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Florida Third DCA rules in PIP case that insurance adjuster was qualified to submit affidavit contesting reasonableness of amount of medical provider’s charges

On August 4, 2021, in United Automobile Insurance Company v. Progressive Health Services, No. 3D21-109, the Florida Third DCA reversed a trial court’s summary judgment in favor of the plaintiff medical provider, the assignee of PIP benefits from the defendant’s insured, in a lawsuit claiming insufficient reimbursement by the defendant for health care provided to the insured. The defendant claimed that the plaintiff’s charges were unreasonable and submitted an affidavit to the trial court from an adjuster in support of its position, but the trial court had found the affidavit “insufficient as a matter of law as it solely presents conclusions of law without supporting facts, and said opinion is therefore speculative.” The Third DCA disagreed, concluding that the adjuster’s affidavit was neither speculative nor conclusory, and was sufficient to create a genuine issue of material fact, citing its recent decisions in United Auto. Ins. Co. v. Progressive Rehabilitation and Orthopedic Servs., LLC, No. 3D21-108 (Fla. 3d DCA July21, 2021) and United Auto. Ins. Co. v. Cent. Therapy, Inc., No. 3D21-58 (Fla. 3dDCA July 28, 2021), which also involved summary judgment defenses based on the adjuster’s affidavit.

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