 1059 (Fla. 2d DCA 2008) (holding that section 627.736(7)(a), applies only to a withdrawal of "treatment authorization" not a mere denial of payment of a single PIP charge); accord Partners in Health Chiropractic v....

..., while occupying a MBCC leased vehicle registered or licensed in Florida. In Count III, plaintiffs seek a declaratory decree regarding Allianz Insurance Company’s obligation to provide PIP or no-fault benefits in the amount of $10,000 pursuant to section 627.736, Florida Statutes....

...s a result of bodily injury, sickness, disease or death arising out of the ownership, maintenance, or use of a MBCC leased vehicle registered and licensed within the State of Florida and who are thus entitled to recover the *669 benefits outlined in section 627.736, Florida Statutes....

...Three years after appellee was injured in an automobile accident State Farm refused to make further med pay reimbursements, but continued to make PIP payments. This refusal resulted in litigation and subsequent summary judgment against State Farm. While med pay coverage is optional, its scope is established by section 627.736(4)(f), Florida Statutes (1989), which reads as follows: Medical payment insurance, if available in a policy of motor vehicle insurance, shall pay the portion of any claim for personal injury protection medical benefits which is otherw...

...Third, appellant argues that the language of the med pay statute itself allows for a time limitation because it states "if available," and thus, appellant argues, in this case med pay coverage was no longer "available" because it expired after three years. See § 627.736(4)(f), Fla....

...erage is available as a supplement to PIP to permit the purchase of insurance that will cover 100% of medical bills (up to whatever monetary limit is chosen). The staff analysis of the 1982 amendment of the insurance code states in pertinent part: "[Section 627.736] [p]aragraph 4(f) provides that medical payments coverage fills the gaps left by the PIP policy......

...pay the portion of any claim for personal injury protection medical benefits which is otherwise covered but not payable due to the coinsurance provision of paragraph (1)(a), regardless of whether the full amount of [PIP] coverage has been exhausted. § 627.736(4)(f), Fla....

...In Christian, the insurance company was trying to avoid paying the med pay portion by labeling it as "excess" coverage to Christian's health insurance and thus excluding it. Id. at 624. This court held that the policy in question "must give way to the mandatory requirements of section 627.736(4)(f), and to the extent that the amount of such coverage permits, medical payments insurance shall be payable to cover those benefits not covered due to the coinsurance provision of [PIP] section 627.736(1)(a), Florida Statutes (1985)." Id....

...utomobile liability insurers and nonresident owners of automobiles frequently driven into Florida. The specific question presented is whether a Georgia resident injured in an insured Florida motor vehicle is barred from recovering PIP benefits under section 627.736, Florida Statutes, from the Florida owner's insurer because the Georgia resident owns an uninsured motor vehicle which is registered, licensed, and garaged in Georgia but driven to work in Florida approximately four or five days each...

...Although Epperson usually kept the truck at his home in Georgia, for slightly more than a year prior to the accident he drove it to work in *174 Tallahassee four or five days a week. Epperson's pickup truck was parked in Florida when the accident took place. Personal injury protection benefits, as provided for in section 627.736, Florida Statutes (1981), are designed to reimburse persons injured in motor vehicle accidents for medical expenses and lost earnings, regardless of fault....

...In general, Florida requires persons owning a motor vehicle regularly operated in Florida to carry automobile liability insurance sufficient to provide the security specified in section 627.733. All insurance policies issued for vehicles required to have security under that section must provide PIP benefits. § 627.736(1), Fla. Stat. (1981). Ordinarily, when a person is injured in a motor vehicle accident in Florida, he or she is entitled to PIP benefits from his or her own motor vehicle insurance carrier. § 627.736(1) and (4)(d), Fla. Stat. (1981). A passenger injured while riding in another's vehicle may not recover PIP benefits from the insurer of that vehicle if the passenger also owns a vehicle which is required to be insured by the Florida statute. § 627.736(4)(d)4 a and b, Fla....

...District Court of Appeal of Florida, Fifth District. August 9, 1996. Dale T. Gobel of Drage, de Beaubien, Knight & Simmons, Romano & Neal, Orlando, for Petitioner. Hallie L. Zobel of Crews & Bodiford, P.A., Orlando, for Respondents. ANTOON, Judge. This case focuses on the requirement of section 627.736(5), Florida Statutes (1995) [1] , that once a medical provider receives an assignment of benefits from an insured, disputed medical claims between the provider and the insurance company must be resolved by binding arbitration....

...Tan, but eventually a dispute arose between State Farm and Dr. Tan regarding a claim for payment. The Gonnellas filed suit in county court alleging that State Farm had failed to pay personal injury protection benefits. State Farm then filed a motion to dismiss based on section 627.736(5) and a corresponding provision in the insurance policy....

...rt the amount allegedly owed Dr. Tan. The circuit court ruled that even though Dr. Tan had accepted benefits under the assignment, and a demand for arbitration had been made, the revocation obviated the requirement for binding arbitration under both section 627.736(5) and the insurance policy....

...Tan included an unambiguous provision that it could be revoked, the revocation terminated Dr. Tan's right to receive their personal injury protection benefits. They also contend that they regained their right to sue for those benefits upon execution of the revocation, and that section 627.736(5) and the policy provision requiring arbitration no longer apply. We reject the Gonnellas' argument. The legislative intent is clear. Section 627.736(5) requires arbitration to resolve disputes involving medical benefits....

...y resolution of disputes as occurred in the instant case. [3] We grant the petition, quash the final order of the circuit court, and issue the writ. PETITION GRANTED; ORDER QUASHED, and WRIT ENTERED. PETERSON, C.J., and HARRIS, J., concur. NOTES [1] Section 627.736(5) provides in pertinent part: 627.736 Required personal injury protection benefits; exclusions; priority.- * * * * * * (5) CHARGES FOR TREATMENT OF INSURED PERSONS.- * * * * * * Every insurer shall include a provision in its policy for personal injury protection benefits for bind...

...Bankers Insurance, 3 Fla. L. Weekly Supp. 673 (13th Circuit June 30, 1995). The decision is not dispositive. Advanced Orthopedic is factually distinguishable because it was the medical provider, not the insured, who challenged the arbitration requirement of section 627.736(5)....

...Allstate Ins. Co., 774 So.2d 679, 682 (Fla.2000))). We grant the petition for writ of certio-rari and quash the opinion of the circuit court appellate division, and remand for further proceedings. . Submission to a reasonably requested IME as provided in section 627.736(7), Florida Statutes (2005), is a condition precedent to coverage....

...ection benefits as required by statute. The applicable statutory provisions refute this contention. The threshold requirement of Section 627.737(2), Florida Statutes (1981), applies only in a tort action where security has been provided. [2] Reading section 627.736(1), Florida Statutes (1981), one discovers that security is not provided to a motorcyclist, who is "an occupant of a self-propelled vehicle." [3] Thus, a motorcyclist need not satisfy the threshold to maintain a suit for the damages enumerated in subsection (2) of section 627.737....

...(a) Significant and permanent loss of an important bodily function. (b) Permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement. (c) Significant and permanent scarring or disfigurement. (d) Death. [3] § 627.736 Required Personal Injury Protection Benefits; Exclusion; Priority....

...or vehicle used as a utility automobile and a pickup or panel truck which is not used primarily in the occupation, profession, or business of the insured." § 627.732, Fla. Stat. The Act provides the guidelines for payments of benefits thereunder in § 627.736(4)(d), Fla....

...." [1] The pivotal issue, then, is whether the injury was caused by physical contact with a motor vechicle. There is no question that the vehicle involved in the accident with plaintiff Camacho's truck was not a motor vehicle as defined in § 627.732, Fla. Stat., infra, and as applied in § 627.736(4)(d), Fla....

...prejudice on April 13, 2010. Nuñez filed a timely motion for reconsideration on May 11, 2010, which the district court denied. Nuñez appeals the dismissal of count two only, which asked the district court to determine whether Florida’s PIP Statute, FLA. STAT. § 627.736, permits EUOs as a prerequisite to receiving PIP benefits....

...Florida’s No-Fault Statute Under Florida’s No-Fault Statute, an insured is not expressly required to attend an EUO as a condition precedent to bringing suit against an insurer to 7 recover PIP benefits. See FLA. STAT. § 627.736....

...rcement of a specific provision would be contrary to the purpose of the . . . statute.” Flores v. Allstate Ins. Co., 819 So. 2d 740, 745 (Fla. 2002). As Geico points out, EUOs are consistent with many provisions in the No- Fault Statute. Section 627.736(4) states that benefits from an insurer are “due and payable as loss accrues, upon receipt of reasonable proof of such loss . . . .” FLA. STAT. § 627.736(4) (emphasis added); see Amador v....

...1999) (acknowledging that “reasonable proof” could include the requirement that an insured submit to an EUO). Subsection (4)(h) of the statute provides that benefits are not due under the statute if there is evidence of fraud “admitted to in a sworn statement by the insured.” FLA. STAT. § 627.736(4)(h)....

...12 the following question to the Florida Supreme Court, pursuant to Fla. Const. art. V, § 3(b)(6). See Pendergast v. Sprint Nextel Corp., 592 F.3d 1119, 1143 (11th Cir. 2010): 1. Whether, under FLA. STAT. § 627.736, an insurer can require an insured to attend an EUO as a condition precedent to recovery of PIP benefits? The answer to this question will assist this court in determining whether Nuñez was required to submit to an EUO prior to filing suit against Geico....

...it, but to which it was not a party, has not been raised: We accordingly do not consider the issue, but treat the case for the purpose of this opinion, as though State Farm had in fact been a party to the suit in the lower court. [4] Specifically F.S. 627.736(3)(a) and F.S. 627.736(3)(b)....

...Nivaldo Cruz appeals from an order dismissing with prejudice his action for declaratory relief. We affirm. Cruz was injured in an automobile accident in July, 1989. He was insured by Union General Insurance for personal injury protection. Upon the insurer's request pursuant to section 627.736(7), Florida Statutes (1989), Cruz underwent an independent medical examination....

...uld no longer make voluntary payments for medical bills incurred after the date of the letter. Cruz sued Union General for declaratory relief and for breach of contract. In the count for declaratory relief, Cruz sought a determination whether, under section 627.736(7), the examination and ensuing report by the independent medical examiner could properly form the basis for a denial of accrued and future medical expenses, relative to any and all medical specialties....

...o County Court. The trial court was correct in dismissing the action for declaratory relief. Cruz's claim for incurred medical expenses requires a purely factual determination of whether his medical expenses were "reasonable, related, or necessary." Section 627.736(7)....

...Albert, 191 So.2d 579 (Fla. 3d DCA 1966). Cruz's avenue of redress, therefore, is an action for breach of contract, which remains pending. Cf. Ponders v. Fortune Ins. Co., 578 So.2d 1129 (Fla. 3d DCA 1991) (declaratory action maintained to determine whether, under section 627.736(7), insurer had waived right to deny PIP benefits for insured's failure to keep appointment with independent medical examiner by rescheduling medical exam at location more convenient to insured); Frielingsdorf v. Allstate *92 Ins. Co., 497 So.2d 289 (Fla. 3d DCA 1986) (declaratory action maintained to determine whether insured who sought PIP benefits and did not live in city was required, under section 627.736(7), to submit to independent medical examination in city in adjacent county), rev....

...Malen, injured in an accident while driving a vehicle owned by Diane Loos, seeks review of a final judgment dismissing with prejudice his claim against American States Insurance Company for personal injury protection benefits under an automobile insurance policy issued to Diane Loos. The trial court held that Section 627.736(4)(d)4a, Florida Statutes (1975), disentitles Malen to benefits since he was "the owner of a motor vehicle with respect to which security is required under ss....

...3d DCA 2009) and Partners in Health Chiropractic, a/a/o Neocles Lebrun v. United Automobile Insurance Co., ___ So.3d ___, 2009 WL 3364884 (Fla. 3d DCA 2009). In these cases we concluded that where, as here, an insurer fails to pay any or some of an insured's medical bills, section 627.736(4)(b) of the Florida Statutes applies. That provision requires only that an insurer have reasonable proof that a rejected claim or claims (or bill or bills) are unreasonable, unrelated, or unnecessary; that such proof may be supplied by a report prepared in accordance with section 627.736(7)(a) or otherwise; and that such proof may be provided at any time....

...Emergency Physicians Kang & Assoc., M.D., P.A., as assignee of Stephanie Carrico, 14 Fla. L. Weekly Supp. 352 (Fla. 9th Cir.Ct.2007). As discussed below, the trial court should have determined that Progressive was entitled to judgment as a matter of law. Subsection 627.736(6), Florida Statutes RMA relies on sections 627.736(6), 627.7401, 627.4137, and 626.9541, Florida Statutes. Subsection 627.736(6) is inapplicable. Section 627.736 requires that all automobile insurance policies include PIP coverage....

...y necessary.... . . . . (d) The injured person shall be furnished, upon request, a copy of all information obtained by the insurer under the provisions of this section, and shall pay a reasonable charge, if required by the insurer. Simply stated, subsection 627.736(6) allows an insurer to investigate a PIP claim and paragraph (d) provides that the insured is entitled to copies of any documents obtained by the insurer. The Third District has previously addressed this issue and properly determined that subsection 627.736(6) does not require pre-suit disclosure to an assignee medical provider....

...Humanitary Health Care, Inc., 975 So.2d 1247 (Fla. 3d DCA 2008). In Southern Group, a health care provider sued an insurer for PIP benefits and a declaration that it was entitled to receive pre-suit disclosure of the insurer's PIP logs pursuant to subsection 627.736(6)....

...and paragraph (d) simply "allows the insured to obtain a copy of all information obtained by the insurer through this process." Id. at 1250. We agree with the Third District. Regarding PIP logs, this Court has previously recognized: No provision of section 627.736, Florida Statutes, dictates that an insurer must provide a PIP log to an insured, or his/her assignee. In fact, there is no provision under section 627.736, Florida Statutes, which requires that an insurer must create a PIP log at all....

...Rural Metro Ambulance as assignee of William Zaniboni, 13 Fla. L. Weekly 573 (Fla. 18th Cir.Ct.2005)). As we recognized in GEICO, nothing in Florida Statutes requires even the creation of, much less a legal duty to produce, a PIP log. Moreover, as the Third District properly determined, subsection 627.736(6) creates discovery rights in an insurance company investigating a PIP claim but does not create any discovery rights for a medical provider who is assigned an insured's PIP benefits....

...Tyler, 890 So.2d 246, 252 (Fla.2004); Harris v. Richard N. Groves Realty, Inc., 315 So.2d 528, 529 (Fla. 4th DCA 1975). Accordingly, Progressive is not entitled to attorneys' fees. RMA has petitioned for attorneys' fees under three Florida Statutes — sections 59.46, 627.428, and subsection 627.736(8)....

...5th DCA 1985). In this case, because insurance proceeds were not at issue and because RMA was not entitled to recover any wrongfully withheld payment, section 627.428 does not apply. Finally, RMA alleges that it is entitled to attorneys' fees pursuant to subsection 627.736(8), Florida Statutes: With respect to any dispute under the provisions of ss....

...s. 627.428 shall apply, except as provided in subsections (10) and (15). By its plain meaning, subsection (8) merely recognizes that the right to attorneys' fees for wrongfully withheld insurance proceeds applies in litigation over PIP benefits. Subsection 627.736(8) does not provide an independent right to attorneys' fees....

...Radio Station WQBA, 731 So.2d 638, 644 (Fla.1999). Hyma argued that the affidavit submitted by State Farm's reviewing physician was invalid. Hyma contended that the reviewing physician's affidavit was not "factually supported by the examination and treatment records [of the insured]." § 627.736(7)(a), Florida Statutes (2008)....

...This petition raises one of the issues addressed by this court's recent opinion in United Automobile Ins. Co. v. Santa Fe Medical Center, 21 So.3d 60 (Fla. 3d DCA 2009) (en banc). This case is a "denial" case, where the insurer never paid any of the claims. A denial case is governed by paragraph 627.736(4)(b), Florida Statutes....

...duced, omitted, or declined' payment of PIP claims that are reasonable, necessary, and related ...." 21 So.3d at 63. See also Partners in Health Chiropractic v. United *701 Automobile Ins. Co., 21 So.3d 858 (Fla. 3d DCA 2009). By contrast, paragraph 627.736(7)(a), Florida Statutes, is applicable in a "withdrawal" case....

...That being so, the summary judgment cannot be upheld on the right-for-wrong-reason analysis offered by Hyma. We therefore quash the opinion of the appellate division of the circuit court. The case must be returned to the county court for further proceedings under paragraph 627.736(4)(b), Florida Statutes....

...and provided a report concluding that both MRIs were not "reasonable," related to the accident, or "medically necessary." State Farm denied the claim, detailing several reasons, including the failure to calculate the charges in accordance *464 with section 627.736(5), Florida Statutes (2006). MRI Associates then submitted a pre-suit demand letter pursuant to section 627.736(11) which showed $1,816.17 and $1,707.33 as the amounts billed for the two MRIs, the same amounts that were contained in the health insurance claim form....

...After receiving the demand letter, State Farm declined to pay. In the county court, MRI Associates filed suit to recover unpaid PIP benefits. On competing motions for summary judgment, the county court ruled that MRI Associates had satisfied the prerequisites of section 627.736(5), and that State Farm could not rely on the report of its expert to deny the claim since it was not a "valid report" as contemplated by section 627.736(7)(a)....

...Fountain sent a pre-suit demand letter seeking a total of $3,000, "(subject to Medicare Fee Schedule)." Id. at 614. The insurer refused to pay and Fountain filed suit. The county court granted the insurer's motion for summary judgment, ruling that section 627.736(11) requires that a pre-suit demand letter contain "notice of the amount due." Id. The circuit court affirmed, providing this analysis of the applicable statute: PIP benefits are not due until receipt of ". . . the amount of expenses and loss incurred which are covered by the policy . . ." Fla. Stat § 627.736(4)(emphasis supplied). The claim must be submitted on a standardized form, properly completed. Fla. Stat. § 627.736(5)(d). An insurer is not required to pay if the bill ". . . does not substantially meet the applicable requirements . . ." Fla. Stat. § 627.736(5)(b)1.d. Payments are overdue "if not paid within 30 days after the insurer is furnished written notice . . . of the amount of [a covered loss]." Fla. Stat. § 627.736(4)(b)(emphasis supplied). Overdue payments bear statutory interest from the date the claim was originally made. Fla. Stat. § 627.736(4)(c). Suit may not be initiated until a demand letter is sent. The letter may not be sent until the payment is overdue. [§ 627.736(11)(a), Fla. Stat.] It must include an "itemized statement specifying each exact amount," though "(a) completed form satisfying the requirements of (5)(d) . . . may be used . . ." Fla. Stat. § 627.736(11). An insurer has 15 days after receipt of the notice to pay the overdue claim, interest, and a 10% penalty, subject to a $250.00 cap. Fla. Stat. § 627.736(11)(d)....

...letter was sent prematurely because payment was not overdue. The health insurance claim form failed to specify the exact amount owed under the statute; the $3,523.50 total exceeded what was allowed for the MRIs by the statute. [2] The language of subsection 627.736(10)(b)3. requires precision in a demand letter by its requirement of an "itemized statement specifying each exact amount"; it also allows a subsection 627.736(5)(d) health insurance claim form to be "used as the itemized statement." A necessary conclusion of this language is that the statute requires the same precision in a subsection 627.736(5)(d) health insurance claim form as it does in a subsection 627.736(11)(b)3....

...Co., ___ So.3d ___, 2010 WL 4340809 (Fla.2010) (citations omitted). [2] At the time, MRI services could "not exceed 175 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001," subject to certain adjustments. § 627.736(5)(b)5., Fla. Stat. (2006). Certain accredited hospitals were able to charge up to 200% of the amounts in the fee schedule. Id. [3] As the supreme court has observed, "[t]he statutory requirements originally contained in section 627.736(11), Florida Statutes (2001), are now located in section 627.736(10), Florida Statutes (2009)." Menendez v....

...Insurance policies tend to provide coverage for the direct benefit of the insured and separate coverage protecting the insured from liability to third parties. Thus, in a typical automobile liability insurance policy, the personal injury protection coverage required to satisfy section 627.736, Florida Statutes (2000), and *466 the uninsured motorist coverage provided to comply with section 627.727, are coverage for the direct benefit of the insured and are often referred to as "first-party coverage." The liability coverage...

...vices rendered to a policy holder who had been in an auto accident. Simon cashed the payment check without protest. Before paying Simon, Progressive informed him, along with other providers whose claims are reduced or denied, that, as established by section 627.736, Florida Statutes (PIP statute), upon submission of new information, a denied or reduced claim would be reconsidered....

...Should the *974 situation recur on remand, plaintiff would be entitled to the instruction. On the cross-appeal, we agree that State Farm was entitled to a setoff for the $10,000 in PIP benefits that it paid. Plaintiff does not dispute the fact that he received those benefits. See § 627.736(3), Fla....

...fee purposes of an unreasonable number of attorney hours and the inappropriate use of a multiplier in calculating the fee. The Care Center then moved in the circuit court for attorney's fees and costs with respect to the appeal pursuant to sections 627.736(8) and 627.428, Florida Statutes (2001)....

...on, statutes, rules of court, and controlling case law. See Kaklamanos. In the present case the circuit court departed from controlling case law in arriving at its appellate attorney's fee determination. Two statutes underlie our conclusions. First, section 627.736(8) authorizes an award of attorney's fees with respect to certain disputes between an insured and its insurer arising out of the Florida Motor Vehicle No-Fault Law, [1] including cases involving personal injury protection....

...She claims in this class action that this amount is insufficient to compensate her for the cost of driving her car to obtain medical treatment. We affirm the dismissal for failure to state a cause of action. The applicable provision of our PIP statute, section 627.736(1)(a), Florida Statutes (2001), includes as medical benefits: Eighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices, and medically necessary ambulance, hospital, and nursing services....

...proceedings. In its class action complaint, Open MRI alleged that it provided magnetic resonance imaging (MRI) services to a person insured by Atlanta Casualty and, pursuant to a written assignment, sought payment for the MRI under the provisions of section 627.736(5)(b)(5), Florida Statutes (2001), which states in relevant part: Effective upon this act becoming a law [i.e., June 19, 2001] and before November 1, 2001, allowable amounts that may be charged to a personal injury protection insuranc...

...Thus, that portion of the statute must be declared inoperative and Atlanta Casualty's nonperformance should be excused. The trial court denied Atlanta Casualty's motion to dismiss and scheduled a hearing on Open MRI's motion for class certification. Atlanta Casualty filed its answer and asserted as an affirmative defense: "Section 627.736(5)(b)(5), Fla....

...asmuch as there is no `medical Consumer Price Index for Florida.' The law cannot require the performance of an impossible act." Both parties filed competing motions for summary judgment on the issue of liability based on the proper interpretation of section 627.736(5)(b)(5), specifically, the meaning of the term "medical Consumer Price Index for Florida." On April 19, 2004, the trial court conducted a hearing on the motions for summary judgment and class certification....

...tate of Florida who [Atlanta Casualty] has failed and/or refused to make full payment for magnetic resonance imaging services in an amount adjusted annually by an additional amount equal to the medical Consumer Price Index for Florida as required by Section 627.736(5)(b)5 from November 1, 2001, through July 31, 2003....

...Further, Atlanta Casualty argues that Open MRI's claim would not be typical of the claims of each class member because proof of the issue of when the CPI adjustment first comes into *138 effect is not necessary to prove Open MRI's individual claim. On the common issue of whether an additional CPI adjustment is required by section 627.736(5)(b)(5), Florida Statutes (2001), it appears that Open MRI is an adequate class representative for all class members....

...e to eliminate the issue regarding the effective date of the annual adjustment. Reversed and remanded for further proceedings. ALTENBERND, C.J., and WHATLEY, J., concur. NOTES [1] In its order granting class certification, the trial court notes that section 627.736(5)(b)(5) was amended in 2003 to clarify the legislature's intent that the required annual adjustment be made "on August 1 to reflect the prior calendar year's changes in the annual Medical Care Item of the Consumer Price Index for All...

...denied, 279 So.2d 305 (Fla.1973). In personal injury protection claims, a party must turn over all medical records concerning a specific condition only after requesting and receiving a copy of medical reports from a medical examination requested by the insurer. § 627.736(7)(b), Fla....

...with United Automobile Insurance Company (UAI). When the insurance company refused to pay the medical bills submitted, Tienna sued. Tienna's amended complaint contained three (3) counts: count I, breach of contract; count II, failure to comply with section 627.736, Florida Statutes (1995); and count III, bad faith. The bad faith claim was abated pending the outcome of the PIP action. Tienna filed a motion for partial summary judgment, arguing that UAI failed to comply with section 627.736(4)(b)....

...This section requires PIP benefits to be paid within thirty (30) days after an insurer is furnished written notice of a covered loss (a claim). However, payment is not overdue after thirty days if the "insurer has reasonable proof to establish that the insurer is not responsible for the payment." § 627.736(4)(a), Fla. Stat. (1995). Section 627.736(7)(a) further provides that PIP benefits may not be withdrawn "unless the insurer first obtains a report by a physician licensed under the same chapter as the treating physician whose treatment authorization is sought to be withdrawn,...

...State Farm Fire and Casualty Co., 746 So.2d 1123 (Fla. 3d DCA 1999), rev. granted sub nom., United Auto. Insurance Co. v. Rodriguez, 767 So.2d 464 (Fla.2000). [1] Perez held that *1011 the burden is on the insurance company to obtain the report required under section 627.736(7)(a) to verify a claim within thirty days after receipt of an application for benefits....

...See Daidone, 760 So.2d at 1112-13. However, if the insurer has refused to pay the bill within thirty days and does not have reasonable proof to establish that it is not responsible, then the insurer is liable for ten percent interest when the bill is paid. See id.; § 627.736(4)(c), Fla. Stat. (1995). The thirty day provision in section 627.736(4)(b) sets forth when interest begins to accrue on unpaid PIP benefits....

...Scott alleged in his complaint for bad faith that, under his policy with Progressive, Progressive was obligated to pay 80% of all reasonable and necessary medical expenses as provided in the Personal Injury Protection (PIP) provisions in the policy as required by section 627.736(1)(a), Florida Statutes (2002)....

...the terms and conditions of his policy and to the Florida No-Fault Act. See §§ 627.730-627.7405, Florida Statutes (2002). Scott contended that Progressive's payment of less than 80% of his reasonable expenses for medically-necessary care violated section 627.736(1)(a) and Progressive's obligations under the policy....

...ral business practice and in wanton and willful disregard for the rights of its insureds, fails to pay 80% of reasonable and necessary medical expenses and continually reimburses its insureds in amounts on less favorable terms than those required by section 627.736(1)(a) and its policy of insurance....

...Lago, 867 So.2d 1184, 1186 (Fla. 4th DCA 2004). "In assessing the adequacy of the pleading of a claim, the court must accept the facts alleged therein as true and all inferences that reasonably can be drawn from those facts must be drawn in favor of the pleader." Id. Section 627.736, Florida Statutes (2002), entitled "Required personal injury protection benefits; exclusions; priority; claims," provides: (1) REQUIRED BENEFITS....

...policy limits of that driver's liability insurance. USAA paid the Sheltons the full amount of the statutorily required no-fault coverage under their automobile insurance policy, $10,000 for PIP benefits and $5000 for additional medical benefits. See § 627.736(1), (1)(a), Fla....

...ly automatic" payment of PIP claims envisioned by the PIP law. Thus, a carrier may well be induced to give the insured the benefit of the doubt and to pay a claim it might otherwise have contested. Moreover, basic PIP coverage is limited to $10,000. § 627.736(1)....

...uffering, mental anguish, and inconvenience because of bodily injury, sickness, or disease arising out of the ownership, maintenance, operation, or use of such motor vehicle only in the event that the benefits which are payable for such injury under § 627.736(1)(a) [or which would be payable for such injury under § 627.736(1)(a)] or which would be payable but for any exclusion or deductible authorized by §§ 627.730-627.741 exceed one thousand dollars or the injury or disease consists in whole or in part of permanent disfigurement, a fracture to a weight-be...

