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Florida Fourth DCA rules that PIP policy issued by defendant insurer plainly limited medical provider reimbursement to 80% of statutory fee schedule

On September 23, 2020, in Plantation Open MEI, LLC., et al. v. Infinity Indemnity Insurance Company, et al., the Florida Fourth DCA affirmed a summary judgment entered by the trial court in favor of the defendant insurers. The plaintiff medical providers contended that the insurers’ personal injury protection (“PIP”) policy created an ambiguity which should require the insurer to pay full reimbursement for the cost of medical services rather than the limit of 80% of the statutory fee schedule for PIP benefits outlined in section 627.736(5)(a)1., Florida Statutes (2018). The Fourth DCA noted that Section 627.419(1), Florida Statutes (2018), requires every insurance contract to “be construed according to the entirety if is terms” and concluded that a true ambiguity did not exist in this case because the 80% limit is plainly set out in the statute.

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