Applicability of the “New” Florida No-Fault Law, and Fee Schedules

Applicability of the “New” Florida No-Fault Law, and Fee Schedules;

I was in Miami before Judge Hague arguing for the applicability of the “new” Florida No-Fault Law, and fee schedules to a policy issued in November of 2007 with an expiration date in March 2008.  The DOL was March with DOS from April to June.  I am pleased to say that Judge Andrew Hague reversed his prior ruling on the issue, and granted the defendant’s motion for summary judgment, and applied the fee schedule. He requested that I prepare a specialized and detailed order granting the motion.  We are working on the order, and final judgment that I hope to overnight to Judge Hague tonight! Note this is like our other case where the insurer wrote to the insured and advised them that the “old” No-Fault law was going to sunset, and that at their election they would be covered by “non-statutory PIP” underwritten on a new endorsement to the policy.

When the “new” No-Fault law passed, they wrote to the insured (as required by the new PIP law) and told them that statutory PIP would be added back into their policy effective 1.1.08 and that the “new” would apply. Based upon this were we able to argue that the insured had to know that the new law had been passed, and would become effective 1.1.08, as would the insured’s assignee, the plaintiff. Judge Hague found this to be very significant. We argued the language of the PIP statute that the new No-Fault law was incorporated into every policy in effect on 1.1.08, and every policy was endorsed by statute to include the new PIP law.

We also pointed out that the policy stated that bills would be paid in accordance with the Florida No-Fault Law, as amended. Along these lines we argued that they Insurance Code is incorporated into every policy as a matter of law, and since the new law was already in effect with an effect date of 1.1.08 it should be applied. We also anticipated the plaintiff argument regarding impairment of contract (which was not pled, nor was the AG put on notice).

The plaintiff’s attorney argued everything under the sun. They argued that the policy states the insurer will be 80% of reasonable charges without reference to the fee schedule, that the law in effect when the policy was written (incepted) applies, that they fee schedules are voluntary, and finally that even if the fee schedules apply and were correctly paid by the insurer, the court would still have to conduct a trial on RRN Along those line I brought not only the statute, but also the limited legislative history that can be found on the Florida Legislature’s website.

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