...Federated's insureds, because PCS does not perform necessary medical services and is not a "physician, hospital, clinic, or other person or institution lawfully rendering treatment to an injured person for a bodily injury covered by PIP insurance." § 627.736, Fla....

...the Florida Automobile Reparations Reform Act, ... ." The Act requires an insurer to pay PIP benefits to certain persons occupying an owner's vehicle provided such *1366 persons do not own unprotected motor vehicles for which security is compelled. Section 627.736(4)(d)....

...If the patient's history is correct in that he was asymptomatic prior to the accident and symptomatic afterwards, I would say his symptoms probably were related to that accident. At the present time there is no objective evidence of any residual injury. Section 627.736, Florida Statutes (1983), provides that "every insurance policy complying with the security requirements of § 627.733 shall provide personal injury protection to ......

...The broad scope of the medical services covered by the No-Fault Act is highlighted by the inclusion of benefits for remedial treatment and services for an injured person who relies upon spiritual means through prayer alone for healing in accordance with his religious beliefs. § 627.736(1)(a)....

...Pekaar reveals that appellant's chest problem related solely to his heart condition and had no relation to the accident. This after-the-fact determination, however, does not absolve appellee from liability under its insurance policy for this expense. § 627.736, Florida Statutes, requires that every insurance policy for personal injury protection benefits provide payment for "......

...actions which sought to challenge, as being too low, the 32.5 cent per mile travel reimbursement benefit paid to PIP insureds for automobile travel expenses incurred while driving to and from medical providers. The appellants' claims are based upon § 627.736(1)(a), Florida Statutes (2000), which requires PIP medical benefits to include the payment of 80% of "all reasonable expenses for necessary medical ......

...Cauley, 666 So.2d 898, 900 (Fla.1996)("Under the principle of statutory construction, expressio unius est exclusio alterius, the mention of one thing implies the exclusion of another."). 848 So.2d at 374 We fully agree with Judge Klein's sound analysis in Malu, and, adopting that reasoning as our own, also hold that § 627.736(1)(a), Florida Statutes does not provide for payment of the automobile transportation expenses at issue....

...le must pay PIP benefits for accidental bodily injury sustained in this state by the owner while (1) occupying a motor vehicle or (2) while not an occupant of a self-propelled vehicle if the injury is caused by physical contact with a motor vehicle. § 627.736(4)(d)(1), Fla....

...O'Kelley, 349 So.2d at 718. In O'Kelley, the court held that a minibike with between 3 1/2 to 5 brake horsepower which was involved in an accident was a "motor-driven cycle" as defined under section 316.003(23) [3] and not a motorcycle as contemplated by section 627.736 and thus the insurance carrier was required to pay PIP benefits to the plaintiff....

...Had it intended to limit recovery under PIP solely to pedestrians, the Legislature could have simply stated so. Under chapter 316, the moped involved here is a "bicycle" and not a "vehicle" and therefore it cannot be a "self-propelled vehicle" for purposes of section 627.736(4)(d)....

...[3] Section 316.003(23) provides as follows: Motor-driven cycles. — Every motorcycle and every motor scooter with a motor which produces not to exceed five brake horsepower, including every bicycle propelled by a helper motor rated in excess of 1 1/2 brake horsepower. [4] Section 627.736(4)(d)(1) originally provided that an insured was entitled to PIP benefits if he were "not an occupant of a motor vehicle or motorcycle......

...What the courts have held to be reasonable in the context of medical exams is not necessarily the same as for depositions. For example, in Progressive American Insurance Company v. Belcher, 496 So.2d 841 (Fla. 5th DCA 1986), an action involving the right to take a medical examination of one seeking PIP benefits, we construed section 627.736(7)(a), Florida Statutes, as requiring that the examination be taken in the resident city of the claimant or, if an appropriate expert was not available there, then in the area closest to the claimant's residence....

...onal injury protection (PIP) benefits. We hold that under Chapter 25C, a hospital lien takes priority over benefits covering funeral expenses, lost wages, and lost earning capacity which would be available to appellant under appellee's PIP coverage. § 627.736, Fla....

...Memorial Hospital [1] and to the personal representative, but the offer was declined on the ground that appellant was entitled to apply PIP benefits to the payment of funeral expenses and lost wages. Appellant filed a lawsuit in which she relied on section 627.736(4)(b), Florida Statutes (Supp....

...rted by the record. Strawgate v. Turner, 339 So.2d 1112 (Fla. 1976). Appellant's remaining points are without merit. Affirmed. NOTES [1] Angel Fernandez incurred more than $72,000 in medical bills at Jackson Memorial Hospital prior to his death. [2] § 627.736(4)(b), Fla....

...denied, 211 So.2d 215 (Fla. 1968); Musachia v. Terry, 140 So.2d 605 (Fla. 3d DCA 1962). [1] Cf. Cleveland v. City of Miami, 263 So.2d 573 (Fla. 1972), mandate conformed to 264 So.2d 864 (Fla. 3rd DCA 1972); Revitz v. Baya, 355 So.2d 1170 (Fla. 1977). [2] § 627.736(7)(a), Fla....

...Additionally, the trial court certified the following question to be of great public importance: WHETHER A PROVIDER OF MEDICAL SERVICES WHO HAS ACCEPTED AN ASSIGNMENT OF BENEFITS FROM AN INSURED IS ENTITLED TO ATTORNEY'S FEES AND COSTS UNDER FLORIDA STATUTE 627.736 AND 627.428(1) IN AN ACTION AGAINST THE INSURER, WHEN THE INSURER HAS MADE PAYMENT SUBSEQUENT TO THE FILING OF THE LAWSUIT, IN LIGHT OF THE DECISION IN DELTA CASUALTY CO. VS. PINNACLE MEDICAL, INC ., WHEREIN THE ARBITRATION PROVISION OF 627.736(5) WAS HELD UNCONSTITUTIONAL? Kristina Chew (Chew) was injured in an automobile accident on October 28, 1997 in a car driven by Eric Horner, and owned by Eric's mother, Joann Horner....

...t excused by Chew's alleged non-compliance with Superior's requests for information; and 2) In what capacity did Libert bring suit. Superior alleges that its delay in payment was excused by Chew's failure to comply with its requests for information. Section 627.736(4)(b), Florida Statutes (1998) states in relevant part: Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same.......

..., unless authorized to do so by the assignee." Ray, 556 So.2d at 813 (citations omitted); see also Rittman v. Allstate Ins. Co., 727 So.2d 391, 395 (Fla. 1st DCA 1999) (Barfield, J. concurring) (pre-dating determination of the unconstitutionality of section 627.736(5) and discussing that assignors cannot bring suit on their own behalf)....

...intiff was entitled from defendant Allstate Insurance Company as the insurer of the Tennessee tortfeasor. Both parties agree that the propriety of the subrogation lien is governed by Florida law. Plaintiff contends that the trial court erred because section 627.736(3), Florida Statutes (1987), the Florida Motor Vehicle No-Fault Law, precludes such a lien by providing: No insurer shall have a lien on any recovery in tort by judgment, settlement, or otherwise for personal injury protection benefits, whether suit has been filed or settlement has been reached without suit. We agree with plaintiff and reverse. Defendant argues in effect that that statutory prohibition of a subrogation lien is implicitly qualified by the next following sentence in section 627.736(3) which provides: An injured party who is entitled to bring suit under the provisions of ss....

...1972), argues that in this case the injured party did have a right to recover such items of damages (and the above-referenced settlement proceeds included such items) because Tennessee law under which the $8,750 settlement money was paid to plaintiff, in contrast to the second of the above-quoted sentences from section 627.736(3), permits such a right of recovery....

...384, 388, 410 S.W.2d 171, 173 (1966), argues that Tennessee law, correspondingly, would permit a subrogation lien of the type awarded here. *152 Defendant additionally cites Purdy v. Gulf Breeze Enterprises, Inc., 403 So.2d 1325 (Fla. 1981), for the point that the elimination in the second above-quoted sentence of section 627.736(3) of an injured party's right to recover from the tortfeasor damages for which PIP type benefits are payable is for the purpose of preventing the injured party from receiving double recovery, the injured party having received those benefits from his own insurance carrier....

...We do not conclude that the legislature intended that attorneys for an injured party negotiating a settlement of the kind involved here should, in determining the settlement amount to be received, perceive that that amount would be subject to reduction by reason of a subrogation lien specifically prohibited by law. If section 627.736(3) is to mean otherwise, that should be for the legislature to say....

...However, January did not attend the scheduled examination, nor did he attend a second scheduled examination, taking the position through counsel that PIP was largely controlled by statute and that the PIP statute did not contemplate statements under oath, only the discovery referenced in section 627.736(b) and (c), Florida Statutes (1999)....

...It is clear that an insurer is not freed from the statutory time constraints of a PIP claim payment simply by raising a coverage issue. As we have repeatedly said and as the supreme court said in United Automobile Insurance Co. v. Rodriguez, 808 So.2d 82 (Fla.2001), the legislative intent of the penalty provision in section 627.736(4) is to promote resolution of PIP claims by imposing reasonable penalties on insurers who pay late....

...PIP coverage. Appellee concedes this point and agrees that the total authorized PIP benefits are $5,373.12. Appellant is also correct in its assertion that prejudgment interest should have been assessed at ten percent rather than the twelve percent. § 627.736(4)(c), Fla....

...In those cases, the carrier failed to recognize and verify the claims within the 30 days, to wit, the carrier simply held the payment of claims until they received "proof" of the loss. In the case at hand, however, Allstate recognized and paid the "reasonable" cost of the services described in the bill. Section 627.736(4)(b), Florida Statutes, requires that benefits due from an insurer be payable within 30 days after the insurer is furnished written notice of the fact of the covered loss and the amount of the claim. Section 627.736(5) requires that a physician, hospital or clinic charge "only a reasonable amount for the products, services, and accommodations rendered" to individual covered by PIP insurance....

...units of treatment. Because Allstate did not pay the entire claim due to an error in the doctor's bill, its failure to pay said claim does not rise to that level of "wrongful" which would entitle Ms. Ivey to an award of attorney's fees. Fla. Stat. §§ 627.736(8), 627.428; see also Obando v....

...regular mail. Telusnor claims that she would have gone to the exams had she known about them. Next we turn to the reasonableness of Telusnor’s excuse for her failure to appear. Reasonable versus unreasonable is at issue because of the language of section 627.736(7), Florida Statutes (2009), which states that if a person unreasonably refuses to submit to a medical exam, the PIP carrier is no longer liable for subsequent personal injury protection benefits. By using the term “unreasonably refuses to submit” in subsection 627.736(7)(b), it is logical to deduce there are scenarios where the insured “reasonably refuses to submit” to the examination....

...Initially, as a putative class representative, Mr. Padilla filed a claim in the Circuit Court for the Eleventh Circuit against Liberty Mutual Insurance Company (Liberty Mutual), seeking additional reimbursement for mileage in personal automobile travel to and from medical appointments. See § 627.736(1)(a), Fla....

...sputes about the amounts of benefits payable under personal injury protection policies. [3] Under the statutory scheme, the courts decide, case by case, whether insurers have met their obligations [4] to pay personal injury protection benefits under section 627.736(1)(a). See § 627.736(4)(b) & (11), Fla....

...[3] Although the Department has authority to regulate the rates at which insurers charge premiums, see §§ 627.011-381, Fla. Stat. (2001), DOI has no statutory authority, rulemaking or otherwise, to set mileage reimbursement rates payable as benefits under section 627.736(1)(a), Florida Statutes (2001). Cf. § 627.736(5)(b), Fla....

...At issue in this appeal is the proper method for determining no-fault medical and wage loss benefits in accord with the provisions of Section 627.739(2), Florida Statutes (1985). Wayne Govan was injured in an automobile accident and incurred medical bills in the amount of $5,887.45. Pursuant to the provisions of section 627.736(1)(a), Florida Statutes (1985), International Bankers insured Govan for 80% of his medical expenses up to a maximum amount of $10,000.00 for any single accident....

...s an amount to be deducted from the claim, but rather would simply be a means of providing for lower policy limits. We do not believe the legislature would have authorized lower policy limits in such an indirect and unusual fashion, especially since section 627.736(1)(a) specifically mandates coverage in the amount of at least $10,000.00....

...Her PIP policy with Fortune was a $10,000 policy with a $2,000 deductible. After a nonjury trial, the trial court awarded McGhee the full amount of the workers' compensation payments, less the $2,000 deductible, and entered a final judgment in the amount of $4,054.21 exclusive of costs and attorneys' fees. Section 627.736, Florida Statutes (1985) requires that all insurance policies for vehicles registered in Florida must provide PIP benefits covering economic losses, including medical and disability (or lost income) benefits. Although section 627.736(4) provides that PIP benefits shall be "primary," it also states "that benefits received under any workers' compensation law ......

...n 440.39. The trial court then shall enter a judgment against Fortune for an amount which includes $2,000 plus the carrier's pro rata share of fees and costs. Reversed and remanded. CAMPBELL, A.C.J., and PARKER and ALTENBERND, JJ., concur. NOTES [1] Section 627.736(4), Florida Statutes (1985), effectively makes both PIP and workers' compensation primary coverage for a work-related automobile accident....

...The trial court granted the insurance company's motion for summary *324 judgment and dismissed the case with prejudice. Turning first to the issue of PIP coverage, it is undisputed that Niglio was a pedestrian at the time of the shooting. Coverage is therefore controlled by section 627.736(4)(d)1, Florida Statutes (Supp.1990), which provides that an insurer shall pay benefits for accidental bodily injury that a covered person sustains "while not an occupant of a selfpropelled vehicle if the injury is caused by physical contact with a motor vehicle." See Hernandez v....

...Any more expansive approach would have ignored the drafter's use of the term "physical contact with a motor vehicle." Recently, this court followed Castagna and held that a pedestrian who dove out of the way to avoid being struck by an automobile was entitled to PIP coverage under section 627.736(4)(d)1....

...Pinkerton-Hays Lumber Co., 120 So.2d 227 (Fla. 1st DCA 1960), cert. denied, 127 So.2d 441 (Fla. 1961); Fla. Std. Jury Instr. (Civ.) 5.1a. Where motor vehicles were incidental to the act causing injury, playing only supporting roles, courts have found no PIP coverage under section 627.736(4)(d)1....

...The front end loader was not a "motor vehicle" under section 627.732(1), Florida Statutes (1983). Applying Castagna, this court held that "there [did not] exist the necessary causal link between [the plaintiff's] injuries and the use of a motor vehicle" so that there was no PIP coverage under section 627.736(4)(d)1. Id. at 644. Welty demonstrates *325 that Castagna requires something more than the application of a simple "but for" test to determine coverage. See Underwriters Guarantee Ins. Co. v. Gregory, 582 So.2d 11 (Fla. 3rd DCA)(no coverage under section 627.736(4)(d)1 when plaintiff slipped on greasy soap at Shell station where she had gone to fuel up her van), rev....

...by the bullet, not the Mustang. The car was not the most substantial factor in bringing about the injury. Although it enabled and facilitated the crime, the car was only incidental to the act causing the injury. Thus, there is no PIP coverage under section 627.736(4)(d)1....

...Co., 542 So.2d 347, 349 (Fla.1989). To resolve the issue of coverage in UM cases, the supreme court in Race decided not to apply the broad "nexus test" of Government Employees Ins. Co. v. Novak, 453 So.2d 1116 (Fla.1984), applicable to PIP coverage under section 627.736(1). Race framed a more narrow test for UM coverage than for PIP, even though the coverage language in the UM policy—"arising out of the ownership, maintenance, or use"—was identical to that of section 627.736(1)....

...n in a drive-by shooting is merely an incidental contribution to the shooting causing the injury, not conduct which itself produces the injury. See Race, 542 So.2d at 349. AFFIRMED. DELL and SHAHOOD, JJ., concur. NOTES [1] It is the applicability of section 627.736(4)(d)1 which distinguishes this case from the line of cases based on the broader standard of section 627.736(1), Florida Statutes (Supp.1990), where coverage is available for an injury "arising out of the ownership, maintenance or use of a motor vehicle." E.g., Government Employees Ins....

...es may be "stacked" to provide more than a $5,000 recovery in a single accident. We hold that personal injury protection benefits may not be "stacked" and that the circuit court departed from the essential requirements of law when it failed to apply Section 627.736(1) [1] *662 and Section 627.736(4)(e), [2] Florida Statutes (1975)....

...rly would have sought recovery from the one at fault. Cf. Government Employees Insurance Co. v. Graff, 327 So.2d 88 (Fla. 1st DCA 1976). As such, the prescribed limitation of $5,000 is applicable to a single accident. Because of the clear wording of Section 627.736(1), Florida Statutes (1975), there is no question but that the total benefits are $5,000. Cf. the wording in Section 627.736(4)(e), Florida Statutes (1975), evidencing the same intent....

...policies there could have been a multiple recovery. That decision noted that the question of multiple recovery *663 for personal injury protection benefits had not been decided by the courts of Florida. We, therefore, hold that the clear language of Section 627.736(1), Florida Statutes (1975), limits recovery of personal injury protection benefits to the statutory limit of $5,000 in a single accident....

...Floyd Pearson Richman Greer Weil Brumbaugh & Russomanno, and Scott D. Sheftall and Steven M. Brady, Miami, for appellee. Before COPE, GODERICH and FLETCHER, JJ. FLETCHER, Judge. Appellant U.S. Security Insurance Co. [Security] appeals the denial of its motion to compel arbitration pursuant to section 627.736(5), Florida Statutes (1995) [1] of a statutory interest claim for late payment under section 627.736(4)(b)-(c), Florida Statutes (1995) [2] ....

...Magnetic filed suit against Security, asserting entitlement to statutory interest because a payment of personal injury protection (PIP) benefits assigned to Magnetic and incurred by Security's insured was made late. Security's only response to the complaint was its motion to compel arbitration, relying on section 627.736(5). The trial court denied the motion and Security filed this appeal which places two main issues before this Court: (1) whether the arbitration provision mandated by section 627.736(5) should be considered part of the insurance policy where it is not included in the policy was written, and (2) if it is, whether a claim for late-payment interest is arbitrable. We answer both questions affirmatively. In 1990, section 627.736(5) was added to the Florida Insurance Code [chs....

...With respect to the second question concerning the arbitrability of the late-payment interest claim, we find that such a claim qualifies as a "claims dispute involving medical benefits arising between the insurer and [a] person [or entity] providing medical services or supplies...." § 627.736(5), Fla....

...potential ramifications of such holding, we cannot agree with Magnetic's position. We decline to hold that a statutory interest claim resulting from a late payment for services rendered is not a "claims dispute involving medical benefits" subject to section 627.736(5) arbitration....

...al injury protection benefits under a policy issued by the respondent, Government Employees Insurance Company (GEICO). Prior to initiating her declaratory action Klipper had agreed to honor GEICO's request for a medical examination, made pursuant to section 627.736(7), Florida Statutes (1989)....

...Gibson, 456 So.2d 1320 (Fla. 4th DCA 1984). However, an examination conducted pursuant to the rules of civil procedure presupposes that litigation has been initiated and that the parties are in an adversarial posture. The medical examination provided for by section 627.736(7), which arises from the contractual relationship between a consumer and the insurer of his choice, is designed to assist the insurer in evaluating whether it is obligated to pay benefits under its policy....

...The appellee Rickey Butler, while a passenger in a public conveyance, was injured when it was struck by an automobile driven by Adres Machado, insured by the appellant Gateway Insurance Company, herein referred to as the insurer. Butler filed action against the insurer for recovery of benefits as provided for in § 627.736(1) Fla....

...We frame the issue as follows: WHEN A PARTICULAR CPT BILLING CODE IS NO LONGER RECOGNIZED BY MEDICARE PART B BUT THE SERVICE REPRESENTED IN THAT BILLING CODE REMAINS COVERED UNDER MEDICARE PART B, IS THE SERVICE “REIMBURSABLE UNDER MEDICARE *961 PART B” FOR PURPOSES OF SECTION 627.736(5)(a)(2)(f), FLORIDA STATUTES (2009)? We answer the question in the affirmative, and we affirm the final judgment of the county court....

...Tedder’s bill and a presuit demand for payment, Allstate ultimately paid $192.80, which represented 80% of the fee for CPT code 99245 under the workers’ compensation fee schedule rather than 80% of 200% of the amount allowable under the participating physicians fee schedule for Medicare Part B. See § 627.736(5)(a)(2)(f)....

...sicians schedule for Medicare Part B for 2007. In opposition, Allstate asserted that CPT code 99245 is not reimbursable under the Medicare Part B schedule for 2010 and that Allstate properly applied the workers’ compensation schedule as allowed by section 627.736(5)(a)(2)(f)....

...ered final summary judgment, it entered an order on rehearing certifying its final judgment as a matter of great public importance pursuant to rule 9.160. Specifically, the order states that the “issue in this matter is interpretation [of section] 627.736(5)(a)(2), (3), and (4) as it relates to consultation codes and the proper fee schedule utilization therein under law.” II....

...We review de novo the county court’s interpretation of the relevant PIP statute and its determination that Dr. Tedder is entitled to summary judgment as a matter of law. See Allstate Ins. Co. v. Holy Cross Hosp., Inc., 961 So.2d 328, 331 (Fla.2007); Judy v. MSMC Venture, LLC, 100 So.3d 1287, 1288 (Fla. 2d DCA 2012). Under section 627.736, an insurer may “choose between two different payment calculation methodology options.” Kingsway Amigo Ins....

...440.13 and rules adopted thereunder which are in effect at the time such services, supplies, or care is provided. Services, supplies, or care that is not reimbursable under Medicare or workers’ compensation is not required to be reimbursed by the insurer. § 627.736(5)(a)(2)(f) (emphasis added). Thus, under section 627.736(5)(a)(2)(f), if services are not “reimbursable” under Medicare Part B, they may be reimbursed under the workers’ compensation schedule....

...Therefore, it is clear that the services represented by CPT code 99245 are still covered by Medicare Part B if they are medically reasonable and necessary. 3 It then follows that the services are “reimbursable under Medicare Part B” for purposes of section 627.736(5)(a)(2)(f). The language of section 627.736(5)(a)(2)(f) is clear....

...Because the services provided by Dr. Tedder are reimbursable under Medicare Part B, Allstate was not permitted to utilize the worker’s compensation fee schedule. Allstate was required to reimburse Dr. Tedder under a Medicare Part B fee schedule. Section 627.736(5)(a)(3) provides that [f]or purposes of subparagraph 2., the applicable fee schedule or payment limitation under Medicare is the fee schedule or payment limitation in effect at the time the services, supplies, or care was rendered an...

...although the services are still reimbursable under Medicare Part B; therefore, Allstate should have referred to the Medicare Part B schedule for 2007, which is the baseline for services reimbursable under Medicare Part B. See id. We acknowledge that section 627.736(5)(d) requires providers to submit bills for services that comply with the CPT coding in effect for the year in which the services are rendered....

...2d DCA 2009) (“[T]his court is not permitted to add words to a statute that were not placed there by the legislature.”). III. Conclusion In sum, we hold that the county court correctly concluded that the consultation services provided by Dr. Tedder are reimbursable under section 627.736(5)(a)(2)(f) despite the fact that the CPT code used to identify those services is no longer recognized by Medicare Part B....

....The article can be found at http://www.cms. gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMatters Articles/downloads/mm6740.pdf (last visited March 18, 2013). . Allstate does not argue that the consultation services were not medically reasonable and necessary. . Section 627.736(5)(d) provides in relevant part that *964 [a]Il billings for such services rendered by providers shall, to the extent applicable, follow the Physicians’ Current Procedural Terminology (CPT) or Healthcare Correct Procedural Coding Sy...

...Prior to instituting suit, the petitioner's lawyer negotiated a settlement with the third party carrier for $10,000, the policy limit. The circuit court awarded the respondent an equitable distribution of that recovery in satisfaction of its claim of a lein for personal injury protection benefits paid, pursuant to Fla. Stat. § 627.736(3)(b). The circuit court later entered an amended order which awarded respondent the full sum of $3,927.26, pursuant to Fla. Stat. § 627.736(3)(a), based on the Third District's decision in State Farm Mutual Auto Insurance Co....

...r, Travelers) agreed upon a settlement of $5,000. Pursuant to plaintiffs' motion for equitable distribution, the trial court awarded the plaintiffs' insurer, State Farm, $150.00 under the equitable distribution reimbursement provisions of Fla. Stat. § 627.736(3)(b)....

...State Farm appealed contending that the trial court *303 should not have employed equitable distribution under paragraph (b), but should have ordered the plaintiff to make full reimbursement of the $1,339.60 "no fault" P.I.P. benefits paid to her. In construing paragraphs (a) and (b) of subsection (3) of Section 627.736, the Third District stated that the two paragraphs "resist reconciliation" in that paragraph (a) requires full reimbursement to the no fault insurer (State Farm) by the insured (Mrs....

...not suit has been filed prior to settlement with the third party tortfeasor. As pointed out by the First District in White, supra, 299 So.2d at 663, the Florida Statutes omitted part of the third line of paragraph (b). As enacted by the legislature Section 627.736(3)(a)-(b) correctly reads: "(3) Insurer's rights of reimbursement and indemnity....

...State Farm specifically sought to determine whether the services were lawfully rendered, reasonable, related, and medically necessary. Unable to verify that the two Millennium facilities that rendered the services were properly accredited, State Farm served Millennium with statutory requests for information pursuant to section 627.736, Florida Statutes (2010)....

...The requests, sent in June and July of 2011, asked for written documentation of the MRI equipment used, and proof of accreditation, as well as various other documents. Millennium did not pro *1088 duce the documents requested. State Farm then filed an action for discovery pursuant to section 627.736, Florida Statutes (2010)....

...court’s discovery order. Boyer, 360 So.2d at 391-92. We note that even if the order had not yet been entered, the circuit court acted within its jurisdiction. “In the event of a dispute regarding an insurer’s right to discovery of facts under [section 627.736(6) ], the insurer may petition a court of competent jurisdiction to enter an order permitting such discovery.” § 627.736(6)(c), Fla....

...on, both the county court and circuit court were vested with equity jurisdiction in this matter. Cf. MRI Servs., Inc. v. State Farm Mid. Auto. Ins. Co., 807 So.2d 783, 786 (Fla. 2d DCA 2002) (noting that a county court has equity jurisdiction over a section 627.736(6)(c) discovery action where the amount in controversy does not exceed the county court’s jurisdictional amount and rejecting argument that circuit court alone has equity jurisdiction to order discovery). In addition, Millennium claims that State Farm’s action for discovery under section 627.736(6)(c) is not a claim in equity....

...specific act. State Farm Mut. Auto. Ins. Co. v. Green, 579 So.2d 402, 403 (Fla. 5th DCA 1991). State Farm’s action for discovery was an equitable action that fell within the circuit court’s equitable jurisdiction. Florida courts have recognized section 627.736(6)(c) actions as actions in equity. See MRI Services, 807 So.2d at 786 (noting that the county court had equity jurisdiction over a section 627.736(6)(b) discovery action); see also State Farm Mut. Auto. Ins. Co. v. Goldstein, 798 So.2d 807 (Fla. 4th DCA 2001) (addressing section 627.736(6)(c) and the circuit court’s discovery order without stating that the circuit court lacked subject matter jurisdiction to rule on the order); Kaminester v....

...The “nature of the breach” here was the violation of a statute requiring a medical provider to comply with an insurer’s discovery requests relating to claims by its insureds. King Mountain, 425 So.2d at 571 . The remedy for such a breach — a remedy section 627.736(6)(c) contemplates — is an order directing a party to comply with such discovery....

...The Florida legislature has codified several actions that are undeniably equitable actions without transforming them into legal actions. See e.g. § 65.061, Fla. Stat. (2013). Therefore, the circuit court acted within its equity jurisdiction in hearing and ruling on State Farm’s action for discovery under section 627.736(6)(c)....

...The trial court entered individual summary judgments followed by final judgments in favor of each of the appellees in the amount of $5,000, plus interest, costs and attorney's fee. In addition, the trial court dismissed with prejudice appellant's counterclaims by which appellant sought, under Section 627.736(3)(a), subtraction of, reimbursement, and/or enforcement of a lien on the recovery obtained by each appellee on her claim in tort against the tort-feasor....

