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Florida Fourth DCA rules that medical provider’s PIP lawsuit was premature because provider had failed to respond to insurer’s numerous Fla. Stat. § 627.736(6)(b) requests for “emergency medical condition” documentation

On June 30, 2021, in Garrison Property & Casualty Insurance Company v. Aventura Orthopedicare Center, P.A., No. 4D21-379, the Florida Fourth DCA reversed a judgment for the medical provider in a case in which the medical provider sought payment of its treatment bills from a Personal Injury Protection (“PIP”) insurance provider. The defendant insurance company claimed that the trial court erred by granting final judgment in favor of the medical provider because the case was in fact premature due to the provider’s failure to respond to the insurance company’s requests for information pursuant to Section 627.736(6)(b), Florida Statutes (2016). The Fourth DCA noted that is has previously held that an insurer has “the right, pursuant to section 627.736(6)(b), to request a written report of the insured’s condition,” Med. Ctr. of Palm Beaches v. USAA Cas. Ins. Co., 202 So. 3d 88, 92 (Fla. 4th DCA 2016), and that as in Medical Center, the medical provider’s demand letter and lawsuit were “premature” due to the medical provider’s failure to respond to Insurer’s numerous section 627.736(6)(b) requests for “emergency medical condition” documentation. The Fourth DCA remanded the case with directions for the trial court to grant the insurer’s motion for summary judgment.

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