Fort Lauderdale West Parner Receives Several Appellate Victories

Orlando Partner Michael Rosenberg has had a string of recent appellate victories. 

In the first case, he obtained a written opinion from the Fifth District Court of Appeal affirming the trial court’s final judgment determining that a PIP insurer properly paid a medical provider for services rendered after an automobile accident. The medical provider argued that the PIP insurer underpaid two charges by one cent each, claiming the PIP insurer should have paid 80% of each individual item rather than 80% of the entire bill. The Fifth District soundly rejected each of the medical provider’s arguments raised on appeal, holding that “the plain language of the statute simply requires reimbursement at 80% of the maximum charge….”

In the second case, he received a per curiam affirmance with citations in favor of a Florida PIP insurer against a medical provider. The trial court granted summary judgment in favor of the PIP insurer on the basis that the insured had made a material misrepresentation during the insurance application process. During the course of the investigation of the PIP claim, the PIP insurer determined that its applicant had not disclosed prior accidents and that the PIP insurer would not have provided insurance had it known about those prior incidents.

On appeal, the medical provider argued the trial court applied the incorrect law. The Third District rejected the medical provider’s appellate argument, noting that both statute and case law impose a duty on an insured to learn the contents of an application for signing it.

Finally, he obtained a per curiam affirmance in favor of a Florida PIP insurer against a medical provider. The trial court granted summary judgment in favor of the PIP insurer, determining that the PIP insurer properly reimbursed the medical provider. On appeal, the medical provider argued that it was owed 23 cents—that it had been underpaid, by a fraction of a penny, twenty-three times.

Mr. Rosenberg argued not only that any alleged underpayment was de minimus, but also that the Florida PIP insurer had properly followed Florida’s PIP statute to properly reimburse 80% of the total reimbursable amount rather than 80% of each individual charge. In sum, the Fifth District Court of Appeal rejected the medical provider’s rounding argument and affirmed the judgment in favor of CSK’s client.

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