...Allstate Indemnity Company appeals from the trial court's non-final order *246 granting class certification and naming Leandro de la Rosa the Class Representative. We affirm. De la Rosa filed a class action complaint in November 1999 in which he alleged that Allstate, his PIP insurer, violated section 627.736, Florida Statutes (Supp.1996) by failing to pay 80% of his medical bills without first obtaining either a report of a physician who performed an independent medical examination or a record review justifying the reduced payment of thos...

...Shutts & Bowen, LLP, and Frank A. Zacherl and Suzanne Youmans Labrit, Miami, for respondent. Before, GREEN, SUAREZ, and CORTIÑAS JJ. GREEN, J. Coral Imaging Services petitions for a writ of certiorari to quash a decision of the Circuit Court Appellate Division interpreting section 627.736(5)(b), Florida Statutes (1999)....

...y claims was improper. The question squarely presented is whether the insurer has the right under the statute to pay for the services rendered by a provider when the provider has concededly failed to submit the bills within the timeframe mandated by § 627.736(5)(b) and has violated the express terms of the statute by including untimely claims in the billing statement submitted to the insurer....

...ting another provider from receiving payments for services provided and billed for on a timely basis. I believe that such a statutory interpretation is not logical, reasonable, or intended by the Legislature. This case involves the interpretation of Section 627.736(5)(b), Florida Statutes (1999), which establishes the requirements for payment of Personal Injury Protection (PIP) benefits under Florida's No-Fault Law....

...The initial question which must be answered, then, is whether the wording of the statute is "clear and amenable to a logical and reasonable interpretation." I conclude that the majority's interpretation of the statute does not meet this threshold test. Under the relevant provisions of Fla. Stat. § 627.736(5)(b): 1) A provider of medical services must submit to the insurer a statement of charges for treatment or services rendered to the insured; 2) The provider's statement of charges " may not include ....

...Only by violating this portion of the statute can we ever reach the question of whether an insurer has the authority to pay an untimely bill. [3] In order to be in a position to receive payment on its untimely claim, Professional Reading had to violate the express provisions of Section 627.736(5)(b) by submitting a statement of charges which included untimely-billed services....

...recourse against the insured because the statute provides that "[t]he injured party is not liable for, and the provider shall not bill the injured party for, charges that are unpaid because of the provider's failure to comply with this paragraph." [§ 627.736(5)(b), Fla....

...This interpretation allows the insurer to avoid or defeat altogether the purpose of the time limitation by paying an untimely provider and subjecting its own insured to liability the statute was created to prevent. Given this application, I do not believe that the majority's interpretation of Section 627.736(5)(b) can be characterized as logical or reasonable....

...statute must be read as: 1. Prohibiting the provider from submitting for payment the untimely charges and (if said untimely charges are improperly submitted) requiring the insurer to deny payment as violative of the express provisions of Fla. Stat. § 627.736(5)(b); or 2....

...Co., 899 So.2d 1090 (Fla.2005). In upholding the time requirements as constitutional, the Court stated: [I]ncluded in the no-fault statute is a provision for a procedure through which medical providers may file claims and receive payment for services provided. See § 627.736(5)(a), Fla. Stat. (1999). Section *16 627.736(5)(b) sets forth the procedures with which treating medical providers must comply in order to receive payment from the no-fault insurer for services rendered....

...f contract claim. As a result, medical providers could potentially allow charges to mount, and submit charges for services rendered over a long period of time, and distant from the time of the original accident. In 1998 . . . the Legislature amended section 627.736(5)(b) to expressly provide a thirty-day limitation on medical provider billing. Section 627.736(5)(b), Florida Statutes (1999), requires medical providers to postmark claims no later than thirty days following the date of treatment, or be subject to automatic claim denial by the insurer....

...ourt actions for breach of contract. Warren, 899 So.2d at 1094, 1095 (emphasis supplied). Although the Supreme Court in Warren was not faced with the question of an insurer's authority to pay a bill that violates the time and billing requirements of Section 627.736(5)(b), it is instructive that the Court used the above language in describing the mandatory nature of the time requirements before a provider can receive payment....

...I believe that, in order to interpret the statute in a logical and reasonable manner, and to effectuate its legislative purpose, the provision must be read as prohibiting Geico from paying the untimely and improperly-billed charges submitted by Professional Reading, as violative of the provisions of § 627.736(5)(b)....

...While Geico remains free to pay providers for charges that are untimely or otherwise submitted in express contravention of the statute, such payments should not be considered a "payment" under the PIP policy. By interpreting the statute in this manner, the remaining provisions of Section 627.736 will be effectuated and the clear legislative intent fulfilled....

...This is an appeal from a final summary judgment entered in favor of the defendant, Allstate Insurance Company, where the county court certified the following question as one of great public importance: Does the phrase "the allowable amount under Medicare Part B" as used in Fla. Stat. Section 627.736(5)(b)5 refer only to Medicare's "participating fee schedule" or does the phrase "the allowable amount" instead refer to Medicare's "limiting charge" amount? We accept jurisdiction. In our recent decision of Millennium Diagnostic Imaging Ctr., Inc. v. Sec. Nat'l Ins. Co., 882 So.2d 1027 (Fla. 3d DCA 2004), we found the legislative history and language of the 2003 amendment to section 627.736(5)(b)5, supported our finding that "the participating fee schedule was the proper fee schedule under the original statute." The mere fact that the services provided in this case were rendered prior to November 1, 2001, does nothing to change our original conclusion on this matter. Thus, we answer the certified question and hold that the term "the allowable amount under Medicare Part B," as used in section 627.736(5)(b)5, refers to the "participating physician fee schedule of Medicare Part B," and affirm the final summary judgment.

...The order affirmed a county- court order that concluded, under Florida’s personal injury protection (“PIP”) statute, 1 a provider of *662 emergency services such as Respondent, Emergency Physicians of Central Florida, LLP (“EPCF”), which submits bills in accordance with section 627.736(4)(c), Florida Statutes, is entitled to have the bills paid, regardless' of the existence of a deductible in the insured’s insurance contract. For the reasons that follow, we grant Mercury’s petition and' quash the circuit court’s order. This proceeding involves the interpretation of, and interplay between, two sections of the Florida’s PIP statute, to wit: section 627.736(4)(c) and section 627.739(2), Florida Statutes (2011). Section 627.736(4)(c) requires the insurer, upon being notified of an accident, to reserve $5,000 of PIP benefits for thirty days, for payment to certain emergency service providers. Specifically, the section provides, in pertinent part: 627.736 Required personal injury protection benefits; exclusions; priority; claims [[Image here]] [4](c) Upon receiving notice of an accident....

...of a claim that is not from a physician or dentist who provided emergency services and care or who provided hospital inpatient care to the extent that the personal injury protection benefits not held in reserve are insufficient to pay the claim ... § 627.736(4)(c), Fla....

...amounts of $250, $500, and $1,000. The deductible amount must be applied to 100 percent of the expenses and losses described in s. 627:736. After the deductible is met, each insured is eligible to receive up to $10,000 in total benefits described in s. 627.736(1). However, this subsection shall not be applied to reduce the amount of any benefits received in accordance with s. 627.736(l)(c). (3) Insurers shall offer coverage wherein, at the election of the named insured, the benefits for loss of gross income and loss of earning capacity described in s. 627.736(l)(b) shall be excluded....

...The issue in this case was whether a PIP insurer could apply the insured’s con *663 tractually-selected deductible to all bills received, in the order they are • received, including a bill submitted by an emergency service provider within the 30-day reserve period provided in section 627.736(4)(c)....

...Here, the circuit court affirmed a judgment of the county court which ruled that the Legislature intended to give priority to emergency providers and, therefore, did not intend to have the deductible applied to them if their bills were submitted pursuant to section 627.736(4)(c)....

...$191 from EPCF for the treatment provided to House. EPCF submitted the bill within 30 days from the date that Mercury received notice of the accident, and EPCF’s bill was the only bill submitted to Mercury within the 30-day period contemplated by section 627.736(4)(c): Thereafter, Mercury applied the $191 bill to House’s $500 deductible....

...atutory emergency benefits. Mercury defended on the basis' that the $191 medical bill was properly-applied to the House’s contracted-for $500 deductible. ’ EPCF moved for summary judgment asking the county court to find that, as a matter of law, section 627.736(4)(c) mandates PIP insurers to reserve $5,000 in benefits for payment to physicians, such as EPCF, who provide emergency services and care, and that the 'statute precludes Mercury from applying the bill to the in.sured’s deductible ■ when the bill was received within 30 days from the notice of the accident. Mercury filed a counter-motion for summary judgment arguing the opposite: • that section 627.736(4)(c) does not preclude an insurer from applying such a bill to the insured’s deductible.- -The county court ruled in favor of EPCF holding, in pertinent part: The Court finds the relevant statutory provisions ambiguous and, therefore, reads Florida Statute 627.736(4)(c) and 627.739(2) in pari material (sic)....

...d by the Legislature.- This Court believes that- the Legislature’s intent was to provide an *664 additional level of protection for emergency care providers, thus ensuring ^payment of their invoices and- bills; The thirty. (30) day -provision - in 627.736(4)(c) would actually work- as -a disadvantage for- emergency care providers as it forces them to promptly bill the insurance provider....

...In this case, the deductible had not yet been met when EPCF’s bill was submitted to Mercury. [[Image here]] There is a mandatory statutory ■ reserve of $5,000 of personal injury protection for payment to emergency physicians (emphasis added). Fla. Stat. § 627.736 (4)(c)....

...This language is plain and unambiguous. Where statutory language is clear and unambiguous, there is no reason to resort to rules of interpretation. The statute must be given its plain and obvious meaning. The implementation of this amended version of Fla. Stat. § 627.736 (4)(c) demonstrates the Legislature’s intent to provide an additional level of protection for emergency care providers that would ensure payment of their bills.[2] To ignore this would render Section (4)(c) meaningless....

...The deductible must first be applied to benefits paid to non-priority providers when both priority and non-priority providers seek payment of PIP benefits. When a priority' provider submits á bill for payment to a PIP carrier and satisfies each of the requirements in Fla. Stat. §' 627.736(4)(c), it is entitled to be paid from the' $5,000 reserve and -its charges cannot be used to '• satisfy an elected deductible....

...There were a myriad of non-priority bills that could have been applied to the deductible first. After this, EPCF’s .bills should have been paid out of- the reserve fund which could then also be used to pay the remainder of the non-priority bills. To act differently would be to render Section 627.736(4)(c) pointless as it would not be fulfilling the legislative .intent of setting aside money for priority providers in order to guarantee that they receive payment instead of risk non-payment as a result of being applied to a deductible....

...f accident was given. Mercury' moved for rehearing, arguing that the circuit court had overlooked and misapprehended the relevant law because (a) the deductible statute provides that the deductible applies to 100% of the providers’ bills listed in section 627.736; (b) the deductible statute was not amended when section 627.736(4)(c) was enacted; (c) although section 627.736(4)(c) gives priority to certain medical providers, it does not guarantee payment to said providers without regard to the contracted-for available coverage; and (d) in that the PIP insurer must satisfy the deductible by applying it to bills from non-priority providers, the circuit court overlooked the 30-day payment requirement set' forth in section 627.736(4)(b)....

...ecture. A.R. Douglass, Inc, v. McRainey, 102 Fla, 1141, 137 So. 157, 159 (1931). Where the' language of a statute is clear and unambiguous, the statute must' be given its plain and ordinary meaning. Zuckerman v. Alter, 615 So.2d 661, 663 (Fla.1993). Section 627.736, Florida Statutes, states that there is a mandatory reserve of $5,000 that should be kept for payment of bills from emergency providers. Section 627.739(2), Florida Statutes, states that the deductible amount must be applied to 100 percent of the expenses and losses that are listed in section 627.736. There is ho exception stating that the bills of emergency providers are not subject to the deductible. There is, however, an exception for death benefits under section 627.736(l)(c), Florida Statutes....

...Order violates established principles of law resulting in a miscarriage of justice. We agree. We hold that the circuit court’s order departed from the essential requirements of the law because the court incorrectly interpreted and applied sections 627.736(4)(c) and 627.739(2), Florida Statutes (2011). Section 627.736(4)(c), addressing the payment of claims made by emergency service providers within the 30-day reserve period, says nothing about the impact (if any) of a contracted-for deductible....

...State, 87 So.3d 774, 777 (Fla.2012) (“A court primarily discerns legislative intent by looking to the plain text of the relevant statute.”). Conversely, section 627.739(2), Florida Statutes (2011), speaks specifically to the impact of the deductible provisions of section 627.736": The deductible amount must be applied to 100 percent of the expenses and losses described in s. 627.736. After the deductible is met, each insured is eligible to receive up to $10,000 in total benefits described in s. 627.736(1). However, this subsection shall not be applied to reduce the amount of any benefits received in accordance with s. 627.736(l)(c). The plain language of section 627.739(2) thus dictates that any, contracted-for deductible must be applied “to 100 percent of the expenses and losses described in s. 627.736”, making no distinction between bills submitted by an emergency service provider and bills submitted by a non-emergency service provider. The statute further states that once “the deductible is met, each insured is eligible to receive up to $10,000 in total benefits described in s. 627.736(1).” The meeting of the contracted-for deductible unlocks -the insured’s right to access his/her $10,000 in PIP benefits....

...aims that are otherwise impacted by the • deductible amount in the insurance policy. The fact that' section 627.739(2) specifically provides that a deductible “shall not be applied to reduce the amount of any benefits received in accordance with s. 627.736(l)(c) [addressing death benefits]” offers further evidence that there was no legislative intent to insulate bills submitted by emergency service providers pursuant to section 627.736(4)(c) from the application of an existing deductible....

...State, 335 So.2d 815, 817 (Fla.1976)). In other words, if the Legislature had intended to exclude claims submitted by emergency service providers from being applied to an existing deductible, it could have certainly said so as it did with respect to death benefits under section 627.736(1)(c)....

...on that the $500 deductible was correctly applied to EPCF’s $191 bill. The plain language of the two sections is not in conflict and provides that,-where an emergency service provider submits its claims within the 30-day reserve-period provided in section 627.736(4)(c), those claims will be prioritized for payment; however, any such payment will be subject to any deductibles that exist in the insurance contract between the insured and the insurer....

...Under these circumstances, • it was a departure from the essential requirements of the law for the circuit court to affirm the county court’s order. Petition GRANTED; Circuit Court Order QUASHED; Cause REMANDED. TORPY and COHEN, JJ., concur. . See § .627.736, Fla....

...mpany at a different address. [1] State Farm thereupon wrote the claimant and asked for a copy of the invoice submitted by the company actually providing the MRI services. At first claimant responded that such information was not within the ambit of section 627.736(6)(b)....

...e terms of the lease between claimant and the owner of the MRI equipment were proprietary and confidential and would not be disclosed to State Farm. At that point State Farm filed a pleading in the circuit court seeking discovery from claimant under section 627.736(6)(c)....

...to supply information. State Farm prayed for an order requiring the corporate president of claimant to "submit to a deposition duces tecum to verify what, if any, amount is due [claimant]." The petition also asked for costs and attorney's fees under section 627.736(6)(c). Respondent reacted to the petition by filing a motion to dismiss it for failure to state a cause of action. [5] The motion argued *984 that the statute in question, section 627.736(6)(c), does not authorize depositions duces tecum, that it merely allows the production of specified documents. The motion referred to the claim attached to the petition and stated that the claim reflects "the charge to the patient for the service in question." It then argued that State Farm already had all the documents to which it was entitled under section 627.736(6)(b)....

...Kaminester, as President of IBK, provide the invoice from Open MRI. On two separate occasions, Mr. Kaminester's counsel denied State Farm's request on the grounds that IBK leased the equipment in question and, therefore, there was no `invoice' and that Section 627.736(6) did not allow for presuit discovery of IBK's lease documents." The order closed with a command for Kaminester to "submit to a deposition duces tecum in order to verify what, if any, amount is due to IBK under [the] PIP policy." It is that order we confront today....

...our decision and will proceed to address the issues. We first address respondent's argument that the scope of discovery which a court can order under subsection (c) is limited to the production of documents specifically identified in subsection (b). Section 627.736(6) provides for informal discovery from the provider to the PIP insurer without resort to litigation....

...the statutory discovery provision "the costs of such treatment." As for the provider's argument that only production of documents is authorized by subsection (c), we point out that the legislature has used the legal term of art "discovery of facts". § 627.736(6)(c) ("In the event of any dispute regarding an insurer's right to discovery of facts about an injured person's earnings or about his or her history, condition, or treatment, or the dates and costs of such treatment, the insurer may petit...

...Thatcher Glass Corp., 445 So.2d 578, 580 n. 2 (Fla.1984) ("Terms of special legal significance are presumed to have been used by the legislature according to their legal meanings."); Davis v. Strople, 39 So.2d 468 (Fla.1949) (same). It should also be emphasized that section 627.736(6) authorizes discovery of "facts", not merely discovery of documents....

...informal production of documents and information by the provider upon simple request of the PIP insurer. We think an outright refusal to supply anything, as was the case here, establishes the necessary good cause for a court to order discovery under section 627.736(6)(c)....

...NOTES [1] The claim was actually submitted by IBK Enterprises, Inc., whose address was in Coral Springs. Apparently its insured had stated that the MRIs were performed by a different facility in Hollywood. Appellant Kaminester is IBK's corporate president. [2] See § 627.736(6)(b), Fla....

...treatment or services was incurred as a result of such bodily injury, and produce forthwith, and permit the inspection and copying of, his or her or its records regarding such history, condition, treatment, dates, and costs of treatment."). [3] See § 627.736(6)(c), Fla....

...g, including reasonable fees for the appearance of attorneys at the proceedings, as justice requires."). [4] The petition was designated: "Petition for Pure Bill of Discovery." The text of the pleading makes clear, however, that it was brought under section 627.736(6)(c)....

...These might include a transcript of an examination under oath by the insured, copies of claims forms, correspondence, invoices, affidavits, and the like. Here the petition attached IBK's claim and copies of the correspondence between State Farm and the claimant. [8] See § 627.736(6)(b), Fla....

...State Farm argued that the MRI was not reasonable, related, or necessary to any injury arising from the accident. Central Magnetic moved for summary judgment arguing that State Farm could not contest the MRI bill because it had failed to comply with section 627.736(7)(a), which requires an insurer to obtain a report from a qualified physician before withdrawing payment of a treating physician without the injured person’s consent....

...n. See Allstate Ins. Co. v. Kaklamanos, 843 So.2d 885, 889 (Fla.2003) (explaining the standard of review in second-tier certiorari proceedings from appellate decisions of the circuit court). The issue that warrants discussion in this case is whether section 627.736(7)(a), Florida Statutes, requires an insurer to obtain an IME before denying a PIP claim or whether a “valid report” under the statute may be based on an expert’s review of the claimant’s treatment records, a so-called “peer...

...Ins. Co. v. Bermudez, 980 So.2d 1213 (Fla. 3d DCA 2008), receded from on other grounds by United Auto. Ins. Co. v. Santa Fe Med. Ctr., 21 So.3d 60 (Fla. 3d DCA 2009) (en banc). The disagreement among the lower courts arises from the 2001 amendment to section 627.736(7)(a)....

...A valid report is one that is prepared and signed by the physician examining the injured person or reviewing the treatment records of the injured person and is factually supported by the examination and treatment records if reviewed and that has not been modified by anyone other than the physician. *784 § 627.736(7)(a), Fla....

...The plain language of the statute permits a report to be based on review of treatment records. “A valid report is one that is prepared and signed by the physician examining the injured person or reviewing the treatment records of the injured person ....” § 627.736(7)(a), Fla....

...Our case law before the 2001 amendment clearly permitted “peer review reports” and squarely held that an insurer was not required to obtain an IME before denying a PIP claim. Nationwide Mut. Fire Ins. Co. v. Se. Diagnostics, Inc., 766 So.2d 229 (Fla. 4th DCA 2000) (holding that a report under section 627.736(7)(a) can be based on review of medical records and need not be based on a physical examination)....

...1 None of the other arguments raised in the petition merit any relief or discussion. The petition for writ of certiorari is denied. STEVENSON, GERBER and LEVINE, JJ., concur. . Although the issue was not raised in this case, we note that other districts have held that the valid report requirement of section 627.736(7)(a) does not apply at all in a case such as this. State Farm Mut. Auto. Ins. Co. v. Rhodes & Anderson, D.C., P.A., 18 So.3d 1059 (Fla. 2d DCA 2008) (holding that section 627.736(7)(a) applies only to a withdrawal of "treatment authorization” not a mere denial of payment of a single PIP charge); accord Partners in Health Chiropractic v....

...of the contractual undertakings by the appellee providers, the appellant insurers, and the PPO networks, the insurers were statutorily barred from paying providers at PPO rates. We do not address those unresolved issues. Both trial courts held that section 627.736(10), Florida Statutes (2000), sets forth the only circumstances under which a PIP insurer may pay medical benefits at a PPO rate....

...ed direct contracts with the preferred providers and had not issued preferred provider policies. Since the appellant insurers admittedly did not have direct contracts with the appellees and had not issued preferred provider policies as authorized by section 627.736(10), the trial courts ruled that the appellant insurers were not entitled to pay the appellee providers PPO rates....

...CERTIFIED QUESTION Each trial court, pursuant to the agreement of the parties, certified the following question to this court: WHETHER [A PIP INSURER] COULD PAY [PIP] BENEFITS AT REDUCED [PPO] RATES WITHOUT OFFERING A PREFERRED PROVIDER PIP POLICY OF INSURANCE AND/OR WITHOUT COMPLYING WITH [SECTION 627.736(10), FLORIDA STATUTES]. For the reasons set forth below, we conclude that the insurers' asserted contractual basis for paying PPO rates to the appellee providers is not affected by the provisions of section 627.736(10). We therefore answer the certified question in the affirmative. III. ANALYSIS Section 627.736 sets forth the medical, disability, and death benefits that are required to be included in all PIP insurance policies. Under section 627.736(1)(a), benefits are required for "[e]ighty percent of all reasonable expenses for medically necessary medical ... services." Section 627.736(5)(a) provides further that [a]ny physician ......

...ion insurance may charge only a reasonable amount for the services and supplies rendered.... In no event, however, may such a charge be in excess of the amount the person ... customarily charges for like services ... in cases involving no insurance. Section 627.736(10)—which is the subject of the certified question—provides: An insurer may negotiate and enter into contracts with licensed health care providers for the benefits described in this section, referred to in this section as "preferred...

...indirect contractual arrangements. Second, subsection (10) does not prohibit insurers that have not issued preferred provider policies from contracting to pay providers at PPO rates. After our discussion of subsection (10), we will turn to sections 627.736(1)(a) and 627.736(5)(a), the general provisions of the no-fault statute governing the payment by PIP insurers of expenses associated with covered medical services....

...If the legislature wishes to prohibit something, it is perfectly capable of saying so. Indeed, few words are more common in the language of legislation than the phrases "may not" and "shall not." B. The Meaning of a "Reasonable Amount" for Services Rendered As set forth above, section 627.736(1)(a) requires PIP insurers to pay 80 percent of "all reasonable expenses" for *86 covered medical services—subject, of course, to the $10,000 policy limits provided for in the statute. Section 627.736(5)(a) limits the charges made by providers for services rendered to PIP beneficiaries to "only a reasonable amount" for the services rendered....

...ally agreed to accept in payment for such services. If a provider has agreed in a valid and enforceable contract to accept payment for services at a particular rate, that rate would necessarily be a "reasonable amount for the services ... rendered." § 627.736(5)(a)....

...d been used. In addition, since each treatment provided by a PPO provider costs the insurer less than the same treatment given by a non-PPO provider, more services will be available to the insured within the $10,000 PIP policy limits provided for in section 627.736(1)....

...CONFLICTING AUTHORITY In Nationwide Mutual Fire Insurance Co. v. Central Florida Physiatrists, P.A., 851 So.2d 762, 766 (Fla. 5th DCA 2003), a case involving factual circumstances similar to those before us now, the Fifth District held that the "[insurer] was required to comply with the provisions of section 627.736(10) in order to take advantage of the option of paying reduced PPO rates for payment of PIP benefits." The court concluded that in the absence of compliance with section 627.736(10), the insurer was required "to pay the statutorily mandated 80% of the reasonable and necessary expenses incurred on behalf of its insured" rather than the reduced PPO rates....

...PER CURIAM. We reverse an order denying Fortune Insurance Company's motion to compel arbitration in a lawsuit against it involving PIP claims. *209 U.S.A. Diagnostics, Inc. (USA) [1] claims that Fortune failed to timely pay PIP claims, as mandated by section 627.736(4)(b), Florida Statutes, and seeks damages, including 10% penalty interest authorized by statute. The lawsuit also seeks treatment as a class action. Fortune asserts that both its insurance policy and section 627.736(5), Florida Statutes, require binding arbitration of claims involving medical benefits arising between insurer and provider where the provider has agreed to accept an assignment of personal injury protection benefits. The Fortune Insurance policy provides: Any claims dispute between us [Fortune Insurance Company] and a medical service or supplies provider who has agreed to accept an assignment of benefits shall be decided by arbitration.... Section 627.736(5), Florida Statutes, provides in pertinent part: Every insurer shall include a provision in its policy for personal injury protection benefits for binding arbitration of any claims dispute involving medical benefits arising between the insurer and any person providing medical services or supplies if that person has agreed to accept assignment of personal injury protection benefits. The trial court determined that the arbitration sought is not governed by section 627.736(5), as the sole dispute is whether Fortune is required to pay a statutory penalty pursuant to section 627.736(4)(c), Florida Statutes, for failure to timely pay PIP benefits. The trial court also concluded that the arbitration provision in section 627.736(5) applies only where the insurance company believes that a health care provider has charged an unreasonable amount....

...We affirmed that position in Florida Farm Bureau Casualty Insurance Co. v. Fichera, 366 So.2d 867 (Fla. 4th DCA 1979). In both Moylan and Fichera we discussed the difficult problem that had arisen as a result of the legislature's pronouncement in the nofault insurance law that PIP coverage was "primary". Section 627.736(4), Florida Statutes (1975)....

...Rules 1-102 and 7-102. [2] Legislative expression of patient confidentiality may be found in section 455.241, Florida Statutes (1981) (regulating reports by physicians), section 395.202, Florida Statutes (1981) (regulating reports by hospitals), and section 627.736(6)(b), Florida Statutes (1981) (regulating reports by health care providers for certain insurance matters)....

...This is an appeal from a final judgment of the Circuit Court of Escambia County ordering full reimbursement to appellee (defendant) of the $5,000 personal injury protection (PIP) benefits paid by appellee to appellant (plaintiff) under appellant's "no fault" automobile liability insurance coverage paid pursuant to Section 627.736(1), Florida Statutes, F.S.A....

...llee, jointly. Appellant brought this suit praying for equitable distribution of the $5,000 PIP benefits. Appellee contends it is entitled to reimbursement of the full $5,000. The trial court in construing paragraphs (a) and (b) of subsection (3) of Section 627.736, Florida Statutes, F.S.A., denied equitable distribution and ordered that appellee was entitled to the full $5,000 reimbursement....

...Reserve Insurance Company, 299 So.2d 661, opinion released May 7, 1974, this court ruled that in the absence of unusual or unforeseen circumstances not now contemplated, "equitable distribution" is applicable to all cases (whether suit be filed or not) arising under Sections 627.736(3)(a) and 627.736(3)(b)....

...3d DCA 1975): While the no-fault law was intended to remedy the concept of fault in automobile negligence cases, we do not think that tort concepts of causation were intended to be entirely abandoned. We think that by inserting the word "caused" in the statue [§ 627.736(4)(d)1, Fla....

...f a motor vehicle. It is not foreseeable that in the ordinary course of using a motor vehicle, an operator will suffer injury by arrest for violation of traffic laws. Reversed and remanded with instructions to enter judgment for appellant. NOTES [1] Section 627.736, Florida Statutes (1983) provides in part: (1) REQUIRED BENEFITS....

...or rent or lease shall be primary unless otherwise stated in bold type on the face of the rental or lease agreement. Such insurance shall be primary for the limits of liability and personal injury protection coverage as required by § 324.021(7) and § 627.736....

...tion of great public importance to this court. 1 We accepted jurisdiction of the fourteen consolidated cases and now conclude that Allstate’s insurance policy provided adequate notice of its election to use the Medicare fee schedules referenced in § 627.736(5)(a)2., Florida Statutes....

...In deciding the case, the Court provided an extensive overview and analysis of the history of Florida’s PIP statutory scheme that informs the analysis here, including the 2008 amendment authorizing insurers to limit reimbursements by the use of fee schedules. Virtual Imaging, 141 So.3d at 152-56 . In sum, § 627.736(l)(a) requires automobile insurers to provide PIP coverage for eighty percent of all “reasonable expenses” for medically necessary services, such as those provided by StandUp MRI in this case....

...nable” for purposes of insurer reimbursements. The first is a fact-dependent methodology that takes into account the service provider’s usual.and customary charges, community-specific , reimbursement levels, and other relevant information. . See § 627.736(5)(a)l., Fla....

...This is the default methodology for calculating PIP *3 reimbursements, which also apparently results in higher reimbursements. The second methodology, introduced by the Legislature in 2008, allows reimbursements for medical services like Stand-Up MRI’s to be limited via the use- of fee schedules identified in § 627.736(5)(a)2....

...by electing those fee schedules in its policy.” Id. at 159 . B. The crux of the PIP dispute here concerns whether Allstate’s policy language adequately notifies insureds- of its election to limit reimbursements via the Medicare fee schedules in § 627.736(5)(a)2., as required by Virtual Imaging....

...e injured person the following benefits.... 1. Medical Expenses Eighty percent of reasonable expenses for medically necessary ... services.... Any amounts payable under.this coverage shall be subject to any and all limitations, authorized by section-627.736, or any other provisions of the Florida Motor Vehicle No-Fault Law, -.as enacted, amended or otherwise continued in the law, including, but not limited to, all fee schedules....

...■ We agree with Allstate that the 'policy gives sufficient notice of its' election to limit reimbursements by use of the fee schedules. Our conclusion stems from the policy’s plain statement that reimbursements “shall” be subject to the limitations in § 627.736, including “all fee schedules.” See Virtual Imaging, 141 So.3d at 157 (quoting State Farm Mut....

...Menendez, 70 So.3d 566, 569-70 (Fla.2011)) (“If the language used in an insurance policy is plain and unambiguous, a court must interpret the policy in accordance with the plain' meaning of the language used so as to give effect to the policy as it was written.”). Section 627.736(5)(a)2., in turn, refers to Medicare fee schedule-based limitations and provides that “insurer[s] may limit reimbursement to 80 percent of the ......

...orth Allstate’s responsibility to reimburse eighty percent of reasonable expenses for medically necessary services. And the provision says that “[a ]ny amounts payable under this coverage shall be subject to any and all limitations authorized by section 627.736 ......

...unambiguously elect/give notice, in accordance with the Supreme Court’s decision in Virtual Imaging, to reimburse medical benefits solely and exclusively according to the. amounts permitted in the Medicare fee schedules and related limitations of section 627.736(5)(a)2-5: Any amounts payable under this coverage shall be subject to any and all limitations authorized by section 027.736 or any other provisions of the Florida Motor Vehicle No-Fault Law, as enacted, amended or otherwise continued in the law, including, but not limited to, all fee schedules....

...Marzulli brought suit in county court claiming that Auto Owners had breached the insurance contract by failing to pay covered PIP claims for thirty-seven separate dates of chiropractic treatment after December 28, 1995. In June 1997, Mr. Marzulli moved for partial summary judgment as to liability. He argued that section 627.736(7)(a), Florida Statutes (1997), provided a procedure whereby an insurer may, under certain circumstances, withdraw payment for medical care that has been rendered. Mr. Marzulli argued, however, that the statute included no provision which allowed for termination of future benefits. Section 627.736(7)(a) is entitled "Mental and Physical Examination of Injured Person; Reports" and provides, in part: Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that h...

...The county court entered final judgment in favor of Auto Owners. Mr. Marzulli appealed to the circuit court. The circuit court reversed the final judgment and remanded the matter. It held that the county court erred in denying Mr. Marzulli's motion for partial summary judgment as to liability because section 627.736(7)(a) applied only to past medical treatment and could not be used to withdraw authorization for future treatment....

...In reaching its conclusion, the circuit court made no mention of the Fourth District's decision in Derius v. Allstate Indemnity Co., 723 So.2d 271 (Fla. 4th DCA 1998). In Derius, the county court certified to the Fourth District the following question: [1] TO RECOVER MEDICAL BENEFITS IN A LAWSUIT UNDER SECTION 627.736, FLORIDA STATUTES (SUPP....

...eatment after June 7, 1994 was necessary and, if so, the total reasonable charges for said chiropractic care." Id. at 272. The jury returned a verdict for Allstate upon which judgment was entered. The Fourth District affirmed. Id. It held that under section 627.736(1)(a), Florida Statutes (Supp.1994), [2] an insurer is not liable for any medical expense to the extent that it is not a reasonable charge for a particular service or if the service is not necessary....

...charge was unreasonable or that a given service was not necessary." Id. The court then concluded that "Allstate's reliance on the IME chiropractor's letter to withdraw payment to [appellant's] chiropractor was in compliance with the requirements of section 627.736(7)(a)." Id....

...Marzulli's chiropractor based on a report from another chiropractor stating that further treatment was not medically necessary and would likely "aggravate injuries and perpetuate continued symptoms." Auto Owners' reliance on this report to withdraw payment to Dr. Fleming was in compliance with the requirements of section 627.736(7)(a)....

...[3] *1035 We also quash the circuit court's order awarding appellate attorney's fees to Mr. Marzulli. BLUE, A.C.J., and WHATLEY and GREEN, JJ., concur. NOTES [1] The county court also certified to the Fourth District the question of "IN AN ACTION FOR PIP BENEFITS, WHERE A TRIAL COURT CHARGES THE JURY USING THE LANGUAGE OF SECTION 627.736(7)(a), MUST THE COURT FURTHER DEFINE THE TERM `NECESSARY' AS USED IN THE STATUTE?" Derius v. Allstate Indem. Co., 723 So.2d 271, 271 (Fla. 4th DCA 1998). This second question is not dispositive of the issue raised in this certiorari proceeding. [2] Section 627.736(1)(a), Florida Statutes (Supp.1994), provides, in part, that PIP benefits include "[e]ighty percent of all reasonable expenses for necessary medical ......

...Omni Insurance Company petitions this court for certiorari review of an order of the circuit court acting in its appellate capacity which affirmed the order of the county court denying Omni's motion to dismiss the complaint filed by Special Care Clinic, Inc. The circuit court concluded that section 627.736(5), Florida Statutes (1995), is ambiguous as to whether a health care provider is mandated to resolve through arbitration a dispute between itself and the insurance carrier over the payment of assigned personal injury medical benefits....

...Omni is the personal injury protection provider for Calvin Reed who was allegedly injured in an automobile accident. Special Care treated Reed for the injuries he received in the accident and accepted an assignment from him of his PIP benefits. Omni complied with section 627.736(5) by including an arbitration clause in the policy it issued to Reed. Section 627.736(5) provides that: Every insurer shall include a provision in its policy for personal injury protection benefits for binding arbitration of any claims dispute involving medical benefits arising between the insurer and any person provid...

...The prevailing party shall be entitled to attorney's fees and costs. A dispute arose between Special Care and Omni regarding claims submitted by Special Care for Reed's treatment, and Special Care filed a complaint for damages in county court. Omni moved to dismiss on the grounds that section 627.736(5) mandates that all disputes involving payment for assigned PIP medical benefits be determined by binding arbitration. The county court *315 denied the motion to dismiss based on Advanced Orthopedic Institute v. Bankers Insurance Co., 3 Fla. Weekly Supp. 673 (13th Jud. Cir.1995), an opinion of the circuit court acting in its appellate capacity which held that section 627.736(5) is ambiguous as to "whether the `binding arbitration' to be provided in policies was intended by the Legislature to be voluntary or mandatory binding arbitration," thereby rendering unenforceable the arbitration provision in that particular policy....

...re that court has decided the legal issue facing the circuit court and its own district court of appeal has not yet ruled on the issue. See Allstate Insurance Co. v. Mazorra, 599 So.2d 739 (Fla. 3d DCA 1992). In Magnetic, the appellee contended that section 627.736(5) does not require "arbitration per se." The Third District disagreed, holding that, "[a]rbitration is mandatory pursuant to section 627.736(5) even in the event that the insurance policy between the insured and the insurance company does not include an arbitration provision with regard to the medical provider." Magnetic, 696 So.2d at 477 (citations omitted)....

...tly from insurers. On April 18, 1995, Magnetic filed suit against Prudential Insurance Corporation of America ("Prudential of America"), alleging that the insurer had regularly failed to pay interest on late-paid PIP benefits as required by sections 627.736(4)(b) and (c), Florida Statutes (1995)....

...After a little more than a year of litigation, Prudential of America moved for summary judgment, arguing that Prudential, not Prudential of America, had issued the insurance policy involved in the action, and that Prudential had timely paid the patient-assignor's benefits as mandated by section 627.736(4)(b)....

...mplaint. Upon substitution, Prudential promptly moved to compel arbitration claiming that disputes "between the insurer and any person providing medical services ... [who] has agreed to accept assignment of [PIP] benefits" had to be arbitrated under section 627.736(5), Florida Statutes (1995)....

...First, in August 1998, Prudential tendered a check for $22.12, the amount purportedly due as interest on Mr. Gentile's late-paid benefits. Second, in February 2000, the Florida Supreme Court held that the provision pursuant to which the action had been referred to arbitration, section 627.736(5), was unconstitutional....

...ave been dismissed following Prudential's tender of interest due on the late-paid benefits without provision for payment of Magnetic's attorney's fees, because: (1) Magnetic had inappropriately sought to litigate rather than arbitrate as mandated by section 627.736(5); and (2) Magnetic had incurred no fees between the time arbitration was ordered and the time payment was tendered....

...3d DCA 1999), this court held that an insurer's payment of PIP benefits demanded by a medical provider assignee following commencement of arbitration constituted a settlement which "is equivalent to a confession of judgment," entitling the assignee to an award of attorney's fees as the prevailing party under section 627.736(5). This court also rejected the notion that an insurer could escape a fee award under 627.736(5) by holding out until an arbitration demand is made, and then paying benefits before action is taken in the arbitration proceeding: An insurer cannot escape the penalty of attorney's fees simply by ignoring an outstanding medical bill, payi...

...3d DCA 1975) (affirming an award of fees for services incurred both before an action to recover PIP benefits was filed and after an offer of judgment was made). Accordingly, Prudential's tender of payment entitled Magnetic to a fee award. The Florida Supreme Court's invalidation of section 627.736(5), and its prevailing party fee provision, does not change this result....

...nst the insurer in favor of the insured, attorney's fees shall be awarded to the insured." Ivey v. Allstate Ins. Co., 774 So.2d 679, 684 (Fla.2000). As the Florida Supreme Court has explained, current PIP law (as evidenced by sections 627.428(1) and 627.736(8)) "is outcome-oriented....

...sured to an attorney's fee award. See id. at 684-85. These general principles apply not only to disputes between insurers and their insureds, but also to disputes between insurers and those like Magnetic, to whom PIP benefits have been assigned. See § 627.736(8), Fla....

...[who] has agreed to accept assignment of [PIP] benefits." Accordingly, the summary judgment denying Magnetic a fee award is reversed and this cause remanded for further proceedings consistent with this opinion. Reversed and remanded. NOTES [1] Sections 627.736(4)(b) and (c), Florida Statutes (1995), in pertinent part provided: (b) Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same.......

...t Allstate's refusal to pay more benefits constituted an anticipatory breach of the PIP policy. Allstate moved to dismiss the amended complaint on the grounds that petitioner failed to meet the conditions precedent to an action under Florida Statute section 627.736(4)(b), because she did not allege that she actually obtained any treatment and incurred any bills that were submitted to Allstate and denied after September 2, 1996....

...The trial court granted Allstate's motion to dismiss the amended complaint with prejudice, agreeing that petitioner failed to "allege that she has submitted reasonable proof of losses and the amount of the expenses or losses incurred which have not been paid by [Allstate]." The court further explained that: F.S. section 627.736(4) provides that PIP benefits are due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of the expenses and loss incurred....

...and the amount of same. Plaintiff has not alleged that any such benefits are outstanding. The court concluded that, "[a]s a matter of law, Rader did not comply with the conditions precedent to maintain an action for PIP benefits as set forth in F.S. section 627.736(4)(b)." In dismissing petitioner's amended complaint with prejudice, the court stated that "this Order shall not be construed to bar Plaintiff from bringing an action against Defendant should she in the future meet the conditions set forth in F.S. § 627.736(4)." The court denied petitioner's motion for leave to file a second amended complaint to plead a cause of action for declaratory relief....

...s misplaced. 759 So.2d 7. Peachtree merely stands for the limited proposition that, where an insurer has notified an insured that it no longer considers medical treatment necessary and does not intend to honor future claims, it is unnecessary, under section 627.736(4)(b), Florida Statutes, for an insured to wait thirty days from the date a claim is submitted before filing a breach of contract action as to accrued claims....

...Before the court ruled on the motion, Rader moved for leave to file a second amended complaint to plead a claim for declaratory judgment. The court dismissed Rader's complaint with prejudice, ruling that as a matter of law, Rader could not maintain an action because she did not comply with subsection 627.736(4), Florida Statutes, by first incurring additional medical expenses and submitting them to Allstate for payment....

...mpany. See id. After filing suit, the insured submitted the additional bills to the insurer, which paid them within thirty days. See id. The insurer then moved for summary judgment, arguing it was not in breach of contract because, as required by subsection 627.736(4), it paid all bills submitted to it within thirty days....

...urance companies will cancel benefit payments to their PIP insured and only resume making payments to those who question the denial.'" Id. The insurer petitioned the Fifth District for a writ of certiorari. See id. The insurer argued that because subsection 627.736(4)(b) requires it only to pay within thirty days bills submitted to it, which it did, summary judgment was appropriate....

...ht. Rather, her remedy would at least in part be a ruling finding she has not in fact reached maximum medical improvement and that the insurance company must, therefore, cover any medical expenses the policy requires it to cover. Moreover, to use subsection 627.736(4) to justify dismissing Rader's cause of action *1051 before she incurs medical expenses misses the point. Subsections 627.736(4) and (4)(b) provide that benefits are "due" upon receipt of proof of loss and expenses and that an insurer must pay a claim within thirty days of its submission. Here, Rader is not alleging that she submitted a bill to Allstate and that benefits are thus "due" or even overdue. Rather, she is alleging that even if she were to submit a medical bill, Allstate would not pay it despite the provisions of subsection 627.736(4)(b) because it has notified her of its belief it no longer must perform under the insurance contract. To state it another way, she is alleging that Allstate has anticipatorily breached the contractual and statutory duties it owes her. Nothing in subsections 627.736(4) and (4)(b) require Rader to first incur medical expenses and submit them to Allstate before bringing such an action....

...Plaintiff appeals from a circuit court judgment dismissing his action against Allstate for automobile personal injury protection benefits exceeding $5,000. Appellant was named insured of a single Allstate policy covering appellant's two automobiles, one of which appellant was driving when injured in an accident. Section 627.736(2), Florida Statutes (1975) provides, in respect to personal injury protection benefits, that an insurer may exclude such benefits "(a) For injury sustained by the named insured ....

...ccident shall be [aggregate total $5,000 each person]." Had appellant's two automobiles been insured by separate Allstate policies, the exclusion would unquestionably limit appellant to $5,000 in personal injury protection benefits, as prescribed by Section 627.736....

...The Insureds had contracts — insurance policies — with State Farm that obligated State Farm to pay for the Insureds' MRIs. ( See id. ¶ 2). State Farm's payments were to be calculated based on the schedule of fees contained in Florida Statutes sections 627.736(a)(2)(f) and 627.736(5)(a)(3), which were incorporated into the contracts....

...Id. ). Because the insurance policies were sold in Florida, the policies were subject to Florida Statute sections 627.730 through 627.7405. ( See id. ¶ 20). CMI alleges State Farm is in breach of the contracts and is in violation of Florida Statute section 627.736....

...v. Holy Cross Hosp., Inc., 961 So.2d 328, 331-32 (Fla.2007) (quoting FLA. STAT. § 627.731 (2006)). The Florida No-Fault Law allows the "security" to be established through PIP insurance. Id. (citing quoting FLA. STAT. § 627.733). Florida Statute section 627.736 contains the requirements for PIP benefits. Insurance policies shall provide personal injury protection for injuries "arising out of the ownership, maintenance, or use of a motor vehicle...." FLA. STAT. § 627.736(1)....

...The PIP statute sets up a "unique" system, "abolish[ing] a traditional common-law right by limiting the recovery available to car accident victims" in exchange for making "PIP insurance compulsory and allow[ing] recovery regardless of fault." State Farm Mut. Auto. Ins. Co. v. Nichols, 932 So.2d 1067, 1077 (Fla.2006). "Under section 627.736(1)(a), PIP benefits are required to be paid to the injured insured's health care providers at 80% of their submitted bills for `all reasonable expenses for necessary medical, surgical, X-ray, dental, and rehabilitative services' until the coverage of $10,000 is exhausted." Progressive Am....

...ndering treatment to an injured person for a bodily injury covered by personal injury protection insurance may charge the insurer and injured party" to "a reasonable amount pursuant to this section for the services and supplies rendered." FLA. STAT. § 627.736(5)(a)(1)....

...Similarly, in the insurance policies at issue State Farm agreed it would "provide coverage for PIP benefits for all medical services rendered to the Insured that were reasonable, related or necessary as a result of an automobile accident." (2d Am. Compl. ¶ 19). The parties address various subsections of section 627.736(5). Subsection (5) contains "strict guidelines for both PIP insurers and medical providers, including how and when charges must be submitted and benefits paid." Allstate Ins., 961 So.2d at 332 (citing FLA. STAT. § 627.736(4)-(5)). State Farm "elected to make payment in accordance with a schedule of fees" from Florida Statute section 627.736(5)(a)(2)(f) and Florida Statute section 627.736(5)(a)(3). (2d Am Compl. ¶ 2). Section 627.736(5)(a)(2)(f) allows insurers to limit their reimbursement to 80 percent of: 200 percent of the allowable amount under the participating physicians schedule of Medicare Part B....

...ance under workers' compensation, as determined under s. 440.13 and rules adopted thereunder.... Services, supplies, or care that is not reimbursable under Medicare or workers' compensation is not required to be reimbursed by the insurer. FLA. STAT. § 627.736(5)(a)(2)(f). Section 627.736(5)(a)(3) then sets the applicable fee schedule or payment limitation under Medicare [as] the fee schedule or payment limitation in effect at the time the services, supplies, or care was rendered and for the area in which such services were rendered, except that it may not be less than the allowable amount under the participating physicians schedule of Medicare Part B for 2007 for medical services, *1316 supplies, and care subject to Medicare Part B. FLA. STAT. § 627.736(5)(a)(3). The final provision at issue, Florida Statute section 627.736(5)(a)(4), restricts insurers' ability to apply limitations on "the number of treatments" or "other utilization limits that apply under Medicare": Subparagraph 2....

...gardless of whether such provider would be entitled to reimbursement under Medicare due to restrictions or limitations on the types or discipline of health care providers who may be reimbursed for particular procedures or procedure codes. FLA. STAT. § 627.736(5)(a)(4)....

...in the community and various federal and state medical fee schedules applicable to automobile and other insurance coverages, and other information relevant to the reasonableness of the reimbursement for the service, treatment, or supply. FLA. STAT. § 627.736(5)(a)(1)....

...Defendants' argument is unavailing. Plaintiff is not challenging the amounts State Farm reimbursed. Instead, it is challenging the use of the MMDIR itself. Under Plaintiff's theory, State Farm is liable for breach of contract simply by applying the MMDIR in violation of section 627.736(5)(a)(4), no matter the reimbursement amount....

...to the class representative and its attorneys. The lawsuit is based on the alleged failure of State Farm Mutual Automobile Insurance Company to correctly compute and pay the amounts due medical providers for magnetic resonance imaging services under section 627.736(5)(b)5, Florida Statutes (2001). We affirm the final judgment in all respects. I. CPI, MRI, PIP, and Commonality The legislature enacted section 627.736(5)(b)5 in 2001 to provide consumer price index (CPI) adjustments for magnetic resonance imaging (MRI) reimbursements in personal injury protection (PIP) claims....

...allowed for mailings and other contacts with putative class members. III. ASI's Intervention and Objections ASI provides MRI services in central Florida and has previously obtained several judgments against State Farm for CPI adjustment claims under section 627.736(5)(b)5....

...h incompatible standards of conduct for the party opposing the class." In this case, different county courts had used different computations for the statutory CPI adjustment. One problem occurred with the application of the 2001 and 2003 versions of section 627.736(5)(b)5....

...State Farm was shown to have refused to apply a method applicable to the entire class. The opt-out provision in the settlement allows a claimant to seek various categories of money damages (attorney's fees and costs, postal costs, penalties, and bad faith claims based on "unfair trade practices," pursuant to section 627.736(11), Florida Statutes (2007), for example), but the predominant feature of the settlement is a uniform interpretation of the CPI adjustment as directed by the legislature....

and application of section 627.736(5)(b)l.c., Florida Statutes (2010). Section 627.736(5)(b)l.c. reads as

...This case is before the Court for review of a question of Florida law certified by the Eleventh Circuit Court of Appeals as being determinative of a cause pending in that court and for which there appears to be no controlling precedent. Specifically, the Eleventh Circuit asks “[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?” Nunez v. Geico Gen. Ins. Co., 685 F.3d 1205, 1211 (11th Cir.2012). We have jurisdiction. See art. V, § 3(b)(6), Fla. Const. We answer the certified question in the negative as to section 627.736, Florida Statutes (2008), and confirm our statement in Custer Medical Center v. United Automobile Insurance Co., 62 So.3d 1086, 1091 (Fla.2010), 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.” A recent amendment to section 627.736 provides otherwise, but did not take effect until January 1, 2013, and does not inform or control our disposition of the present case. See ch. 12-197, § 10, at 2737, 2752, Laws of Fla. (now codified in § 627.736(6)(g), Fla....

...and as often as we may reasonably require.” Geico denied Nunez’s PIP claim for failing to satisfy this condition after she was injured in a car accident on September 17, 2008. She alleged that Geico had thereby violated Florida’s PIP statute (section 627.736, Florida Statutes (2008)) in a class action complaint seeking a declaratory judgment filed in state circuit court on October 26, 2009....

...s in ' Custer amounted to a holding or dicta. Upon examining Custer, the PIP statute, and relevant caselaw, the Eleventh Circuit concluded that Florida law was unclear, and certified the following question to this Court: ‘Whether, under FLA. STAT. § 627.736, an insurer can require an insured to attend an EUO as a condition precedent to recovery of PIP benefits?” Nunez, 685 F.3d at 1211 (issued April 3, 2012)....

...seeking benefits under the Florida Motor Vehicle No-Fault Law “comply with the terms of the policy, which include, but are not limited to, submitting to an examination under oath.” Ch. 12-197, § 10, at 2737, 2752, Laws of Fla. (now codified in § 627.736(6)(g), Fla. Stat. (2012)). II. ANALYSIS In disputing the meaning of section 627.736, Florida Statutes (2008), the parties and amici curiae in this case primarily argue in terms of Custer and the 2012 amendment of the PIP statute....

...The PIP Statute Section 627.786, Florida Statutes (2008), is silent regarding EUOs — it does not authorize their use, much less denial of benefits for failure to attend one. As summarized by the Eleventh Circuit in this case: Geico points out [that] EUOs are consistent with many provisions in the No-Fault Statute. Section 627.736(4) states that benefits from an insurer are “due and payable as loss accrues, upon receipt of reasonable proof of such loss....” FLA. STAT. § 627.736(4) (emphasis added); see Amador v....

...�� could include the requirement that an insured submit to an EUO). Subsection (4)(h) of the statute provides that benefits are not due under the statute if there is evidence of fraud “admitted to in a sworn statement by the insured.” FLA. STAT. § 627.736(4)(h)....

...Accordingly, we reject the dissent’s view that the EUO provision employed by Geico in its PIP policy may be applied pursuant to section 627.414(3). Instead, PIP policy provisions should be promulgated by insurers in a manner that is consistent with the statutory goal under section 627.736 of ensuring “swift and virtually automatic payment” of benefits to insureds under the PIP statute....

...onable manner.” Dissenting op. at 399. With all due respect to our colleague, in this case we are obliged to address whether Geico unreasonably exercised authority to require a condition precedent, where no such authority existed at the time under section 627.736....

...We conclude that Geico’s policy provision requiring Nunez and other insureds who sought PIP benefits prior to January 1, 2013, to be subjected to an EUO as a condition precedent was unreasonable and unnecessary under Florida law. See Custer, 62 So.3d at 1091 ; Flores, 819 So.2d at 745 ; § 627.736, Fla....

...Supreme Court may not follow the appellate court’s statement in Shaw.” Id. The Eleventh Circuit’s speculation is correct. Based on the analysis above, we hold in alignment with Custer that EUO conditions are invalid as contrary to the terms of section 627.736, Florida Statutes (2008)....

...sureds seeking benefits under the Florida Motor Vehicle No-Fault Law “comply with the terms of the policy, which include, but are not limited to, submitting to an examination under oath.” Ch. 12-197, § 10, at 2752, Laws of Fla. (now codified in § 627.736(6)(g), Fla....

...We accordingly hold that the 2012 amendment does not inform or control our disposition of the present case. We do not otherwise comment on the applicability or validity of the 2012 amendment. III. CONCLUSION In sum, we hold in alignment with Custer that EUO conditions are invalid as contrary to the terms of section 627.736, Florida Statutes (2008). We disapprove Shaw to the extent it holds otherwise. We also hold that the 2012 amendment at issue substantively changed, not just legislatively clarified, section 627.736, and that the amendment therefore does not inform or control our disposition of the present case....

...Nowhere does the opinion focus on the presence of counsel as more than a mere fact therein or infer a different result otherwise." . We note that if Geico had particular concerns about fraud or improper claims by Nunez in the present case, it could have pursued court-ordered discovery under section 627.736(6)(c), Florida Statutes (2008) (providing that such an order "may be made only on motion for good cause” and that the "court may, in order to protect against annoyance, embarrassment, or oppression, as justice requires, enter an ord...

...eived an insurance contract before the effective date of the statute. See Menendez, 35 So.3d at 879-80 . We explained the statute as it existed before and after the amendment as follows: Before the addition of the statutory presuit notice provision, section 627.736 did not require an insured to provide notice to an insurer before filing an action for overdue benefits. PIP benefits became overdue if the insurer failed to pay within thirty days after receiving notice from the insured of the fact of a covered loss and the amount of such loss. § 627.736(4)(b), Fla. Stat. (2000). Any overdue payment was subject to a ten percent simple interest rate per year. § 627.736(4)(c), Fla. Stat. (2000). However, if the insurer had reasonable proof to establish that it was not responsible for the payment, the payment was not overdue. § 627.736(4)(b), Fla. Stat. (2000). In contrast, the statute as amended in 2001 requires an insured to provide a *133 presuit notice of intent to initiate litigation and provides an insurer additional time to pay an overdue claim. § 627.736(ll)(a), (d), Fla. Stat. (2001). Second, the amendment mandates that the payment from the insurer must include interest and penalties not exceeding $250. § 627.736(1l)(d), Fla....

...Third, if the insurer pays within the additional time provided by the statute, the payment precludes the insured from bringing suit for late payment or nonpayment and shields the insurer from a claim for attorneys’ fees. Id. Finally, the amendment tolls the statute of limitations. § 627.736(ll)(e), Fla....

...1st DCA 1992) (according “great deference” to “[a] trial court’s determination under section 90.403”). The Legislature, through years of experience, assuredly knows how to abrogate the collateral source rule, and indeed has done so, albeit in an incremental manner. See, e.g., § 627.736(3), Fla....

...r as to the noneconomic damages. We affirmed, specifically applying the two issue rule. Barhoush represented, as we candidly stated, an extension of the rule. The reasons that justified the extension operate with full force here. [3] Defendant cited section 627.736(3), Florida Statutes (1991), for the proposition "an injured party has no right to recover any damages for which [PIP] benefits are paid or payable." That is certainly what the statute says, but here defendant consented to a verdict form that asked the jury to ascertain these very damages....

...missions, is hereby exempted from tort liability for damages because of bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use of such motor vehicle in this state to the extent that the benefits described in § 627.736(1) are payable for such injury, or would be payable but for any exclusion or deductible authorized by §§ 627.730-627.741, under any insurance policy or other method of security complying with the requirements of § 627.733, or by an owne...

...inconvenience for such injury under the provisions of subsection (2)." The record clearly establishes that security had been provided by both drivers (Stockton and Christensen) as required by sec. 627.733, F.S. Under the terms and provisions of sec. 627.736, F.S., every insurance policy complying with the security requirements of sec. 627.733 shall provide personal injury protection. In particular sec. 627.736(4)(d)4: "627.736 Required personal injury protection benefits; exclusions; priority "......

...r Appellant. David Lee Sellers, Pensacola, for Appellee. DAVIS, J. This is an appeal from county court in which the court certified the following question as one of great public importance: IN AN ACTION TO RECOVER MEDICAL BENEFITS IN A LAWSUIT UNDER SECTION 627.736, FLORIDA STATUTES, WHERE THE ONLY DEFENSE BY AN INSURER IS THAT THE MEDICAL TREATMENT WAS NOT RELATED, NOT REASONABLE AND/OR NOT NECESSARY, MUST AN INSURER OBTAIN THE REPORT REQUIRED UNDER SECTION 627.736(7), FLORIDA STATUTES, CONSTITUTING "REASONABLE PROOF" WITHIN THIRTY (30) DAYS OF RECEIVING WRITTEN NOTICE OF THE FACT OF A COVERED LOSS AND OF THE AMOUNT OF SAME BEFORE IT CAN DEFEND ON THE BASIS THAT THE MEDICAL BILLS ARE NOT REASONA...

...se as to the claim for payment of the Nu-Best diagnostics bill. The trial court entered a stipulated summary *506 final judgment in favor of Jones, certifying the question as stated above, which this court accepted as one of great public importance. Section 627.736(4), Florida Statutes (Supp.1996), provides in part: BENEFITS; WHEN DUE.—Benefits due from an insurer under ss....

...However, any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding that written notice has been furnished to the insurer. (c) All overdue payments shall bear simple interest at the rate of 10 percent per year. Section 627.736(7), Florida Statutes (Supp....

...er as the treating physician whose treatment authorization is sought to be withdrawn, stating that treatment was not reasonable, related, or necessary. In response to a substantially similar certified question, the Fourth District held: We interpret section 627.736(4) to mean that if PIP benefits are payable, they are due within thirty days after notice....

...Pacheco, 695 So.2d at 395 (emphasis in original) (quoting Dunmore v. Interstate Fire Ins. Co., 301 So.2d 502, 502 (Fla. 1st DCA 1974)). The court in Pacheco also held that "once an insurer receives notice of a loss and medical expenses, it must pay within thirty days, unless pursuant to section 627.736(4)(b), it has obtained reasonable proof to believe that it is not responsible for the payment." Id. However, as noted by the Fourth District, both Dunmore and Pacheco are distinguishable, in that in both cases it was not disputed that benefits were owed. Daidone, 760 So.2d at 1112. Except for section 627.736(8), Florida Statutes (Supp.1996), which provides for attorney's fees, section 627.736(4)(c), Florida Statutes (Supp.1996), is the only penalty specified by the legislature for an insurer failing to pay a claim or obtain reasonable proof that it is not responsible within thirty days of notice of the claim under section 627.736, Florida Statutes (Supp.1996). The plain language of section 627.736(4), Florida Statutes (Supp.1996), requires only that the insurer pay the claim within thirty days or have reasonable proof that the insurer is not responsible for payment; if an insurer refuses to pay or obtain reasonable proof, it is subject to ten percent interest on the payment and attorney's fees....

...Buttressing the decisions of the Fourth and Fifth District, is the Second District's opinion in Pioneer Life Insurance v. Heidenfeldt, 773 So.2d 75 (Fla. 2d DCA 2000). In Heidenfeldt, the court held that section 627.613, Florida Statutes (1997), which is substantially similar to section 627.736(4), Florida Statutes (Supp.1996), subjects an insurer to a ten percent interest penalty if it does not timely reimburse an insured, but does not prohibit the insurer from defending the claim if it does not timely reimburse....

...ty bus she was driving as a city bus is excluded from the no-fault law's definition of "motor vehicle." In Scherzer, this court held that the threshold requirements under the no-fault law apply only in a tort action where security has been provided. Section 627.736(1), Florida Statutes (1981), applicable in that case, provided that every insurance policy shall provide personal injury protection benefits to the named insured, relatives residing in the same household, persons operating the insured...

...sonal injury protection coverage of the burden of paying for or engaging in litigation regarding the use of certain diagnostic tests determined to be medically unnecessary for the treatment of an injured insured. Accordingly, the Legislature enacted section 627.736(5)(b)(6), Florida Statutes, which provides in material part: The Department of Health, in consultation with the appropriate professional licensing boards, shall adopt, by rule, a list of diagnostic tests deemed not to be medically nec...

...t response. The Department of Health subsequently commenced its statutorily required rulemaking process and, after reviewing a number of proposed diagnostic tests for inclusion on the list, adopted rule 64B-3.004, which provides: For the purposes of Section 627.736(5)(b)6., F.S....

...available evidence, regardless of whether the evidence was presented to the Department during its rulemaking proceedings or was presented for the first time during the section 120.56 hearing. The appellants next argue that the judge misconstrued the section 627.736(5)(b)(6) requirement that "[i]nclusion of a test on the list of invalid diagnostic tests shall be based on lack of demonstrated medical value" when the judge concluded that a test could not be included on the list if it was shown to have any medical value at all....

...gnostic testing failed to satisfy the statutory requirement, even under the broader reading suggested by the Department, and thus should not have been included on the list. The appellants likewise argue that the judge misconstrued the requirement in section 627.736(5)(b)(6) regarding the "level of general acceptance by the relevant provider community" because the judge limited the relevant provider community in this case to chiropractors, thereby excluding other providers, most notably medical doctors....

...was not limited to the chiropractic community alone. Competent substantial evidence supports this finding, and this again demonstrates that the statutory requirement was not satisfied. The appellants also claim that the judge improperly interpreted section 627.736(5)(b)(6) as precluding the inclusion of an objective diagnostic test such as surface EMG testing on the list....

...ty, we need not construe this statutory language. Because the judge's material findings of fact are supported by the record and demonstrate that surface EMGs failed to qualify for inclusion on the list of medically unnecessary diagnostic tests under section 627.736(5)(b)(6), the judge properly concluded that the Department exceeded its grant of delegated legislative authority when it adopted subsection (2) of Florida Administrative Code Rule 64B-3.004....

...ntitlement to personal injury protection benefits. Appellants argue that traditional causation is necessary for benefits to accrue. Since the errant vehicle caused appellant's injury, benefits are due. We agree that insurance benefits are due below. Section 627.736(4)(d)(1), Florida Statutes (1981), provides that for an insured not occupying a motor vehicle, personal injury protection benefits are payable if the injuries were caused by physical contact with a motor vehicle....

CANADY, J. In this case we consider whether a personal injury protection (“PIP”) insurance policy provides legally sufficient notice of the insurer’s election to use the permissive Medicare fee schedules identified in section 627.736(5)(a)2., Florida Statutes (2009), to limit reimbursements for medical expenses....

...We have jurisdiction. See art. Y, § 3(b)(4), Fla. Const. For the reasons that follow, we hold that Allstate’s insurance policy provides legally sufficient notice of Allstate’s election to use the permissive Medicare fee schedules identified in section 627.736(5)(a)2....

...o Allstate’s insureds. Orthopedic Specialists, 177 So.3d at 20 . The Providers argued that Allstate’s policy is ambiguous as to whether Allstate has elected to reimburse the Providers in accordance with the Medicare fee schedules provided for in section 627.736(5)(a)2....

...and medically necessary ambulance, hospital, and nursing services. Id. An endorsement to the policy provides: Limits of Liability *975 [[Image here]] Any amounts payable under this coverage shall be subject to any and all limitations, authorized by section 627.736, or any other provisions of the Florida Motor Vehicle No-Fault Law, as enacted, amended or otherwise continued in the law, including, but not limited to, all fee schedules....

...art of the PIP statute’s coverage requirements.” Id. “[T]here are two different methodologies for calculating reimbursements to satisfy the PIP statute’s reasonable medical expenses coverage mandate.” Id. at 156 (emphasis omitted). Compare § 627.736(5)(a)l., Fla. Stat. (2009), with § 627.736(5)(a)2., Fla....

...Under the first payment methodology contained within section 627,736(5)(a)l., “reasonableness is a fact-dependent inquiry determined by consideration of various factors.” Virtual Imaging, 141 So.3d at 155-56 . Under the alternative, permissive payment methodology contained within section 627.736(5)(a)2., “insurers ‘may limit reimbursement’ to eighty percent of a schedule of maximum charges set forth in the PIP statute.” Id at 154 (quoting § 627.736(5)(a)2., Fla. Stat.). Reimbursements made under section 627.736(5)(a)2....

...e schedules to limit reimbursements without notifying its insured by electing those fee schedules in its policy.” Id at 160. This Court concluded that notice to the insured, -through an election in the policy, is necessary because the PIP statute, section 627.736, requires the insurer to pay for “reasonable expenses ... for medically necessary ... services,” § 627.736(l)(a), Fla. Stat., but merely permits the insurer-to use the Medicare fee schedules as a basis for *977 limiting reimbursements, see § 627.736(5)(a)2., Fla. Stat. Id. at 150 (alterations in original). Accordingly, this Court reasoned that [bjecause the fee schedule provision of section 627.736(5)(a)2.f....

...g Kingsway Amigo Ins. Co. v. Ocean Health, Inc., 63 So.3d 63, 67-68 (Fla. 4th DCA 2011)). The Instant Case Allstate’s PIP policy provides legally sufficient notice of Allstate’s election to use the permissive Medicare fee schedules identified in section 627.736(5)(a)2. to limit reimbursements. The endorsement to Allstate’s policy clearly and unambiguously states that “[a]ny amounts payable” for medical expense reimbursements “shall be subject to any and all limitations, authorized by section 627.736, ......

...including ... all fee schedules.” When read in its context and as a whole with Allstate’s policy, the plain and obvious meaning of the endorsement is that reimbursements will be made in accordance with all of the fee schedule limitations contained within section 627.736(5)(a)2....

...30, 2016) (explaining that “Virtual Imaging did not dictate a form of notice” or require insurers to specifically state the word “Medicare”). Allstate’s policy thus places both providers and insured on notice of Allstate’s election to use the permissive Medicare fee schedules identified in section 627.736(5)(a)2....

...Respondents argue that Allstate’s policy is ambiguous under Virtual Imaging because it fails to state that Allstate: (1) will not actually pay eighty percent of reasonable charges and (2) will instead calculate benefits only under the permissive Medicare fee schedules contained within section 627.736(5)(a)2....

...sclaim the PIP statute’s reasonable medical expenses coverage mandate. See Virtual Imaging, 141 So.3d at 155 . Furthermore, a PIP policy cannot state that the insurer will calculate benefits solely under the Medicare fee schedules contained within section 627.736(5)(a)2....

...because the Medicare fee schedules are not the only applicable mechanism for calculating reimbursements under the permissive.payment methodology. See id. at 159 (explaining that “the Medicare fee schedules are not the only mechanism for calculating reina- *978 burseraents”). Compare § 627.736(5)(a)2.a., Fla. Stat. (referring to the Medicare fee schedules), with § 627.736(5)(a)2.b,-c., Fla....

...But it is frequently unambiguously the case that “[t]he word ‘shall’ is mandatory in nature.” Sanders v. City Of Orlando, 997 So.2d 1089, 1095 (Fla. 2008); see Virtual Imaging, 141 So.3d at 155 (interpreting the word “shall” contained within section 627.736(1) as mandatory)....

...Here, in the context of Allstate’s PIP policy, the only reasonable interpretation of the phrase “shall be subject to” is as a mandatory command. By stating that “[a]ny amounts payable” for medical expense reimbursements “shall be subject to any and all limitations, authorized by section 627.736, ......

...Under that interpretation, the provision amounts to nothing more than a nugatory recitation of the statutory authorization. Respondents argue that Allstate’s policy is ambiguous because the phrase “all fee schedules” includes both the non-Medicare fee schedules listed in section 627.736(5)(a)l. and the Medicare fee schedules listed in section 627.736(5)(a)2. Not so. In the context of Allstate’s policy, the endorsement unambiguously references “any and all limitations, authorized by section 627.736, ... including ... all fee schedules.” (Emphasis added.) A review of section 627.736 reveals that the only fee schedule limitations applicable to insurer payments contained within that statute are located in section 627.736(5)(a)2. See § 627.736(5)(a)2., Fla. Stat. (“The insurer may limit reimbursement to 80 percent of the following schedule of maximum charges ....” (emphasis added)); § 627.736(5)(a)3.-5., Fla. Stat. (referencing the fee schedule limitations contained within section 627.736(5)(a)2.)....

...ufficient to authorize Allstate to apply the Medicare fee schedules. Stand-Up MRI correctly concluded that Allstate’s PIP policy provides legally sufficient notice of Allstate’s election to use the permissive Medicare fee schedules identified in section 627.736(5)(a)2....

...Travelers presented no testimony, expert or otherwise, in rebuttal. Instead, it advanced the proposition that, because Mrs. Vega had found a job working as a laundress at a higher wage than she had earned bagging groceries before the accident, Travelers was thereby absolved from liability under section 627.736, Florida Statutes (1985)....

..."work loss" means with respect to the period of disability of the injured person, any loss of income and the earning capacity from inability to work proximately caused by the injury sustained by the injured person[.] [2] Personal injury protection benefits required under section 627.736, Florida Statutes (1985), include, in part, REQUIRED BENEFITS....

...rst prove that Midland either breached obligations owed to her under her husband's group life insurance contract, or perhaps that Midland violated some relevant insurance regulation that required the claim to be processed within a specific time. Cf. § 627.736(4)(b), Fla....

...Kane of Greenspan & Kane, Boca Raton, for appellee. HAZOURI, J. The county court has certified a question of great public importance to this court pursuant to Florida Rule of Appellate Procedure 9.160(b) which we rephrase as follows: IS AN INSURER REQUIRED BY SECTION 627.736(7)(a) [1] , FLORIDA *230 STATUTES TO OBTAIN A MEDICAL REPORT BASED UPON A PHYSICAL EXAMINATION OF AN INSURED BEFORE IT MAY WITHDRAW PERSONAL INJURY PROTECTION BENEFITS? We have accepted jurisdiction pursuant to Florida Rules of Appellate Procedure 9.030(b)(4)(a) and 9.160(d)....

...Southeast then initiated a two-count complaint against Nationwide, seeking monetary damages and a declaration that Nationwide was required to provide PIP benefits for the Southeast treatment. Count I, the damages claim, was referred to arbitration pursuant to section 627.736(5), Florida Statutes (1995), and the arbitration was stayed pending a ruling on Count II, the declaratory judgment claim. Southeast filed a motion for summary judgment on Count II asserting that section 627.736(7)(a) requires that the PIP insurer must obtain a report based upon a physical examination of the insured before it may withdraw benefits. Nationwide asserted that there was no requirement under 627.736(7)(a) that the medical report had to be based upon a physical examination of the insured. The trial court granted Southeast's motion for summary judgment and certified the issue to this court as a matter of great public importance. In the legislative session of 1987, section 627.736(7)(a) was amended to add the following language: An insurer may not withdraw payment of a treating physician without the consent of the injured person covered by the personal injury protection, unless the insurer first obtains a repor...

...an licensed under the same chapter as the treating physician whose treatment authorization is sought to be withdrawn, stating that the treatment was not reasonable, related, or necessary. Prior to July 4, 1987, the effective date of the amendment to section 627.736(7)(a), there was neither a statutory nor contractual limitation regarding the withdrawal of PIP payments under a contract of insurance....

...discontinue paying for services previously authorized by a physician but was instead simply denying an initial claim for payment by a provider whose bills it had not previously approved and paid. For these reasons I concur in the reversal. NOTES [1] Section 627.736(7)(a), Florida Statutes (1995), provides: Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury pr...

...unless the insurer first obtains a report by a physician licensed under the same chapter as the treating physician whose treatment authorization is sought to be withdrawn, stating that the treatment was not reasonable, related, or necessary. [2] See § 627.736(7)(a), Fla....

...From her own policy, Rudnick had $10,000 in PIP coverage and $5,000 in medpay coverage remaining at the time of trial. Allstate argues that the trial court erred by refusing to set these amounts off against the verdict. In support of its argument, Allstate cites to sections 627.727(1), 627.736(3), and 768.76(1), Florida Statutes (1993)....

...... personal injury protection benefits ... and such coverage shall cover the difference, if any, between the sum of such benefits and the damages sustained, up to the maximum amount of such coverage provided under this section. (Emphasis supplied). Section 627.736(3), dealing with PIP benefits, states that an insured who is entitled to bring suit shall have no right to recover any damages for which personal injury protection benefits are paid or payable....

...(Emphasis supplied). The issue presented is whether, at the time of trial, the $15,000 coverage for future PIP and medpay claims was "available" or "paid or payable" within the meaning of these statutes. Previous decisions of this court construing sections 627.736(3) and 768.76(1), compel the conclusion that Allstate was not entitled to a set-off in this case....

...ounts *391 which have been paid ") or presently earned and currently due and owing ("otherwise available to him"). Id. at 1153. Recently, in Pizzarelli v. Rollins, 704 So.2d 630 (Fla. 4th DCA 1997), this court held that a benefit was "payable" under section 627.736(3), if it related to a medical bill which the plaintiff incurred before trial but which had not been processed by the PIP carrier at the time the offset was sought....

...The trial court misconstrued the governing authority regarding collateral source evidence, and misinterpreted the facts. *268 A review of the governing authority and the record supports this finding. Governing Statutory Provisions Section 768.76(1) and Section 627.736(3) of the Florida Statutes are two separate statutory provisions governing collateral sources....

...laimant, or made on the claimant's behalf, by or pursuant to: (2) any health, sickness, or income disability insurance, automobile accident insurance that provides health benefits or income disability coverage.... § 768.76(2)(a), Fla. Stat. (2002). Section 627.736(3) of the Florida Statutes specifically addresses the recovery of collateral source payments in tort claims stemming from motor vehicle accidents. Section 627.736(3) is set forth in Part XI of the Florida Statutes entitled Motor Vehicle & Casualty Insurance Contracts. Section 627.736(3) reads, in part, An injured party who is entitled to bring suit ......

...The plaintiff may prove all of his special damages notwithstanding this limitation, but if special damages are introduced in evidence, the trier of fact, whether judge or jury, shall not award damages for personal injury protection benefits paid or payable. § 627.736(3), Fla. Stat. (2002). Thus, under Section 627.736(3), the judge or the jury, as the trier of fact in an automobile case, is authorized to off-set an award of damages by the amount of personal injury protection benefits paid or payable if evidence of the benefits is presented at trial. A cursory comparison of Section 627.736(3) with Section 768.76(1) initially reveals that the set-off provisions differ as to whether the judge, post-trial, or the jury, during trial, shall ultimately reduce the damage award....

...2003), the trial court granted the defendant's request to conduct post-trial discovery and present post-trial evidence of personal injury protection benefits. On appeal, the appellate court reluctantly upheld the trial court's ruling. The court applied Section *269 768.76(1) in lieu of Section 627.736(3). Although suggesting that a defendant is required to present evidence of PIP benefits during trial, pursuant to Section 627.736(3), the court, nevertheless, concluded that it was bound by an earlier decision rendered by that court announced in Allstate Insurance Co....

...Scott, 773 So.2d at 1290. This court agrees with those decisions which cite both statutory provisions interchangeably. [4] This court finds Section 768.76(1) merely enlarges the scope of collateral sources from "personal injury protection benefits" (as set forth in Section 627.736(3)) to "all collateral sources" and defines the latter term specifically to include certain enumerated insurance benefits among which is "health or income disability insurance benefits" provided under automobile insurance (as set forth in Section 768.76(2))....

...reclude the application of Section 768.76(1) to automobile tort cases. Section 768.71(3) provides: "if a provision of this part is in conflict with any other provision of the Florida Statutes, such other provision shall apply." This court finds that Section 627.736(3) does not conflict with or supplant Section 768.76(1)....

...Such a construction would render meaningless subsection (2) of Section 68.76 that expressly provides that benefits provided under auto insurance are collateral sources which are deductible. Furthermore, it is implausible to conclude that the collateral source law, set forth in Section 627.736(3), supersedes Section 768.76(1) by operation of Section 768.71(3). Although the role of the jury was delineated under Section 627.736(3), the rights and obligations of the court were not extinguished....

...the judge to admit into evidence the total amount of collateral source deductions, and to instruct the jury to deduct from its verdict the value of the collateral source benefits received. Section 768.76 did not repeal or supplant Section 627.7372. Section 627.736 was enacted in 1971. [7] This provision embodied the concept of Section 627.7372 but not the language. Unlike Section 627.7372, Section 627.736 does not require evidence of collateral source payments to be introduced during trial....

...It only specifies that certain collateral source payments shall reduce the damage award if such evidence is presented during trial. While Section 627.7372 stood for the premise that collateral source payments arising from automobile cases must be presented during trial and not post-trial, Section 627.736 eliminated the distinction between mandatory and elective procedural practices. Therefore, Section 627.736 should be read in tandem with Section 768.76, similar *271 to Section 627.7372 and Section 768.76. Section 768.76 was enacted to harmonize, not nullify, existing laws. It is logical to conclude that Section 627.736 should be construed harmoniously with Section 768.76....

...Accordingly, this matter is reversed and remanded to the trial court for further consideration of the appellant's post-trial motion in accordance with this opinion. REVERSED and REMANDED. STEVENSON and MAY, JJ., concur. NOTES [1] Section 768.71(1), Fla Stat. (2003). [2] The appellate court implied that Section 627.736(3) was the better rule of law, but declined to change the rule in Scott, and left any change up to the state Supreme Court. The court certified the following question for the Supreme Court's review: IN AN AUTOMOBILE ACCIDENT CASE, DOES SECTION 627.736(3) REQUIRE THAT EVIDENCE OF PIP BENEFITS FOR PURPOSES OF SET OFF BE PRESENTED TO THE TRIER OF FACT, BE IT JUDGE OR JURY, AND IF A JURY, MUST THE JURY BE INSTRUCTED THAT THE PLAINTIFF SHALL NOT RECOVER FOR SPECIAL DAMAGES FOR PERSONAL...

...TY, ASSERTING SET OFF OF PIP BENEFITS INTRODUCE THAT EVIDENCE AFTER A JURY TRIAL TO THE JUDGE FOR A FACT FINDING OF AMOUNTS INVOLVED, AND FOR PURPOSES OF REDUCING THE PLAINTIFF'S RECOVERY? [3] Other examples of court decisions which have not applied Section 627.736(3) contemporaneously with Section 768.76(1) include Kirkland v....

...The sole issue involved in this appeal is whether the occupant of a motor vehicle which is involved in an accident with a second motor vehicle is entitled to personal injury protection benefits from the insurer of the owner of the second motor vehicle under Section 627.736(4)(d), Florida Statutes (Supp....

...Based on the above undisputed facts, both parties moved for summary judgment. The trial court granted the motion for summary judgment as to the plaintiff Kraver. This appeal from such a nonfinal order follows. Fla.R.App.P. 9.130(a)(3) (C)(iv). This case is directly controlled by the plain language of Section 627.736(4)(d), Florida Statutes (Supp....

...is not himself: a. The owner of a motor vehicle with respect to which security is required under ss. 627.730-627.741, or b. Entitled to personal injury benefits from the insurer of the owner of such a motor vehicle." [Emphasis added] All agree that Section 627.736(4)(d)1-3, Florida Statutes (Supp. 1976) is inapplicable *1261 to this case. The plaintiff is neither the owner nor a relative of the owner of the insured motor vehicle herein. The dispute in this case centers on the applicability of Section 627.736(4)(d)4, Florida Statutes (Supp. 1976). In our view, the plaintiff does not come within the protection of Section 627.736(4)(d)4, Florida Statutes (Supp....

...overy. The order under review is reversed and the cause remanded for further proceedings consistent with this opinion. NOTES [1] This statute has since been amended but such amendment did not take effect until after the date of the subject accident. § 627.736(4)(d), Fla. Stat. (1977). [2] There are, of course, other requirements essential to the recovery of personal injury protection benefits under the statute which are not relevant here. § 627.736(4)(d)4a-b, Fla....

...efits “to a limit of $10,000 for loss sustained . . . as a result of bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle.” 1987 Fla. Sess. Law Serv. Ch. 87-226 (West); see Fla. Stat. § 627.736(1)(a) (2015). The Florida legislature amended the No-Fault Law in 2012. See 2012 Fla. Sess. Law Serv. Ch. 2012-197 (West). Those amendments added two subparagraphs to § 627.736(1)(a), one requiring: 3....

...ent to bodily functions[; or] (c) [s]erious dysfunction of any bodily organ or part.” Fla. Stat. § 627.732(16). 3  Case: 14-13724 Date Filed: 12/30/2015 Page: 4 of 11 Fla. Stat. § 627.736(1)(a)(3)–(4) (emphases added)....

...After they were injured in separate car accidents in 2013, Robbins and Enivert sought reimbursement for medical expenses from their insurers. Neither of them submitted a medical provider’s determination about whether she had suffered an emergency medical condition. Relying on their interpretation of Fla. Stat. § 627.736, as amended, Garrison and Progressive limited Robbins’ and Enivert’s benefits to $2,500. Robbins and Enivert each filed in the same district court a purported class action challenging her insurer’s interpretation of § 627.736....

...e: 5 of 11 The lawsuits were assigned to two different judges who entered separate orders dismissing them. Both orders reached the same conclusion, which is that absent an emergency medical determination by one of the providers listed in § 627.736(1)(a)(3), the higher limit of $10,000 in benefits does not apply....

...“resort to the rules of statutory construction, which permit [them] to examine the legislative history to aid in [their] determination regarding legislative intent.” Diamond Aircraft Indus., Inc. v. Horowitch, 107 So. 3d 362, 367 (Fla. 2013). The amended language in § 627.736 does not address the situation presented here, where no medical provider has determined if the insured’s medical condition was, or was not, an emergency....

...or. See Byrd v. Richardson–Greenshields Sec., Inc., 552 So. 2d 1099, 1102 (Fla. 1989) (“[O]ur obligation is to honor the obvious legislative intent and policy behind an enactment . . . .”). For these reasons, we hold that Fla. Stat. § 627.736, as amended, limits an insurer’s obligation to provide personal injury protection benefits to $2,500, unless one of the medical providers listed in subparagraph (1)(a)(3) has determined that the injured person had an emergency medical condition. Because neither Robbins’ nor Enivert’s claim was supported by such a determination, neither Garrison nor Progressive violated Fla. Stat. § 627.736 by limiting benefits to $2,500....

...facts and law of the instant case. The Florida PIP statute states that "as a condition precedent to filing any action for benefits under this section, the Insurer must be provided with written notice of an intent to initiate litigation." Fla. Stat. § 627.736(11)(a)....

...the assignment of rights, the claim number or policy number, the name of the medical provider, and an itemized statement specifying the exact amount, date of treatment, service or accommodation, and the type of benefit claimed to be due. Fla. Stat. § 627.736(11)(b)....

...the assignment of rights, the claim number or policy number, the name of the medical provider, and an itemized statement specifying the exact amount, date of treatment, service or accommodation, and the type of benefit claimed to be due. Fla. Stat. § 627.736(11)(b)....

...In particular, FEP's letter stated: Please note that your response does not include several items previously referenced in our 15-Day Letter dated *968 5/10/04. The information previously sent was blank. Specifically, pursuant to Florida Statute 627.4137, 627.7401, 627.736(6)(d) and/or the policy that covers this loss: 1....

...for this purpose. To the extent that the circuit court concluded that Zaniboni required the PIP insurer to produce a "PIP Log", the circuit court has misread the Zaniboni decision. In Zaniboni, the circuit court expressly concluded: No provision of section 627.736, Florida Statutes, dictates that an insurer must provide a PIP log to an insured, or his/her assignee. In fact, there is no provision under section 627.736, Florida Statutes, which requires that an insurer must create a PIP log at all....

...Buttressing the holding in Zaniboni is the subsequent holding in Southern Group Indemnity, Inc. v. Humanitary Health Care, Inc., 32 Fla. L. Weekly D1396, ___ So.2d ___, 2007 WL 1542019 (Fla. 3d DCA May 30, 2007). There, in response to a similar argument, the Third District held: Section 627.736(6) does not provide for nor address the insured's right to access documents prepared internally by the insurer. As the insurer's PIP payout log is a document generated by the insurer and is not a document the insurer obtained pursuant to section 627.736(6), we conclude that the circuit court, acting in its appellate capacity, applied the incorrect law by finding that (1) section 627.736(6)(d), Florida Statutes (23), requires an insurer to provide its ipIP payout log to an insured or the insured's assignee, presuit....

...ourt order, and reinstate the county court order. Petition GRANTED; circuit court opinion QUASHED. SAWAYA and EVANDER, JJ., concur. NOTES [1] "PIP" is an acronym commonly used to refer to personal injury protection automobile insurance coverage. See § 627.736, Fla....

...As affirmative defenses, United claimed that payment was not required because PMG did not provide United with proper written notice of a covered loss where: (1) the initial set of bills did not include a disclosure and acknowledgment form ("D and A form"), as described in section 627.736(5)(e), Florida Statutes (2004); and (2) Box 31 of the CMS-1500 claim form did not contain the physician's license number, as required by section 627.736(5)(d), Florida Statutes (2004)....

...Miami-Dade County, 969 So.2d 389, 392 (Fla. 3d DCA 2007). III. ANALYSIS On appeal, United first claims [2] that the physician's failure to provide his or her license number on a claim form fails to provide United with "written notice of the fact of a covered loss" as required by section 627.736(4)(b), Fla. Stat. (2004), and that this omission cannot be cured prior to litigation. Second, United argues that in order for it to have received notice of a covered loss, the initial and timely set of bills must include the D and A form as described in section 627.736(5)(e), and that this omission cannot be cured prior to litigation. We find both arguments to be without merit. Pursuant to section 627.736(4)(b), personal injury protection benefits are overdue *24 "if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss." As such, the triggering event for determining when a payment is overdue is the insurer's receipt of written notice of a covered loss. Section 627.736(5)(d) sets forth the requirements for providing notice of a loss: All statements and bills for medical services rendered by any physician, hospital, clinic, or other person or institution shall be submitted to the insurer on a properl...

...ntially accurate responses as to all material elements to each applicable request for information or statement by a means that may lawfully be provided and that complies with this section, or as agreed by the parties. (emphasis added). Additionally, section 627.736(5)(b)1.d., Florida Statutes (2004), states that an insurer is not required to pay a claim or charges "[w]ith respect to a bill or statement that does not substantially meet the applicable requirements of paragraph (d)." Accordingly, b...

...Given these facts, United cannot claim it was harmed or prejudiced by the missing number. As such, we find that the initial set of bills PMG provided to United were "substantially complete" as to all relevant and material information as required by section 627.736(5)(d)....

...Additionally, even if the physician's license number were deemed a material provision of the statements or bills, nothing in the statute's plain language indicates that the absence of the license number cannot be cured by later submission of the number to the insurer on a claim form as described in section 627.736(5)(d)....

...a demand letter prior to litigation. Accordingly, any error or omission, if it existed, was sufficiently *25 cured by PMG prior to the initiation of litigation. With respect to the issue of the D and A form, the same reasoning also applies. Sections 627.736(5)(e)1, and (5)(e)5 state: 1....

...guardian, to execute a disclosure and acknowledgment form.... 5. The original completed disclosure and acknowledgment form shall be furnished to the insurer pursuant to paragraph (4)(b) and may not be electronically furnished. United claims that the section 627.736(5)(e)5's reference to paragraph (4)(b) means that a failure to provide a D and A form with the initial, timely set of bills results in a failure to place the insurer on notice of a covered loss....

...rance contract, purportedly allowing Blue Cross the right to recover any medical benefit proceeds which Mr. Tyson might recover from appellee. [2] *833 Although Blue Cross was aware of the collateral source statutes in Florida, sections 627.7372 and 627.736(3), which appear to preclude Blue Cross from asserting its subrogation rights, it argued that these statutory provisions are unconstitutional as applied to it, or, alternatively, that they are preempted by the Employee Retirement Income Security Act (ERISA), 29 U.S.C. §§ 1001-1381. The trial judge found Sections 627.736(3) and 627.7372, Florida Statutes, constitutional and that the statutes are not preempted by ERISA, and therefore denied the petition for leave to intervene. Blue Cross first argues that Sections 627.736(3) and 627.7372, Florida Statutes, [3] violate that provision of the Florida Constitution guaranteeing access to courts....

...easonable alternative to protect the rights of the people of the State to redress for injuries, unless the Legislature can show an overpowering public necessity for the abolishment of such right. Kluger v. White, 281 So.2d 1, 4 (Fla. 1973). Sections 627.736(3) and 627.7372 reduce the amount of damages an injured plaintiff may recover from tortfeasors by the amount of benefits received from collateral sources, including any sickness, income disability, or health insurance such as that provided by Blue Cross....

...asonable alternative as required by Kluger; therefore the statutes in question are unconstitutional. In Purdy v. Gulf Breeze Enterprises, Inc., 403 So.2d 1325 (Fla. 1981), the Florida Supreme Court addressed this same argument, finding that sections 627.736(3) and 627.7372 do not deprive plaintiffs injured in automobile accidents their right of access to courts since the purpose of the statutes was simply to *834 bar injured persons from receiving double benefits....

...[4] We find appellant's remaining argument on this point [5] without merit and affirm the trial judge's finding that the collateral source statutes are not unconstitutional as applied to Blue Cross. Appellant's second point on appeal is that Sections 627.736(3) and 627.7372, Florida Statutes, are preempted by ERISA....

...ERISA does, however, provide that it shall "supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan." 29 U.S.C. § 1144(a). Appellant argues that the preemption provision supersedes state law (Sections 627.736(3) and 627.7372, Florida Statutes), since these laws relate to the employee welfare benefit plan, [7] the insurance contract....

...f recovery or proceeds therefrom shall execute and deliver such proceeds or such instruments or papers and do whatever else is necessary to secure to the Company such rights of recovery and proceeds and shall do nothing to prejudice such rights. [3] Section 627.736(3), Florida Statutes, provides in pertinent part: (3) INSURED'S RIGHTS TO RECOVERY OF SPECIAL DAMAGES IN TORT CLAIMS....

...of the common law of the State pursuant to Fla. Stat. § 2.01", under Kluger, 281 So.2d at 4 (e.s.). We need not directly address this point since we find that under Purdy there is no constitutional violation. [5] Appellants also argue that sections 627.736(3) and 627.7372 violate the equal protection clause of the Florida Constitution....

...Diagnostics, Inc., 696 So.2d 1334 (Fla. 4th DCA 1997), for lack of jurisdiction. The issue is whether a voluntary assignee-provider of PIP benefits can be compelled under the arbitration provision in the policy to arbitrate the assignee's claim against the insurer for payment. See § 627.736(5) Fla....

...She went to an urgent care center due to pain in her cervical region and right shoulder. The doctor referred her to appellant for physical therapy. Appellant then submitted bills for payment to appellee USAA, the insurer, but USAA provided no additional payment, explaining that, pursuant to section 627.736(l)(a)(4), Florida Statutes, $2,500 had already been reimbursed under the policy....

...ave an emergency medical condition. Upon receipt' of this documentation, USAA paid all outstanding charges under the policy until the limits were reached. USAA moved for summary judgment, which the trial court granted, finding that the provisions of section 627.736(l)(a)(3)-(4) limit medical benefits to $2,500 until there is a determination that the insured had an emergency medical condition. The trial court also determined USAA properly requested that appellant provide information regarding the insured’s medical condition, pursuant to section 627.736(6)(b), to justify additional reimbursement....

...The Florida Motor Vehicle No-Fault Law requires that automobile insurers provide personal injury protection “to a limit of $10,000 in medical and disability benefits ... resulting from bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle.” § 627.736(1), Fla. Stat. (2013). Section 627.736(l)(a)(3)-(4), Florida Statutes (2013), states, 3....

...y determines that there is an emergency medical condition and notifies the insurer of that condition. The statute addresses the situation where there has been an affirmative determination of an emergency medical condition, authorizing up to $10,000. § 627.736(1)(a)(3), Fla. Stat. The statute also addresses the situation where there has been an affirmative determination of no emergency medical condition, authorizing up to only $2,500. § 627.736(1)(a)(4), Fla....

...term “emergency medical condition.” Allowing an insured to escape that restriction on the higher limit would defeat the legislative intent and policy behind the amendments, which we are bound to honor. For these reasons, we hold that Fla. Stat. § 627.736 , as amended, limits an insurer’s obligation to provide personal injury protection benefits to $2,500, unless one of the medical providers listed in subparagraph (l)(a)(3) has determined that the injured person had an emergency medical condition. Id. at 587-88 (citations omitted). We agree that section 627.736 “limits an insurer’s obligation to provide personal injury protection benefits to $2,500, unless one of the medical providers listed in sub-paragraph (l)(a)(3) has determined that the injured person had an emergency medical condition.” See id....

...Upon receiving the determination, USAA paid all outstanding charges until reaching the policy limits. We must therefore consider whether USAA had the right to receive a written report of insured’s condition prior to issuing a payment in excess of the $2,500 statutory limit. We find that USAA had the right, pursuant to section 627.736(6)(b), to request a written report of the insured’s condition. Under section 627.736(6)(b), Every [qualifying medical provider] shall, if requested by the insurer against whom the claim has been made, furnish a written report of the ......

...jury constituted an emergency medical condition. ■ Consequently, appellant’s demand letter was premature. Although appellant filed a demand letter for payment of benefits, appellant failed to respond to USAA’s request for discovery pursuant to section 627.736(6)(b)....

...1984), a woman driver was shot and pulled from the car, after which her assailant fled in her car. She had previously refused the assailant's request for a ride. The court ruled that the phrase "arising out of the ownership, maintenance, or use of a motor vehicle" in section 627.736(1), Florida Statutes (1983), requires a nexus, i.e....

...denied, 308 So.2d 113 (Fla. 1975), allowing the insurer reimbursement for PIP benefits only "to the extent that the injured person has recovered said benefits" from a tortfeasor. Id. at 665. The Graff court explained: [P]ersonal injury protection benefits are payable under § 627.736 in amounts determinable irrespective of fault in order to compensate the recipient for losses formerly assessable only against the party at fault; on the other hand, disability benefits payable under § 627.727 are not insurance against al...

...without the necessity of a suit being filed, and that the trial court improperly took these hours into consideration in its award of attorney's fees to appellee. With respect to any disputes between the insured and the insurer arising under the Act, § 627.736(8), Fla....

...sum of $1500.00 as and for attorney's fees, for which let execution issue. "DONE AND ORDERED at Key West, Monroe County, Florida on August 6, 1974. (s) _______ Circuit Judge" After a careful review of the record in the instant appeal and in view of § 627.736(8), we are unable to ascertain that the trial judge considered any improper evidence in entering the order of August 6, 1974 awarding an amount of $1500.00 to appellee for attorney's fees....

...o appear for the EUO was unreasonable. After the trial court entered its ruling, our supreme court decided Nunez and held that an EUO provision as a condition precedent to the payment of PIP benefits was invalid and contrary to the PIP provisions of section 627.736, Florida Statutes (2009)....

...See Haines City Cmty. Dev. v. Heggs, 658 So.2d 523 (Fla.1995). The insured was injured in an automobile accident in March 1996. At that time she was covered by an insurance policy issued by State Farm which included personal injury protection (PIP) benefits. Section 627.736, Florida Statutes (1995), provides in relevant part: 627.736 Required personal injury protection benefits: exclusions; priority....

...The statute further provides that, as a condition precedent to withdrawing payment of a PIP claim submitted by a treating physician, the insurer must obtain an independent medical examination (IME) report stating that the claim is not reasonable, related, or necessary. § 627.736(7), Fla....

...On appeal, the circuit court reversed the county court's final judgment, citing to Jones v. State Farm Mut. Auto. Ins. Co., 694 So.2d 165 (Fla. 5th DCA 1997) and AIU Ins. Co. v. Daidone, 760 So.2d 1110 (Fla. 4th DCA 2000). The circuit court panel interpreted section 627.736(4)(b), Florida Statutes (1995), to mean that, if PIP benefits are payable then they are due within thirty days of the date the bills are received, and if they are not paid or contested within that thirty-day time period then the insurer is liable for paying ten percent interest when the bill is paid....

...We agree with this ruling while acknowledging that a split of opinion exists in Florida on this issue. In Perez v. State Farm Fire and Cas. Co., 746 So.2d 1123 (Fla. 3d DCA 1999), rev. granted sub nom. United Auto. Ins. Co. v. Rodriguez, 767 So.2d 464 (Fla.2000), the Third District held that section 627.736(4)(b), requires the insurer to obtain, within thirty days, a medical report providing "reasonable proof" that the insurer is not responsible for payment....

...t responding to Dr. Tall's bills within thirty days of receipt. Notably, if the jury had determined that State Farm was liable for paying the insured PIP benefits pursuant to the terms of her policy, then State Farm would have also been liable under section 627.736(4)(c) of the Florida Statutes (1995) for a ten percent penalty for its failure to timely respond to Dr....

...Roberts J. Bradford, Jr. of Marks & Fleischer, P.A., Fort Lauderdale, for appellee. WARNER, J. The county court certified the following as a question of great public importance: WHERE THE INSURED HAS ASSIGNED HIS/HER BENEFITS TO HIS/HER MEDICAL PROVIDER, DO SECTION 627.736(5)(a) AND/OR SECTION 627.736(5)(d), FLORIDA STATUTES, REQUIRE THE INSURED TO COUNTERSIGN THE MEDICAL BILLS SUBMITTED ON HCFA FORM 1500, AND IS THE INSURER PERMITTED UNDER THESE CIRCUMSTANCES TO DENY PAYMENT ENTIRELY OF REASONABLE, NECESSARY, AND RELATED MEDICAL B...

...te involve[d] such complex or difficult issues, or that the case ha[d] such widespread ramifications, so as to make the case of `great public importance.' " Everard v. State, 559 So.2d 427, 427 (Fla. 4th DCA 1990). The statute involved in this case, section 627.736, Florida Statutes, was originally passed by the legislature in 1971....

...It has remained essentially unchanged for the past twenty-five years, and county courts have adjudicated under this statute the rights and obligations of insurers, insureds, and medical providers. Some of those decisions have been appealed to circuit courts which have uniformly interpreted the countersignature requirement in section 627.736(5)(a) as a permitted, not mandatory, mechanism that does not require the insured's signature on the reimbursement form where the insured has assigned benefits to the medical provider....

...Here, appellant argues that she should have received an additional credit of the $499.82, representing ten percent of the gross PIP amount. Specifically, appellant asserts that the trial court's reduction of the set-off led to a double recovery by appellee. She supports her argument by reference to the PIP set-off statute, section 627.736(3), Florida Statutes (1997), which provides in part, "[a]n injured party who is entitled to bring suit......

...5th DCA 1982). We have jurisdiction, article V, section 3(b)(3), Florida Constitution, and we quash the Velez decision and find that petitioner, Velez, may recover under his personal injury protection coverage. This cause involves the interpretation of section 627.736(4)(d)1, Florida Statutes (1981), and a determination of whether the legislature intended to characterize a moped as a self-propelled vehicle....

...y protection benefits for: 1. Accidental bodily injury sustained in this state by the owner while occupying a motor vehicle, or while not an occupant of a self-propelled vehicle if the *1349 injury is caused by physical contact with a motor vehicle. Section 627.736(4)(d)1, Fla....

...t liable under a motor vehicle policy for payment of personal injury protection benefits to an insured who is injured while riding a moped. The district court affirmed the trial court, finding that a moped is a self-propelled vehicle for purposes of section 627.736(4)(d)1 and, therefore, Velez was precluded from recovery under the personal injury protection coverage on his automobile....

....003(2), Florida Statutes (1981), [2] and not a vehicle as defined in section 316.003(64). [3] That court reasoned that a moped could not, therefore, be a self-propelled vehicle for purposes of the personal injury protection benefits exclusion under section 627.736(4)(d)1....

...Further, it is clear that under this definition a bicycle is not a vehicle. Therefore, as correctly determined in Link, the legislature did not intend that a moped be considered as a self-propelled vehicle. Accordingly, we find that Velez is not precluded from recovery under section 627.736(4)(d)1 and we quash the decision of the district court and remand for further proceedings consistent with this opinion....

...BRADY on the 3rd day of June, 1985, in the County and State aforesaid, did knowingly solicit business upon a public street or highway for the purpose of making a motor vehicle tort claims or claims for personal injury protection benefits required by Section 627.736 Florida Statutes, in violation of 817.234(8) Florida Statutes....

...or highway; in or about private hospitals, sanitariums, or any private institution; or upon private property of any character whatsover for the purpose of making motor vehicle tort claims or claims for personal injury protection benefits required by s. 627.736....

...l injury protection (PIP) benefits to its insured, the appellee herein. The trial court awarded this sum as equitable distribution to the appellant for its previous payment of $1,727 to the appellee in PIP benefits under the provisions of Fla. Stat. § 627.736(1), F.S.A. In so doing, the court determined that subsection (3) (b) of Section 627.736 was applicable to the instant case, and not subsection (3) (a)....

...including permanent disability and loss of earning and working ability, which are permanent and continuing in nature. In State Farm Automobile Ins. Co. v. Hauser, Fla.App. 1973, 281 So.2d 563, this court stated that subsections (3) (a) and (3)(b) of Section 627.736 "resist reconciliation." Therein, we indicated that (3)(a) applies when no lawsuit has been filed, and (3) (b) when suit has been commenced....

...Richard Caldwell, Jr., Pitts, Eubanks, Ross & Rumberger, Orlando, for appellant. Hubert I. Sears, Jr. and James F. Page, Jr., Best & Sears, Orlando, for appellees-Oller. OWEN, Chief Judge. The issue in this case is whether the court properly denied to appellant-insurer the right to any reimbursement or indemnity under § 627.736(3), F.S., where appellant had paid maximum personal injury protection benefits (PIP) to an insured who subsequently made a recovery from the negligent tort-feasor. Appellant contends (1) it was entitled to full reimbursement under § 627.736(3)(a), F.S., or (2) alternatively, even if it was entitled only to equitable distribution under § 627.736(3)(b), F.S., the court abused its discretion in totally denying appellant any recovery under the facts of this case....

...The first contention has already been decided adversely to appellant's position by this court's opinion in Reyes v. Banks, Fla. App. 1974, 292 So.2d 39. We discuss herein only the alternative contention, which we feel has merit. In the Reyes case, supra, we analogized the equitable distribution provisions of § 627.736(3)(b), F.S., to the equitable distribution provisions of § 440.39(3)(a), F.S., the workmen's compensation statute, and adopted the view, theretofore established in cases involving equitable distribution under the workmen's compensation st...

...eration in light of the principles announced herein and in our decision in Reyes v. Banks, supra. The court may, in its discretion, permit the parties an opportunity to submit additional evidence relative to the issue of equitable distribution under § 627.736(3) (b), F.S....

...he extent that PIP benefits are payable for a qualifying injury, see, e.g., Auto-Owners Ins. Co. v. Tompkins, 651 So.2d 89 (Fla.1995); Smey v. Williams, 608 So.2d 886 (Fla. 5th DCA 1992), and PIP benefits are not payable for noneconomic damages. See § 627.736, Fla....

...When Dairyland denied the claims, Professional Massage discovered Peachtree's identity and billed them for Cliett's services. However, Peachtree denied the claims, because they were not submitted within 30 days from the dates of the services as required by section 627.736(5)(b), Florida Statutes (1998). [1] In response, *550 Professional Massage filed suit in county court arguing Peachtree was responsible for paying the claims under section 627.736(5)(b) (1998), because the claims were "previously billed [to Dairyland ] on a timely basis." Both parties subsequently filed motions for summary judgment on the issue of whether Peachtree properly denied Professional Massage's claims under section 627.736(5)(b) (1998)....

...A "departure from the essential requirements of law" occurs when a lower court fails to fulfill its constitutional duty to apply a correct principle of law to admitted facts. See Kaklamanos v. Allstate Ins. Co., 796 So.2d 555, 557 (Fla. 1st DCA 2001), approved by Allstate, 843 So.2d 885. Section 627.736(5)(b) (1998) is Unambiguous Section 627.736(5)(b) (1998) provides that an insurer is not responsible for paying bills submitted more than 30 days after a medical service was rendered "except for past due amounts previously billed on a timely basis under this paragraph....

..., it is undisputed that Peachtree was "the insurer" — not Dairyland. Thus, it was a departure from the essential requirements of law for the circuit court to apply the exception to the claims originally submitted to Dairyland. The 2001 Amendment to Section 627.736(5)(b) (1998) is Irrelevant It is not clear in the summary judgment whether the county court was actually applying the 2001 amendment to Professional Massage's claims, or merely referencing it to discern the Legislature's intent behind the 1998 version of the statute....

...is not required to pay, charges for treatments or services rendered more than 30 days before the postmark date of the statement, except for past due amounts previously billed on a timely basis under this paragraph." [2] The 2001 amendment renumbered section 627.736(5)( b ) (1998) to section 627.736(5)( c ) and provided an exception to the 30-day billing requirement directly addressing the situation at bar....

...The exception allows medical providers 35 additional days to submit a claim when they are furnished incorrect insurance information by a patient. [3] This section of Florida's 2001 No-Fault Act provides in pertinent part that "[p]aragraphs. . . (5)(b) and (c) . . . of section 627.736, Florida Statutes as amended by this act ....

...After careful consideration, we reverse the final summary judgments. During its 2001 session the legislature enacted Chapter 2001-271, General Laws of the State of Florida [the Act], which included certain revisions relating to PIP benefits. Section 6 of the Act enacted official Florida statutory section 627.736(5)(b)(5) establishing a revised MRI fee schedule....

...This paragraph does not apply to charges for magnetic resonance imaging services and nerve conduction testing for inpatients and emergency services and care as defined in chapter 395 rendered by facilities licensed under chapter 395." [e.s.] Thus subsection (5) of 627.736(5)(b) unambiguously provided for its own effective date, that is, when the Act became a law, June 19, 2001....

...oncluded that October 1, 2001, was the date the new MRI fee schedule of subsection (5) began, rather than June 19, 2001. This October 1, 2001 date appears in section 11(3) of the Act and provides: "Paragraphs (4)(b), 5(b) and (c) and subsection 6 of Section 627.736, Florida Statutes, as amended by this act and subsection (11) of section 627.736, Florida Statutes shall apply to treatment and services occurring on or after October 1, 2001, except that subsection (11) of Section 627.736, Florida Statutes, shall apply to actions on or after the effective date of this act with regard to a claim or amended claim or judgment for interest only which was not paid or was incorrectly calculated." [e.s.] As can be seen, the a...

...Pursuant to this rule the trial court was not free to depart from the plain and ordinary meaning of the words used by the legislature in order to establish the effective date. E.g., Specialty Restaurants Corp. v. City of Miami, 501 So.2d 101 (Fla. 3d DCA 1987). [2] The effective date of section 627.736(5)(b)(5), Florida Statutes as established by section 6 of the Act, is the effective date of the Act, June 19, 2001....

...Accordingly the final summary judgments are reversed and the causes remanded for further proceedings consistent herewith. NOTES [1] The Act became a law on June 19, 2001, having been approved by the Governor on that date. It was filed with the Secretary of State that same date. [2] As an observation, 627.736(5)(b), provides in its subsections (1)-(4), allowable amounts that may be charged for services other than MRI services. MRI service charges stand alone in 627.736(5)(b)(5). There is thus no disharmony in 627.736(5)(b)(1)-(5).

...tion (PIP) benefits from United Auto. In August 1999, United Auto suspended benefits based on the opinion of its IME physician. Ortega subsequently filed an action in the County Court. At trial and on appeal, United Auto contended that, by virtue of Section 627.736(5)(d), Florida Statutes (Supp.1998), Ortega was required to prove, as part of his prima facie case, that his medical providers were licensed to perform the services that they rendered....

...e.'" Ivey, 774 So.2d at 682 (quoting Stilson v. Allstate Ins. Co., 692 So.2d 979, 982-83 (Fla. 2d DCA 1997)). In the instant case, Ortega contends that the Circuit Court departed from the essential requirements of the law when (1) it determined that Section 627.736(5)(d), Florida Statutes (Supp.1998), required an additional statement of medical providers' licensure in addition to the other items required to provide notice to the insurer; and (2) based on the foregoing determination, concluded that Ortega was required to prove, as part of his prima facie case, that his medical providers were licensed to perform the services that they rendered. We agree with Ortega. Section 627.736(5)(d) [2] , Florida Statutes (Supp....

...forms, or another standard form approved by the Department of Insurance. Second, those bills are required, to the extent applicable, to follow the Physicians' Current Procedural Terminology (CPT) in the year in which the services are rendered. While Section 627.736(5)(d) contains no other affirmative requirements, it states that no such statement for medical services may include charges performed by a person or entity who did not possess the valid licenses to perform such services....

...NOTES [1] In Haines City Community Development v. Heggs, 658 So.2d 523, 530 (Fla.1995), the Florida Supreme Court concluded that the term "applied the correct law" is synonymous with "observing the essential requirements of the law." [2] Under the current statute, this provision is found in Section 627.736(5)(e), Florida Statutes.

...cedent to filing their lawsuit. Both parties subsequently filed motions for summary judgment. Progressive argued that the plaintiffs lacked standing to sue because they failed to provide Progressive with a presuit demand letter in compliance with subsection 627.736(11), Florida Statutes (2001). [1] The trial court denied Progressive's motion and granted the plaintiffs' motion for partial summary judgment, finding that the presuit notice requirement of subsection 627.736(11) did not apply to any part of Menendez's PIP claim, and that even if subsection 627.736(11) did apply, she was not required to serve a presuit written demand because "Progressive effectively denied Menendez's claim." Legal Analysis The presuit notice requirement relied upon by Progressive is contained in subsection *328 627.736(11), Florida Statutes (2001). Subsection 627.736(11) provides that as a condition precedent to filing a claim for overdue PIP benefits, the insured must provide the insurer with written notice of the intent to initiate litigation....

...has been provided documentation or information at the insurer's request pursuant to subsection (6). Such notice may not be sent until the claim is overdue, including any additional time the insurer has to pay the claim pursuant to paragraph (4)(b). § 627.736(11)(a), Fla. Stat. (2001) (emphasis added). The plaintiffs argue that they were not required to provide Progressive with presuit notice pursuant to subsection 627.736(11) because: (1) Progressive denied Menendez's PIP claim; (2) the issuance of the policy and Menendez's accident occurred prior to the effective date of the legislation adding this presuit notice requirement; and (3) the presuit notice requirement does not apply to wage loss benefits....

...s cured by the complying demand letter sent in November 2003. Because we conclude that: whether Progressive denied the plaintiffs' claim is a disputed issue of fact requiring further analysis on remand; the presuit notice requirements detailed in subsection 627.736(11) applied to the plaintiffs' claim; and abatement was not requested by the plaintiffs, we reverse....

...n Progressive denied the plaintiffs' claims and maintained that it owed the plaintiffs nothing because Menendez previously received workers' compensation benefits. While we agree with the plaintiffs that the presuit written demand requirements of subsection 627.736(11), Florida Statutes (2001), do not apply where an insurer denies *329 a PIP claim, see § 627.736(11)(a) (providing that "such notice is not required for an overdue claim that the insurer has denied or reduced"), there is, however, a material disputed issue of fact as to whether Progressive denied the plaintiffs' claim, thereby precluding summary judgment....

...law, and remand for resolution of this critical factual dispute by the appropriate trier of fact. Application of the Presuit Demand Requirements Does Not Violate Florida's Rule Against Retrospective Operation of Statutes The plaintiffs argue that subsection 627.736(11) does not apply to their claim for PIP benefits because Menendez's policy was issued on April 1, 2001, and her accident occurred on June 14, 2001, and that both of these events took place prior to the effective date of subsection 627.736(11). We disagree, as the statute specifies that its application is dependent upon the date of treatment and services and when the lawsuit is filed, not when the policy was issued or when the accident occurred. Subsection 627.736(11), Florida Statutes (2001), was enacted on June 19, 2001, as a part of Florida's No-Fault Act. Although June 19, 2001, was the general effective date of the amendments, selected portions of section 627.736 have a later effective date. See Ch. 2001-271, § 11(3), at 2948, Laws of Fla. (applying a later effective date to specific subsections of section 627.736, Florida Statutes (2001)). Subsection 627.736(11) is one of those portions of the statute with a later effective date....

...or after October 1, 2001. Otherwise, the statute provides that the presuit demand requirements shall apply to actions filed on or after the general effective date of the act, June 19, 2001. (3) Paragraphs (4)(b), (5)(b) and (c) and subsection (6) of section 627.736, Florida Statutes, as amended by this act and subsection (11) of section 627.736, Florida Statutes, shall apply to treatment and services occurring on or after October 1, 2001, except that subsection (11) of section 627.736, Florida Statutes, shall apply to actions filed on or after the effective date of this act with regard to a claim or amended claim or judgment for interest only which was not paid or incorrectly calculated. Ch. 2001-271, § 11(3), at 2948, Laws of Fla. The plaintiffs also argue that to apply the presuit notice requirements in subsection 627.736(11) to their pre-existing policy violates Florida's constitutional prohibition of laws impairing existing contracts....

...bition against retroactive legislation and they may be held immediately applicable to pending cases."). Although the plaintiffs' lawsuit clearly arises out of events (the execution of the policy and Menendez's accident) predating the enactment of subsection 627.736(11), Florida Statutes (2001), applying subsection 627.736(11) to the plaintiffs' action would not violate the general rule against retrospective operation unless new legal consequences attach to these events....

...If application of the statute is merely procedural, retroactive application is not prohibited. On the other hand, retroactive application of a statute that alters the substantive, *331 vested, or contractual rights is prohibited absent clear legislative intent. Because we conclude that the application of subsection 627.736(11) to the plaintiffs' claim for PIP benefits is procedural in nature, and it does not alter any contractual or vested rights of the plaintiffs, we find that to require the plaintiffs to provide presuit notice before filing their laws...

...retrospective operation. The Presuit Demand Requirements Apply to Claims for Wage Loss Benefits The plaintiffs contend that only claims for treatment and services, and claims for "interest only," are subject to the presuit demand requirements in subsection 627.736(11), not wage loss benefits. We disagree. Subsection (11) of section 627.736 is that part of the statute which requires the insured to provide the insurer with presuit notice....

...n; provided, however, that, except with regard to a claim or amended claim or judgment for interest only which was not paid or was incorrectly calculated, such notice is not required for an overdue claim that the insurer has denied or reduced. . . . § 627.736(11)(a), Fla. Stat. (2001) (emphasis added). Paragraph 627.736(4)(b), which sets the time parameters for the payment of PIP benefits, states in relevant part: (b) Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished notice of the fact of a covered loss and the amount of same....

...ded in this act, this act shall take effect upon becoming a law." Ch. 2001-271 § 11(1), at 2948, Laws of Fla. Paragraph 11(3) of the enacting legislation specifically addresses the effective date of the presuit notice requirement provided for in subsection 627.736(11). (3) Paragraphs (4)(b), (5)(b) and (c) and subsection (6) of section 627.736, Florida Statutes, as amended by this act and subsection (11) of section 627.736, Florida Statutes, shall apply to treatment and services occurring on or after October 1, 2001, except that subsection (11) of section 627.736, Florida Statutes shall apply to actions filed on or after the effective date of this act with regard to a claim or amended claim or judgment for interest only which was not paid or incorrectly calculated....

...Thus, the plaintiffs argue that because their PIP benefits claim was based on a claim for lost income and a claim for a lien satisfaction payment, it was not a claim for treatment, services, *332 nor a claim for interest only, and therefore their claim falls outside of the limited applicability of subsection 627.736(11). This reading is contrary to ordinary statutory construction. Paragraph (3) of the enacting legislation provides for separate effective dates to satisfy the presuit notice requirement provided for in subsection 627.736(11)....

...Presuit notice is required for treatment and services occurring on or after October 1, 2001, whereas, presuit notice for any other overdue claim, such as lost wages, is required for any action filed on or after the effective date of the act, which is June 19, 2001. When considering subsection 627.736(11) and its enacting legislation, "[i]t is our duty to give effect to the language the legislature used." D.M....

...Additionally, "[w]hen interpreting a statute, courts must determine legislative intent from the plain meaning of the statute." Id. at 509 (quoting State v. Dugan, 685 So.2d 1210, 1212 (Fla.1996)). Accordingly, we turn first to the language within subsection 627.736(11) itself....

...treatment, services, accommodations, or supplies that form the basis of the claim." (Emphasis added). Specifically, subsection (11) provides in part: (11) DEMAND LETTER.— . . . . (b) The notice required shall state that it is a "demand letter under § 627.736(11)" and shall state with specificity: 1....

...To the extent applicable, the name of any medical provider who rendered to an insured the treatment, services, accommodations, or supplies that form the basis of such claim; and an itemized statement specifying each exact amount, the date of treatment, service, or accommodation, and the type of benefit claimed to be due. § 627.736(11)(b), Fla. Stat. (2001). The addition of the qualifying phrase "to the extent applicable" makes it clear that presuit demand letters under subsection 627.736(11) are required where the information regarding medical care is inapplicable. Subsection 627.736(11) requires a presuit demand letter as a condition precedent to filing a lawsuit for overdue PIP benefit claims for all services received in connection with the claim, not just medical care and medical supplies. Thus, the plain meaning of the legislature's words in the statute itself indicates that claims for lost wages or reimbursements to workers' compensation are subject to the requirements of subsection 627.736(11)....

...act with regard to a claim or amended claim or judgment for interest only which was not paid or incorrectly calculated." Ch. 2001-271, § 11(3), at 2948, Laws of Fla. The plaintiffs interpret this language as a limitation on the applicability of subsection 627.736(11)....

...J.M., 824 So.2d 105, 111 (Fla.2002) (quoting Hayes v. State, 750 So.2d 1, 4 (Fla.1999)). Additionally, the trial court was not free to depart from the ordinary meaning of the words of the statute to establish the applicability and effective date of subsection 627.736(11)....

...ights, money, property, and other remedies. See generally Black's Law Dictionary 264-66 (8th ed. 2004) (detailing multiple ordinary definitions of the word "claim"). The plaintiffs' and the trial court's interpretation of the legislation enacting subsection 627.736(11), impermissibly limits the language of the statute. We, therefore, hold that the presuit written demand requirement of subsection 627.736(11) applies to lawsuits arising out of all types of claims for PIP benefits, including claims for lost supplemental wages. The Plaintiffs Are Not Entitled To Abatement Because They Waived the Right To Seek That Remedy Arguing in the alternative, the plaintiffs contend that if the presuit demand requirements of subsection 627.736(11), Florida Statutes (2001), applied to their claim, their lawsuit was merely premature, and should have been abated until their failure to comply with the statutory condition precedent was cured....

...City of Deerfield Beach, 840 So.2d 389, 393 (Fla. 4th DCA 2003) ("If there remains sufficient time to comply with the statutory precondition, the action should be dismissed with leave to amend.") (emphasis added). The presuit demand letter requirement of subsection 627.736(11) was an unambiguous condition precedent to the filing of the plaintiffs' lawsuit, and as described *334 above, the statute applied to the plaintiffs' claim unless Progressive denied or reduced the claim. See § 627.736(11)(a), Fla....

...ation to do so. See Ingersoll v. Hoffman, 589 So.2d 223, 224 (Fla.1991) ("To suggest that the requirements of the statute may be easily circumvented would be to thwart the legislative will."). Conclusion The presuit written demand requirements of subsection 627.736(11), Florida Statutes (2001), are applicable to the plaintiffs' claim without violating Florida's rule against the retrospective operation of statutes....

...The complying demand letter sent after eleven months of litigation was, therefore, of no legal moment. Accordingly, the plaintiffs were in material breach of the statutory condition precedent unless Progressive denied or reduced the plaintiffs' claim. See § 627.736(11)(a), Fla....

medical services were reasonable. Because section 627.736(4)(b)(6) allows an insurer to dispute the reasonableness

...On December 29, 2003, Humanitary Health filed suit against Southern Group in county court, seeking to collect PIP benefits. Count I was for breach of contract, alleging that Southern Group failed to pay the benefits within thirty days as required by paragraph 627.736(4)(b), Florida Statutes (2003). [1] In Count II, Humanitary Health requested that the circuit court issue a declaratory judgment providing that it was entitled to presuit disclosure of Southern Group's PIP payout logs. Humanitary Health asserted that pursuant to paragraph 627.736(6)(d), as part of its presuit investigation, it requested information *1249 from Southern Group, including a PIP payout log, which would have allowed it to determine whether the medical bills it submitted to Southern Group were properly applied to the deductible, but that Southern Group failed to submit these documents. Humanitary Health asserted that paragraph 627.736(6)(d) requires an insurer, upon a request from the injured person, to furnish the PIP payout logs presuit, and that because Lopez executed an assignment of benefits, it was placed in Lopez's shoes....

...moved for summary judgment. As to the breach of contract count, Southern Group argued that Humanitary Health's bill for medical services was applied to the deductible. As to the declaratory judgment count, Southern Group argued that under paragraph 627.736(6)(d), it did not have a duty to produce the PIP logs presuit because this section does not refer to PIP logs or any other internal documents prepared by the insurance carrier, and that paragraph 627.736(6)(b) only refers to documents from physicians, hospitals, clinics or other medical institutions....

...assignee is forced to file a lawsuit because of an insurance company's pre-litigation refusal to provide the log, a post-litigation production of the document is tantamount to a confession of judgment." [2] The court also concluded that "[w]hile ß 627.736(6)(d) does not specifically identify the PIP log as a document that must be produced by an insurer presuit, ....

...Thereafter, Southern Group filed its petition for writ of certiorari in this Court. The issue presented in this petition is whether the circuit court, acting in its appellate capacity, applied the correct law when it determined that pursuant to paragraph 627.736(6)(d), Florida Statutes (2003), an insurer is required to provide in presuit discovery its payout log to its insured and/or its insured's assignee, which in this case is the insured's medical provider. Section 627.736, Florida Statutes (2003), provides personal injury protection to the various persons identified in subsection (1). Subsection (6) of the statute pertains to the obligation of the various entities to provide discovery to the insurer. Paragraph 627.736(6)(a) pertains to the obligation of the insured's employer to provide information to the insurer. Paragraph 627.736(6)(c) provides a mechanism for the insurer to petition the court to resolve disputes regarding the insurer's right to the requested discovery, and paragraph *1250 627.736(6)(d) allows the insured to obtain a copy of all information obtained by the insurer through this process. Specifically, paragraph 627.736(6)(d), Florida Statutes (2003), provides as follows: (6) DISCOVERY OF FACTS ABOUT AN INJURED PERSON; DISPUTES.— ....

...(d) The injured person shall be furnished, upon request, a copy of all information obtained by the insurer under the provisions of this section, and shall pay a reasonable charge, if required by the insurer. Humanitary Health, standing in the shoes of the insured, argued below that pursuant to paragraph 627.736(6)(d), it was entitled to a copy of Southern Group's payout log presuit. The circuit court agreed that paragraph 627.736(6)(d) was applicable and, while recognizing that the statute did not expressly require the insurer to provide its PIP payout log to the insured, concluded that the statute is broad enough to include it. Humanitary Health's arguments before this Court are that the circuit court correctly interpreted paragraph 627.736(6)(d), and that whether we agree or disagree with the circuit court's interpretation is not dispositive, as mere disagreement with the appellate court's interpretation of an applicable statute is not a sufficient basis for granting second-tier certiorari review. While we completely agree with Humanitary Health's premise, we disagree with its conclusion. We do not merely disagree with the circuit court's interpretation of paragraph 627.736(6)(d), we conclude that the statute is completely inapplicable....

...noted that the district court's decision did not consider why the circuit court's decision constituted an application of the incorrect law. Id. Because the circuit court misapplied the law, we conclude that certiorari is appropriate in this case. Subsection 627.736(6) does not provide for nor address the insured's right to access documents prepared internally by the insurer. As the insurer's PIP payout log is a document generated by the insurer and is not a document the insurer obtained pursuant to subsection 627.736(6), the circuit court, acting in its appellate capacity, applied the incorrect law by finding that: (1) paragraph 627.736(6)(d), Florida Statutes (2003), requires an insurer to provide its PIP payout log to an insured or the insured's assignee, presuit; and (2) that "[i]n the event an assignee is forced to file a lawsuit of an insurance company's pre-litigation...

...RAMIREZ, J. (dissenting). I dissent from our denial of rehearing en banc based on Ivey v. Allstate Insurance Company, 774 So.2d 679 (Fla.2000), which was eerily similar to our current case. Ivey was also a suit seeking payment of PIP benefits under section 627.736, Florida Statutes (1995)....

...When Allstate realized that Ivey had received treatment for two injuries, it finally paid the additional amount to which the doctor was actually entitled and for which Ivey had initially submitted a claim. Both the county and the circuit courts determined that Ivey was entitled to attorney's fees pursuant to sections 627.736(8) and 627.428(1), Florida Statutes (1995), because Allstate had conceded and paid the additional amount actually due and owing....

...to an error in the doctor's bill, its failure to pay said claim did not rise to that level of `wrongful' which would entitle Ms. Ivey to an award of attorney's fees." Allstate Ins. Co. v. Ivey, 728 So.2d 282, 283 (Fla. 3d DCA 1999), (citing sections 627.736(8), 627.428)....

...tion of the applicable law, which was an improper basis for common law certiorari. Id. at 683. Our decision today pays homage to the dictates of Ivey, but then states, "[w]e do not merely disagree with the circuit court's interpretation of paragraph 627.736(6)(d), we conclude that the statute is completely inapplicable....

...How can the panel opinion find the statute inapplicable without interpreting its application? The same could have been said in Ivey, that Ivey should not recover fees, not only because this Court disagreed with the circuit court's interpretation of sections 627.736(8) and 627.428(1), but because those statutes were completely inapplicable....

...774 So.2d at 682. This Court has been tempted successfully "to announce a `miscarriage of justice' simply to provide precedent where precedent is needed." Stilson, 692 So.2d at 982. Until our decision, there was simply no reported case interpreting section 627.736(6)(d) not to apply to PIP payout logs....

...If they can obtain these logs quickly and cheaply, everyone can determine where they stand in relation to the deductible, averting needless litigation with its concomitant fees and costs. The circuit court here concluded on the last page of its opinion as follows: While ß 627.736(6)(d) does not specifically identify the PIP log as a document that must be produced by an insurer pre-suit, it is the opinion of this, and numerous other courts, that the statutory language is broad enough to encompass the PIP log....

...wn claim. Assignees should not be forced to rely on the representations of insurance companies without accompanying documentation. In my view, this is a perfectly reasonable interpretation of the statute. The pertinent language of the statute is: ß 627.736(6) Discovery of facts about an injured person; disputes.‚Äî (d) The injured person shall be furnished, upon request, a copy of all information obtained by the insurer under the provisions of this section, and shall pay a reasonable charge, if required by the insurer. Our opinion takes the view that "the insured's PIP payout log is a document generated by the insurer and is not a document the insurer obtained pursuant to subsection 627.736(6)." But what is the payout log if not "information obtained by the insurer?" It is merely a list of the bills received in chronological order....

...Appellant, United Automobile Insurance Company ("United Auto") appeals an order directing a verdict in favor of appellee, Metelit Viles ("Viles"), in a breach of contract claim for Personal Injury Protection ("PIP") benefits. We affirm based upon our conclusion that Section 627.736(7)(a), Florida Statutes (1997), requires an insurer to obtain a physician's report as a condition precedent to withdrawing or denying further medical payments....

...United Auto answered and affirmatively defended that the chiropractic bills were fraudulent and not reasonably related to the accident in question. United Auto paid $1,100 to Viles before denying payment on the outstanding bills. At the end of the trial, Viles moved for directed verdict arguing that Section 627.736(7)(a) required United Auto to first obtain a report from a similarly licensed physician before it could withdraw payment. Section 627.736(7)(a) provides in pertinent part: Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury protection...

...Since Viles had a $2,000 deductible and the verdict did not exceed that amount, United Auto argued that final judgment should be entered in its favor. However, despite these factual findings, the trial court granted Viles' renewed motion for directed verdict based upon Section 627.736(7)(a), finding that United Auto was barred from raising the defense that the bills were not reasonable or necessary, because it failed to obtain a physicians report prior to denying payment....

...the following question of great public importance to this Court: In any claim for personal injury protection benefits in which the insurance carrier has withdrawn, reduced benefits or denied further benefits, is it a condition precedent pursuant to Section 627.736(7)(a), Florida Statutes, that an insurer obtain a report by a physician licensed under the same chapter as the treating physician stating that the treatment was not reasonable, related or necessary in order for the insurance carrier t...

...1970). Moreover, statutory provisions under Florida's no fault laws will be construed liberally in favor of the insured. See Farmer v. Protective Cas. Ins. Co., 530 So.2d 356 (Fla. 2d DCA 1988). Applying these principles to the language at issue in Section 627.736(7)(a), we agree with the trial court's well reasoned analysis concluding that United Auto was required to first obtain a physician's report before refusing to pay further medical bills....

...The statute plainly provides that an insurer must first obtain the referenced report before electing to withdraw payment. As accurately stated in Derius v. Allstate Indemnity Co., 23 Fla. L. Weekly D1383 (Fla. 4th DCA 1998): This language is part of the independent medical examination requirement of section 627.736(7) which is "intended to give insurers an opportunity to determine the legitimacy of a claim so that an appropriate decision can be made as to whether benefits should be paid." U.S. Security Ins. Co. v. Silva, 693 So.2d 593, 596 (Fla. 3d DCA 1997). The quoted language from section 627.736(7)(a) sets up a procedural requirement that an insurer cannot withdraw payment of a treating physician unless the decision is supported by an expert that the treatment does not comply with the statutory criteria....

..., and breach of contract. (ECF No. 16.) The Plaintiff's allegations center around the Defendant's improper application of the Plaintiff's deductible to its medical bills under Florida's no-fault personal injury protection ("PIP") statute, Fla. Stat. § 627.736 ....

...le in the circuit court trial de novo”). Compare Chrysler Corp. 721 So.2d at 714 , and Kahn, 693 So.2d at 1030 , with Nationwide Mut. Fire Ins. Co. v. Pinnacle Med., Inc., 753 So.2d 55, 57 (Fla.2000) (holding the mandatory arbitration provision of section 627.736(5), Florida Statutes (1995), for PIP claims was unconstitutional because it violated the medical providers’ right of access to the courts to pursue breach of contract claims)....

...'s insurance policy with Cavalier. Cavalier contends that since the Bronco was registered in Alabama and not in Florida the plaintiff's injury was not caused by physical contact with a "motor vehicle" and that therefore PIP benefits are not payable. Section 627.736(4)(d)(1), Florida Statutes (1975), provides that the insurer of the owner of a motor vehicle shall pay personal injury protection benefits for accidental bodily injury sustained in this state by the owner while occupying a motor vehicle or, while not an occupant of a motor vehicle or motorcycle, if the injury is caused by physical contact with a motor vehicle. Subsection 3 of § 627.736(4)(d) gives to a relative of the owner residing in the same household the same benefits as the owner, *1062 provided the relative at the time of the accident is not himself the owner of a motor vehicle with respect to which security is required....

...uninsured motorist, not PIP benefits, and was analyzed under a coverage defense which *270 alleged breach of a cooperation clause. Id. at 102. Unlike the situation in De Ferrari, an insurer under PIP has the right to have the insured examined under section 627.736(7), Florida Statutes (2009)....

...work and the right to recover for loss of income from that day forward. It is necessary that we consider the statutory provisions pursuant to the mandate of which the policy was issued as well as the provisions of the policy itself. Florida Statute § 627.736, F.S.A, provides as follows: “627.736....

...endant motor vehicle operator because a motorcycle is not a "motor vehicle" under the no-fault law. [2] The threshold requirement of Section 627.737(2), Florida Statutes (1981), applies only in a tort action where security has been provided. Reading section 627.736(1), Florida Statutes (1981), one discovers that security is not provided to a motorcyclist who is "an occupant of a self-propelled vehicle." Thus, a motorcyclist need not satisfy the threshold to maintain a suit for the damages enumerated in subsection (2) of section 627.737....

...hiropractic treatment of Garrett was required, Allstate advised Garrett that the payment of the PIP benefits was being discontinued. Garrett thereupon filed her action below alleging that Allstate's withdrawal of the payment of PIP benefits violated section 627.736(7)(a), Florida Statutes (1987). Section 627.736(7)(a) provides that an insurer may not withdraw payment to a treating physician [1] (in this case a chiropractor) without the consent of the injured person for whom the benefits are paid unless the insurer first obtains a report by a...

...Allstate presents three issues to us in support of its argument that the summary judgment for Garrett should be reversed and that on remand we should direct the entry of summary judgment for Allstate pursuant to its motion for summary judgment on the constitutionality of the 1987 amendment to section 627.736(7)(a), as it applies to Allstate's contract. Allstate first argues that section I of chapter 87-282, Laws of Florida, which amended section 627.736(7)(a), is unconstitutional as violative of article III, section 6 of the Florida Constitution because it embraces more than one subject or matter properly connected with that one subject. Section I of chapter 87-282 amends section 627.736(7)(a) *24 by adding only a final sentence thereto which contains the prohibition against an insurer withdrawing PIP payments to a physician absent a report from a similarly licensed physician. The title of chapter 87-282 begins with: "An act relating to insurance; amending s. 627.736, F.S., providing conditions under which a personal injury insurer may withdraw payment of a treating physician without consent of the injured person covered by insurance; ......

...We conclude that the subjects which were the object of chapter 87-282 are reasonably related and not violative of article III, section 6. Fine v. Firestone, 448 So.2d 984 (Fla. 1984); Chenoweth v. Kemp, 396 So.2d 1122 (Fla. 1981); State v. Lee, 356 So.2d 276 (Fla. 1978). Allstate next argues that the amendment to section 627.736(7)(a), enacted by chapter 87-282, violates article I, section 10 of the Florida Constitution in that it impairs the obligation of Allstate's contract of insurance issued to Garrett's mother prior to the effective date of chapter 87-282....

...Subsequently, chapter 87-282 was enacted and became effective on July 4, 1987. Allstate attempted to terminate payments to Garrett's chiropractor on the basis of the report of the orthopedic surgeon on August 7, 1987. Prior to July 4, 1987, the effective date of the amendment to section 627.736(7)(a), there was neither a statutory nor a contractual limitation regarding the termination of PIP payments under a contract of insurance....

...e time Allstate commenced the PIP payments for the benefit of Garrett, there was no limitation upon the type or specialty of qualified physicians upon whom Allstate could choose to rely in terminating PIP payments. After the date of the amendment to section 627.736(7)(a), Allstate was limited in basing its right to termination of benefit payments to a report from a physician "licensed" similarly to the "physician" whose treatment was sought to be terminated....

...Chiropractors who are sometimes referred to in the other parts of the Florida Statutes as "physicians" are licensed under a separate chapter, chapter 460, Florida Statutes, and osteopathic physicians under chapter 459, Florida Statutes. [2] The apparent intent of the amendment to section 627.736(7)(a) is to prevent an insurer from using reports of a medical doctor as a basis for termination of payments to a chiropractor or osteopath and vice-versa....

...State Farm Mutual Automobile Insurance Co. v. Gant, 478 So.2d 25 (Fla. 1985); Poole v. Travelers Insurance Co., 130 Fla. 806, 179 So. 138 (Fla. 1937); Allison v. Imperial Casualty and Indemnity Co., 222 So.2d 254 (Fla. 4th DCA 1969). Any application of the amendment to section 627.736(7)(a) to Allstate's contract of insurance entered into before the amendment became effective constitutes *25 a violation of article I, section 10 of the Florida Constitution....

...Ceballos, 440 So.2d 612 (Fla. 3d DCA 1983); Keith v. Culp, 111 So.2d 278 (Fla. 1st DCA), cert. denied, 114 So.2d 5 (Fla. 1959). Finally, Allstate argues a third issue which it stated, as follows, whether: CHAPTER 87-282, LAWS OF FLORIDA, AND THE 1987 AMENDMENT TO SECTION 627.736(7), FLORIDA STATUTES, DO NOT PRECLUDE AN INSURER FROM SEEKING AN INDEPENDENT MEDICAL EXAMINATION WITH A BOARD CERTIFIED MEDICAL DOCTOR PHYSICIAN TO DETERMINE THE REASONABLENESS OR NECESSITY OF CHIROPRACTIC TREATMENT PROVIDED BY A CHIROPRACTOR WHO IS NOT DEFINED AS A PHYSICIAN PURSUANT TO CHAPTER 458, FLORIDA STATUTES. As framed, we answer the issue as posed by Allstate in the affirmative. Section 627.736(7)(a) places no limitation upon the type of physician or physicians an insurer may choose to perform an independent mental or physical examination of an injured person covered by PIP insurance. The limitation imposed by the amendment to section 627.736(7)(a) relates only to the type of physician whose report may be used to terminate benefits....

...The search indicated that Palmer's husband, William Palmer, who also resided at 465 King Charles Circle, owned a vehicle that was insured by State Farm. Fortune then contacted Palmer's attorney and stated that William Palmer's policy would provide PIP coverage to Henne. See generally § 627.736(4)(d)3., Fla.Stat....

...her address at the time of the accident. Fortune sent the affidavit, with a letter to Palmer's counsel *1021 on December 3, 1997. On December 29, 1997 Fortune received the executed affidavit from Palmer, and immediately paid her claim. See generally § 627.736(4)(d)4., Fla.Stat....

...The county court entered an order denying the motion for summary judgment, and on May 27, 1999, entered final judgment against Palmer. Palmer then appealed the final judgment, and the circuit court in a 2-1 decision affirmed the judgment by opinion which issued February 10, 2000. Pursuant to section 627.736(4)(b), Florida Statutes (1999): Personal injury protection benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same. See also § 627.736(4)(c), Fla.Stat....

...(1999) (overdue payments shall bear interest at rate of 10% per year). Under section 627.428(1), Florida Statutes (1999), upon rendition of a judgment against an insurer and in favor of an insured or beneficiary under a policy, the court shall determine a reasonable sum as attorney fees. See also § 627.736(8), Fla.Stat....

...NOTES [1] Fortune argues that it paid Palmer's PIP claim within a reasonable time, and any delay was caused by the opposing party. Fortune states that the erroneous and incomplete information in the PIP application did not give it "written notice of the fact of a covered loss." See § 627.736(4), Fla.Stat....

...milliliters of blood. See § 316.193, Fla. Stat. (2000). Even though driving under the influence is a crime in Florida, there currently is no statutory authorization for an alcohol exclusion in a Florida No-fault Automobile Insurance PIP policy. See § 627.736(2), Fla....

...by section 817.505, Florida Statutes. We also agree with the court in Federated National Insurance Co. v. Physicians Charter Services, 788 So.2d 403 (Fla. 3d DCA 2001), that a company such as MMGO is not entitled to be compensated for PIP benefits. Section 627.736(1)(a) provides that the insurer must pay 80% of the "medically necessary medical ......

...Essentially, we agree with the holding in Reliance Ins. Co. v. Kilby, 336 So.2d 629 (Fla. 4th DCA 1976) that fees should be awarded when the insured is successful in a judicial battle with his own p.i.p. carrier over the amount of equitable distribution to which the company is entitled under § 627.736(8), Fla....

...Mackinnon of Fisher, Rushmer, Werrenrath, Keiner Wack & Dickson, P.A., Orlando, for appellee. COWART, Judge. This case involves a question of whether a person injured while occupying a motor vehicle covered by personal injury protection (PIP) insurance is barred by section 627.736(4)(a), Florida Statutes (1985), from recovering PIP benefits from the insurer of the owner of that vehicle because the injured person is the owner of an uninsured motor vehicle which is not in fact being driven or operated on the roads of this state because of needed repairs....

...sured it on April 25, 1985. However, on March 9, 1985, appellant sustained bodily injuries while riding as a passenger in a vehicle owned by another person and insured by appellee insurance company for personal injury protection (PIP) benefits under section 627.736(4)(d)4., Florida Statutes. Appellee insurer denied appellant's claim for PIP benefits on the basis that she was the owner of a motor vehicle for which she was required to carry PIP coverage and section 627.736(4)(d)4., Florida Statutes (1985), provides that a PIP insurer of the owner of a motor vehicle, such as appellee, shall pay PIP benefits to a person injured while occupying the insured vehicle, such as appellant, but only if the injure...

...The material facts being uncontested, both parties moved for summary judgment. The trial court granted summary judgment for the insurer. Appellant appeals relying on Fortune Insurance Co. v. Oehme, 453 So.2d 920 (Fla. 5th DCA 1984). Appellant is not barred by section 627.736(4)(d)4., Florida Statutes (1985) from recovering PIP benefits from the insurer of the vehicle she was occupying on March 9, 1985, when injured unless on that date she was the owner of a motor vehicle with respect to which security was required under sections 627.730 through 637.7405, Florida Statutes....

...The medical payments provision provided for coverage of medical bills incurred within one year of the accident involved. However, the insured also had personal injury protection benefits (hereafter referred to as PIP) under the same policy with limits of $5,000.00 and under Section 627.736(4), Florida Statutes (1975) these PIP benefits are primary....

...). This particular area of the insurance code is commonly referred to as no-fault insurance and inter alia provides that these statutorily mandated benefits are primary and must be exhausted prior to any other insurance benefits becoming applicable. Section 627.736(4), Florida Statutes (1975)....

...We were faced with an identical contention in the recent case of Charter Oak Fire Insurance Company v. Regalado, 339 So.2d 277 (Fla. 3d DCA 1976). We stated there *849 that the purpose of the Automobile Reparations Reform Act was to broaden insurance coverage and that pursuant to Section 627.736(4), Florida Statutes (1975), workmen's compensation benefits received by a claimant were therefore to be credited against p.i.p....

...THE COURT has considered the Motions and the pertinent portions of the record and is otherwise fully advised in the premises. Background At issue in this case is the proper reimbursement for magnetic resonance imaging ("MRI") services under the 2008 amendment to Florida Statute § 627.736....

...¶ 2.) Plaintiff All Family Clinic of Daytona Beach, Inc. (the "Clinic") is a MRI service provider who provides MRIs to State Farm's insureds pursuant to assignments of benefits. ( Id. ¶¶ 1, 3.) II. Statutory Framework A. Florida's No-Fault Statute Florida's No-Fault Law, Fla. Stat. § 627.736 (the "No-Fault Statute"), requires motor vehicle owners to purchase PIP coverage and is designed to provide various insurance benefits without regard to fault....

...¶ 7.) Accordingly, with respect to MRI services, Florida's No-Fault Statute now provides that an insurer may limit reimbursement to 80% of "200 percent of the allowable amount under the participating physicians schedule of Medicare Part B." Fla. Stat. § 627.736(5)(a)(2)(f)....

...which such services were rendered, except that it may not be less than the allowable amount under the participating physicians schedule of Medicare Part B for 2007 for medical services, supplies, and care subject to Medicare Part B. *1299 Fla. Stat. § 627.736(5)(a)(3) (emphasis added)....

...gardless of whether such provider would be entitled to reimbursement under Medicare due to restrictions or limitations on the types or discipline of health care providers who may be reimbursed for particular procedures or procedure codes. Fla. Stat. § 627.736(5)(a)(4). B. Federal Law It is undisputed that the participating physicians schedule for Medicare Part B is the proper schedule to use when calculating reimbursement payments for MRI services under Florida's No-Fault Statute. (Facts ¶ 10; Fla. Stat. § 627.736(5)(a)(2)(f).) The federal statute establishing the participating physicians schedule is 42 U.S.C....

...*1301 ANALYSIS This case raises an issue of statutory construction that can be decided as a matter of law. The sole issue for determination is whether State Farm's decision to reimburse the Clinic in the amount of the OPPS cap was proper under Florida's No-Fault Statute, § 627.736....

...le" under the Medicare statute generally. Instead, the Florida statute refers only to the participating physicians schedule and limits reimbursement to "the allowable amount under the participating physicians schedule of Medicare Part B." Fla. Stat. § 627.736(5)(a)(2)(f) (emphasis added)....

...The most sensible reading of the phrase `the allowable amount' suggests that the [L]egislature intended for a specific Medicare schedule to be incorporated into the PIP statute, rather than either, any, or all of the schedules." Advanced Diagnostic, 2003 WL 23868672 at *9 (interpreting the 2001 version of the Fla. Stat § 627.736(5)(b))....

...icians schedule" from subsection (5)(a)(2)(f) of the No-Fault Statute. [9] Indeed, the Florida Legislature chose to include prospective payment systems, like OPPS, as the schedule for maximum charges elsewhere in subsection (5)(a)(2). See Fla. Stat. § 627.736(5)(a)(2)(d) (providing that the schedule for maximum charges for certain inpatient services is "200 percent of the Medicare Part A prospective payment applicable to the specific hospital providing outpatient services." (emphasis added))....

...[10] The "limiting charge" is a surcharge borne by a Medicare patient who opts to use the services of a non-participating providers who then submits the claim on an unassigned basis. Advanced Diagnostic, 2003 WL 23868672 at *5-6. [11] The 2001 version of Fla. Stat. § 627.736(5)(b) provided in pertinent part that "[i]maging services shall not exceed 200% of the allowable amount under Medicare Part B for the year 2001, for the area in which treatment was rendered." [12] The Court has considered but is unpersuaded by State Farm's supplemental authority, Bravo v....

...Plaintiff sues for the following relief: Count I: a class action for declaratory relief asking this Court to declare the Defendants are not lawfully authorized to pay their insureds' medical benefit claims pursuant to the statutory PIP fee schedule described in Florida Statute 627.736(5)(a)(2)a-f (2007-2008); Count II: a class action seeking injunctive relief against the Defendants, ordering the Defendants to cease and desist from using the statutory fee schedule; and Count III: an individual (non-class action) breach of c...

...by Defendants' policy. Plaintiffs claims stem from Florida's 2007 enactment of a new PIP statute which included a new fee schedule which insurers were allowed to use to calculate payments to medical providers (the PIP fee schedule). Florida Statute § 627.736(5)(a)2 (2007-2008)....

...Florida's statutory PIP benefit scheme requires, before filing suit, that a claimant send a pre-suit notice of intent to initiate litigation specifying the date of treatment, service provided, type of benefit, and exact amount claimed to be due. Fla. Stat. § 627.736(10) (2007-2008)....

...of the PIP statutes. The class is defined to include a "pre-suit notice sub-class" which is defined as "all persons and/or entities who: (a) are a member of the class, and (b) submitted a pre-suit notice to one or more of the Defendants pursuant to § 627.736(10), Florida Statutes (2007-2008)." Plaintiff states that this pre-suit notice class would only include those persons who had previously submitted a pre-suit notice....

...not predicated on an independent medical examination conducted by the insurance company. We grant the writ and quash the decision on the authority of this court's most recent decisions confirming that a physician's report, whether used to support a section 627.736(4)(b) denial of a claim that a bill or claim is not reasonable, related or necessary or whether used to support withdrawal or termination of payments being made to a treating physician under section 627.736(7)(a), need not be based on a physical examination conducted by either the reporting physician or by another physician on the insurance company's behalf....

...ger the owner of the truck. Nor was Hartzog covered as the owner, because under both Florida law and Welch's policy, no-fault benefits are not available to a person who owns a vehicle but chooses not to obtain no-fault benefits for that vehicle. See § 627.736(4)(d)(4)(a), Fla....

...1975, to be so insured. Appellee Butler was not herself the owner of a motor vehicle for which security was required by the no-fault law, nor was she entitled to personal injury benefits from the insurer of the owner of some other motor vehicle. Sec. 627.736(4)(d) 1, 3, 4 a, b, F.S....

...rm under its policy insuring the owner of the rear-ended motor vehicle. The issue is whether appellee Butler, passenger in a motor vehicle in the generic sense of that term, was nevertheless "not an occupant of a motor vehicle" within the meaning of § 627.736(4)(d), which provides in relevant part: "(d) The insurer of the owner of a motor vehicle shall pay personal injury protection benefits for: * * * * * * "4....

...person *1186 [other than those to whom personal injury protection benefits are payable under subparagraphs 1, 2 and 3]... while not an occupant of a motor vehicle or motorcycle, if the injury is caused by physical contact with such motor vehicle... ." It has been held that § 627.736(4)(d) 1 [1] permits a passenger in a bus or other exempted motor vehicle who owns an insured motor vehicle to recover from his own insurer if injured by physical contact of the exempted vehicle with an automobile for which insurance is required, Negron v....

...rson and why the items identified by the insurer were reasonable in amount and medically necessary, together with a sworn statement that the treatment or services rendered were reasonable and necessary with respect to the bodily injury sustained.... Section 627.736(6)(b), Florida Statutes (2001)....

...Additionally, subsection (c) of the same statute gives the insurer the right to petition the court for permission to engage in discovery. It appears that the legislature has covered all bases. State Farm also claims that the order of dismissal can be affirmed because Marlin failed to submit a demand letter. Section 627.736(11)(a), Florida Statutes (2001), [1] provides: As a condition precedent to filing any action for an overdue claim for benefits under paragraph (4)(b), the insurer must be provided with written notice of an intent to initiate litigatio...

...After obtaining medical treatment, Lauzan assigned the GEICO policy benefits to All X-Ray Diagnostic Services, Corporation (“All X-Ray”). All X-Ray subsequently assigned the benefits to Gables Insurance and submitted Lau-zan’s medical bills to GEICO. Relying on the fee payment structure set forth in section 627.736(5)(a)2.f., Florida Statutes (2008), 1 GEICO paid less than the total amount billed....

...Gables Insurance moved for summary disposition and claimed that GEICO was obligated under the policy to pay 80% of all reasonable medical expenses. GEICO filed a cross motion for summary disposition, arguing that its liability was capped pursuant to section 627.736(5)(a)2.f., and that regardless of the statutory fee schedule, all available PIP benefits had been exhausted....

...Every insurance policy issued in compliance with section 627.733, Florida Statutes (2008), “shall provide personal injury protection to the named insured ... to a limit of $10,000 for loss sustained ... as a result of bodily injury ... arising out of the ... use of a motor vehicle.” § 627.736(1), Fla....

...there has been a violation of a clearly established principle of law resulting in the miscarriage of justice with the potential to impact a significant number of other cases. We grant the petition and quash the order below. PETITION GRANTED. . Under section 627.736(5)(a)2.f., an insurer is permitted to pay an amount equal to 80% of 200% of the maximum allowable amount under the physician fee schedule of Medicare PartB....

...not need to address that issue in order to resolve the exhaustion issue. GEICO concedes that subsequent case law resolved the issue of whether the policy at issue authorized the payment of benefits pursuant to the fee payment structure set forth in section 627.736(5)(a)2.f„ Florida Statutes (2008)....

...This evidence supports the trial judge's conclusion that, at the time of the accident, Oehme had abandoned the use of the truck as a motor vehicle within the meaning of Chapter 320, and accordingly, the judgment appealed is AFFIRMED. COBB, C.J., and COWART, J., concur. NOTES [1] § 627.730-627.741, Fla. Stat. (1981). [2] § 627.736(4)(d)4.a., Fla....

...nefits. She obtained a jury award of $15,214.88 in damages, of which $8,255.00 was for future medical expenses. State Farm moved to determine setoffs, and the trial court set off $10,000.00 for personal injury protection ("PIP") benefits pursuant to section 627.736(3), Florida Statutes, and $1,331.04 for medpay benefits paid pursuant to section 627.7372(2)(b), Florida Statutes....

...The court ruled that this amount could not be setoff pursuant to section 627.7372(2)(b). State Farm argues that the trial court incorrectly relied on section 627.7372, the collateral source statute, to deny the setoff for unpaid medpay benefits. State Farm contends that because medpay benefits must be paid pursuant to section 627.736(4)(f) in a PIP claim, section 627.736(3) permits a setoff of medpay benefits paid and payable in the future. Section 627.736(3), Florida Statutes (1991), reads in part: An injured party who is entitled to bring suit ......

...Thus, argues State Farm, the medical payment benefits should be used as a setoff against Klinglesmith's award for future medical expenses. The issue, then, is whether medpay benefits are a collateral source or the equivalent of PIP benefits. The basis for State Farm's equating medpay benefits with PIP benefits, section 627.736(4)(f), actually demonstrates that medpay benefits are a collateral source. That statute provides that if PIP medical benefits have paid 80 percent of an insured's medical expenses, see section 627.736(1)(a), medpay benefits, "if available in a policy of motor vehicle insurance," must be applied to the remaining 20 percent even if PIP benefits have not been exhausted....

...We held in Kokotis that the setoff provision contained in section 627.737 (the tort exemption statute) rather than setoff provision contained in section 627.7372 (the collateral source statute) should control in this type of litigation. We then considered section 627.736(3), which provides that a setoff will be applied against a judgment containing an award for special damages (past and future medical expenses) in the amount of "personal injury protection benefits paid or payable" and then construed t...

...t support the notion that the legislature intended that the term "payable" as used in the statute included the obligation to pay future medical expenses as incurred? I think so. In the same provision in which the "paid or payable" provision appears [section 627.736(3)], the legislature took away from the insurers their subrogation rights for personal injury protection benefits which they are required to pay "whether suit has been filed or settlement has been reached without suit." In other words...

...This provision also involves "personal injury protection benefits" for which the insurer is denied subrogation rights and represents a double payment for damages already compensated for in the judgment. The majority's holding that med-pay benefits are not covered by section 627.736 by implication holds that the insurers retain their common law right of subrogation as to med-pay benefits....

...Because the trial court improperly relied upon Klipper v. Government Employees Insurance Co., 571 So.2d 26 (Fla. 2d DCA 1990), rev. denied, 576 So.2d 288 (Fla.1991), in concluding that the appellant was unlikely to prevail in her claimed right to have her attorney present with a video camera during a section 627.736(7), Florida Statutes, physical examination by a physician, we reverse the order....

...The appellant was injured in an automobile accident and sought benefits pursuant to her personal injury protection automobile insurance policy with the appellee. When the appellee scheduled a physical examination of the appellant with a physician of its choice pursuant to section 627.736(7) and a provision in the policy, the appellant requested that her attorney be present to videotape the examination with a small, hand-held video camera....

...ion and comply with the conditions *1093 stated by the appellee would cause termination of her benefits. The appellant then filed an action for declaratory judgment, seeking to have the court determine her rights under the insurance policy and under section 627.736....

...s required by decisions such as City of Jacksonville v. Naegele Outdoor Advertising Co., 634 So.2d 750 (Fla. 1st DCA 1994), that she would likely prevail on the merits. Relying upon Klipper, the court ordered the temporary injunction dissolved. Both section 627.736(7), which authorizes physical examinations in the context of personal injury protection claims, and the policy are silent as to who may attend the examination....

...amination. See McClennan v. American Building Maintenance, 648 So.2d 1214 (Fla. 1st DCA 1995). *1094 In Klipper, the court held that the insured seeking personal injury protection benefits was not entitled to have a court reporter present during the section 627.736(7) examination....

...While acknowledging the caselaw interpreting rule 1.360, the court distinguished those cases upon the following basis: [A]n examination conducted pursuant to the rules of civil procedure presupposes that litigation has been initiated and that the parties are in an adversarial posture. The medical examination provided for by section 627.736(7), which arises from the contractual relationship between a consumer and the insurer of his choice, is designed to assist the insurer in evaluating whether it is obligated to pay benefits under its policy....

...We held that the claimant was entitled to have his attorney present, reasoning, "[N]othing in Section 440.13(2)(c) requires such discussion be had in the absence of Perez's counsel." 569 So.2d at 1291. Similarly in the present case, nothing in the language of either the insurance policy or section 627.736(7) precludes the appellant's attorney from attending the examination....

...stribution pro-rating the amount of medical payments, lost earnings, court costs and reasonable attorneys fees. Liberty Mutual filed a memorandum of law in opposition thereto, and seeking full reimbursement of its prior PIP payments under Fla. Stat. § 627.736(3)(a), F.S.A....

at the end of appellant’s case stating that section 627.-736(l)(a), Florida Statutes (Supp.1984), requires

...ion. Bosem further seeks reversal on the notion his insurance claim amounts to two separate and distinct claims—one for medical expenses and one for lost wages—and fraudulent misrepresentations as to one claim do not vitiate coverage on the other. Section 627.736(4)(g), Florida Statutes (2006), states in pertinent part: "any insurance fraud shall void all coverage arising from the claim related to such fraud under the personal injury protection coverage of the insured person who committed the fraud." (Emphasis added)....

...r rent or lease shall be primary unless otherwise stated in bold type on the face of the rental or lease agreement. Such insurance shall be primary for the limits of liability, and personal injury protection coverage as required by § 324.029(7) and § 627.736....

...AGREE THAT THE LIABILITY INSURANCE OR PERSONAL INJURY PROTECTION INSURANCE OF LESSEE OR OTHER PERMITTED OPERATOR OF THE PROPERTY SHALL BE PRIMARY FOR THE LIMITS OF LIABILITY AND PERSONAL INJURY PROTECTION COVERAGE REQUIRED BY SECTIONS 324.021(7) AND 627.736, FLORIDA STATUTES....

...Viewing the facts in the light most favorable to Trott, Finlayson arguably fired at Hurst's vehicle to stop the vehicle and retrieve his son. Even under this most favorable scenario, no PIP coverage exists because Trott's injuries did not "[arise] out of the ownership, maintenance, or use of a motor vehicle." § 627.736(1), Fla.Stat....

...sonance imaging *12 (MRI) reimbursements in personal injury protection (PIP) claims. We review the decisions of the county courts on questions they certified as matters of great public importance. These certified questions involve the application of section 627.736(5)(b)5, Florida Statutes (2003), which provides for an adjustment of the allowable amount for MRI fees by an additional amount equal to the Consumer Price Index (CPI)....

...State Farm paid pursuant to the Medicare Part B fee schedule, but failed to include any Consumer Price Index (CPI) increase. Florida MRI maintained that it was entitled to a 4.1% CPI adjustment to the Medicare Part B fee schedule, in accordance with Florida Statute § 627.736(5)(b)5....

...State Farm appealed and moved to consolidate this case with eleven other appeals it filed with our court, which are factually indistinguishable and involve the same issue. The trial court certified the following question as a matter of great public importance: WHEN DOES THE CONSUMER PRICE INDEX ADJUSTMENT AS REFERENCED IN § 627.736(5)(B)(5), FLA. STAT. (2001) TAKE EFFECT, AND HOW IS THE CONSUMER PRICE INDEX ADJUSTMENT TO BE CALCULATED? Based on the applicable facts and issues determined below, we rephrase the certified question as follows: IS THE MRI INFLATION ADJUSTMENT CALLED FOR BY § 627.736(5)(B)(5) TO BE MADE FOR THE YEAR 2001?" We answer that question in the affirmative....

...New Sea Escape Cruises, Ltd., 894 So.2d 954, 957 (Fla.2005); Volusia County v. Aberdeen at Ormond Beach, L.P., 760 So.2d 126, 130 (Fla.2000). In 2001, the Florida Legislature enacted a fee schedule to regulate the amount that MRI healthcare providers could charge PIP insurers and their insureds. See § 627.736(5)(b)5, Fla....

...01, for the area in which the treatment was rendered, adjusted annually by an additional amount equal to the medical Consumer Price Index for Florida. (emphasis supplied). After considerable litigation arose concerning the meaning and application of section 627.736(5)(b)5, in 2003 the Legislature amended section 627.736(5)(b)5 to establish the date for the annual CPI adjustment and methodology for its calculation....

...ges in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor for the 12-month period ending June 30 of that year. § 627.736(5)(b)5, Fla....

...was published by the Bureau of Labor Statistics (BLS) of the Department of Labor. According to State Farm, the CPI for the calendar year 2002 did not exist at the time Florida MRI's bill was due and owing. Relying, however, on the 2003 amendment to section 627.736(5)(b)5, the county court ruled that Florida MRI was entitled to a CPI adjustment to the Medicare Part B fee schedule for 2001 (base price) for MRI services rendered on August 5, 2002....

...One Stop Medical, Inc. claimed that it was owed an additional $288.72 based on the 2003 formula for calculating CPI adjustments. It sought a declaratory judgment determining whether the CPI adjustments are annual and cumulative under Florida Statute section 627.736(5)(b)5 and when they commenced....

...ill for the amount of $1,850.00. On July 14, 2005, Plaintiff demanded payment. Defendant denied any further obligation and instead, asserted that it *15 had already reimbursed the Plaintiff at the maximum allowable amount pursuant to Florida Statute § 627.736(5) in the amount of $827.44 (80% of $1,030.96) plus $9.02 in interest....

...� the year in which the statute was amended to rely on the Consumer Price Index for All Urban Consumers in the South Region. Plaintiff contends that Defendant's calculations incorrectly apply the Consumer Price Index as instructed by Florida Statute § 627.736(5)(b)(5) and incorrectly computes $1,030.95 as the allowable amount a medical provider may collect for an MRI CPT Code 72141 performed on May 4, 2005....

...This realizes $1,115.16 as the allowable amount that a medical provider may charge for the subject MRI performed between August 1st 2004 and July 31st 2005. This Court agrees. In an amended order, the county court certified the following question of great public importance: Under Fla. Stat. § 627.736(5)(b)(5)(2004), is the statutory adjustment applicable to the MRI fee schedule annual and cumulative commencing August 1st, 2002 to the date of the subject scan? We answer the certified question in the affirmative. The trial court correctly concluded that the 2003 amendment to Florida Statute section 627.736(5)(b)5 required applying cumulative and compounding inflation adjustments for 2001, 2002, and succeeding years, so that "the fee schedule amount for the year in question will reflect the combined prior year's increases from 2001 throu...

...For example, if 2001 had a 5% inflation rate and 2002 a 6% rate, the correct formula for a 2003 MRI would be the base charge x 1.05 x 1.06, and so on, unless or until the legislature resets the base year. [2] Chapter 2003-411, Laws 2003 § 16(4) provides: "Subsection (5) of section 627.736, Florida Statutes, as amended by this act, shall apply to treatment and services occurring on or after October 1, 2003."

...ts by Ocean Harbor as was done in earlier cases, but by insurance contracts entered into under Florida no-fault statutes. MSPA's proof to establish liability therefore will necessarily devolve into a series of mini-trials under Florida no-fault law. § 627.736, etseq....

...s the direct or indirect right and responsibility to obtain reimbursement for covered Medicare services, for which the Defendant, as the primary payer pursuant to Defendant's contract covering the Medicare enrollee pursuant to Florida No-Fault law ( section 627.736(4), Florida Statutes ), was/is financially responsible to a Medicare beneficiary for medical bills incurred as a result of the use, maintenance or operation of a motor vehicle; and where the Defendant failed to properly pay for medica...

...s insureds and has otherwise failed to reimburse the MAO's or its assignees for their payment(s) as calculated pursuant to the recognized Current Procedure Terminology ("CPT") codes based on the fee-for-service by the primary payer, as delineated by section 627.736, Florida Statutes, for medical services and/or supplies for their damages....

...dited payments of medical bills and lost income up to a statutory amount to covered persons. Substantively, Florida law provides that claims under No-Fault policies "are due and payable as loss accrues upon receipt of reasonable proof of such loss." § 627.736(4), Fla....

...chedules]." Id. It allows exclusions from coverage for certain injuries, including injuries that were intentionally self-inflicted, incurred during the commission of a felony, or incurred while operating a vehicle without the owner's permission. Id. § 627.736(4), Fla. Stat. Procedurally, Florida law mandates that a demand letter to be sent to the insurer as a condition precedent to litigation. § 627.736(6) & (7), Fla....

...It provides that payments are overdue if not paid within 30 days of written notice of the circumstances and amount of a covered loss, but allows an insurer to decline to pay all or part of a claim subject to the insurer specifying in writing what and why it is declining to pay. § 627.736(4), Fla....

...uire a mental or physical examination of an insured by physicians. Id. In terms of remedies, Florida law provides civil actions for penalties against an insurer who fails to timely pay valid claims and against an insured who commits insurance fraud. § 627.736(12), Fla. Stat. It makes its payments primary to Medicare and requires an insurer to repay the full amount to a Medicare program "within 30 days after receiving notice that the Medicare program paid such benefits." § 627.736(4), Fla....

...establish that other medical bills paid by a different MAO should also have been paid by Ocean Harbor as a primary payer. To the contrary, proof to establish liability will necessarily devolve into a series of mini-trials under Florida no-fault law, § 627.736, etseq....

...in conflict with this opinion. The remainder of the order is quashed without prejudice. REVERSED and REMANDED for further proceedings consistent with this opinion. The Florida term for no-fault insurance is "personal injury protection" ("PIP"). See § 627.736, etseq....

...ts by Ocean Harbor as was done in earlier cases, but by insurance contracts entered into under Florida no-fault statutes. MSPA's proof to establish liability therefore will necessarily devolve into a series of mini-trials under Florida no-fault law. § 627.736, etseq....

...s the direct or indirect right and responsibility to obtain reimbursement for covered Medicare services, for which the Defendant, as the primary payer pursuant to Defendant's contract covering the Medicare enrollee pursuant to Florida No-Fault law ( section 627.736(4), Florida Statutes ), was/is financially responsible to a Medicare beneficiary for medical bills incurred as a result of the use, maintenance or operation of a motor vehicle; and where the Defendant failed to properly pay for medica...

...s insureds and has otherwise failed to reimburse the MAO's or its assignees for their payment(s) as calculated pursuant to the recognized Current Procedure Terminology ("CPT") codes based on the fee-for-service by the primary payer, as delineated by section 627.736, Florida Statutes, for medical services and/or supplies for their damages....

...dited payments of medical bills and lost income up to a statutory amount to covered persons. Substantively, Florida law provides that claims under No-Fault policies "are due and payable as loss accrues upon receipt of reasonable proof of such loss." § 627.736(4), Fla....

...chedules]." Id. It allows exclusions from coverage for certain injuries, including injuries that were intentionally self-inflicted, incurred during the commission of a felony, or incurred while operating a vehicle without the owner's permission. Id. § 627.736(4), Fla. Stat. Procedurally, Florida law mandates that a demand letter to be sent to the insurer as a condition precedent to litigation. § 627.736(6) & (7), Fla....

...It provides that payments are overdue if not paid within 30 days of written notice of the circumstances and amount of a covered loss, but allows an insurer to decline to pay all or part of a claim subject to the insurer specifying in writing what and why it is declining to pay. § 627.736(4), Fla....

...uire a mental or physical examination of an insured by physicians. Id. In terms of remedies, Florida law provides civil actions for penalties against an insurer who fails to timely pay valid claims and against an insured who commits insurance fraud. § 627.736(12), Fla. Stat. It makes its payments primary to Medicare and requires an insurer to repay the full amount to a Medicare program "within 30 days after receiving notice that the Medicare program paid such benefits." § 627.736(4), Fla....

...establish that other medical bills paid by a different MAO should also have been paid by Ocean Harbor as a primary payer. To the contrary, proof to establish liability will necessarily devolve into a series of mini-trials under Florida no-fault law, § 627.736, etseq....

...in conflict with this opinion. The remainder of the order is quashed without prejudice. REVERSED and REMANDED for further proceedings consistent with this opinion. The Florida term for no-fault insurance is "personal injury protection" ("PIP"). See § 627.736, etseq....