Florida/Georgia Personal Injury & Workers Compensation

...es and the like, in order not to drive them into dire financial circumstances with the possibility of swelling the public relief rolls. Lasky v. State Farm Ins. Co., 296 So.2d 9, 16 (Fla.1974). The statutory provision at issue in the instant case is section 627.736(4), which describes when personal injury protection (PIP) benefits are due and the method by which notice must be given. The intent of this provision is to promote the prompt resolution of PIP claims. See Rodriguez, 808 So.2d at 86. Under section 627.736(4), PIP benefits "shall be due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered by the policy." An insured may seek the payment of benefits for a covered loss by submitting "reasonable proof of such loss to the insurer; if the benefits are not paid within thirty days and the insurer does not have reasonable proof that it is not responsible for the payment, the payment is "overdue." See § 627.736(4)(b), Fla....

...(2001); Rodriguez, 808 So.2d at 86. However, even where written notice is furnished to the insurer as provided by the statute, a payment is not deemed overdue "when the insurer has reasonable proof to establish that the insurer is not responsible *892 for the payment." § 627.736(4)(b), Fla....

...See Rodriguez, 808 So.2d at 86; AIU Ins. Co. v. Daidone, 760 So.2d 1110, 1111 (Fla. 4th DCA 2000). If the insurer is ultimately found liable for a contested claim, then the statutory penalties of interest and attorney's fees would be applicable. See § 627.736(4)(c), (8), Fla....

...Further, the recipient of such bills is entitled to sue the defaulting insurer for PIP and medpay benefits when the benefits have not been "paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." § 627.736(4)(b), Fla....

...pril 25, 1985. However, on March 9, 1985, [Quanstrom] sustained bodily injuries while riding as a passenger in a vehicle owned by [Terry Nelson] and insured by [Standard Guaranty Insurance Company] for personal injury protection (PIP) benefits under section 627.736(4)(d)4., Florida Statutes....

...n, finding that Quanstrom was not entitled to coverage. The Fifth District Court of Appeal identified the issue as follows: [W]hether a person injured while occupying a motor vehicle covered by personal injury protection (PIP) insurance is barred by section 627.736(4)(a), Florida Statutes (1985), from recovering PIP benefits from the insurer of the owner of that vehicle because the insured person is the owner of an uninsured motor vehicle which is not in fact being driven or operated on the roads of this state because of needed repairs....

...roper cost of treatment for one injury. Ivey filed the present action seeking payment of the proper PIP amount alleging that Allstate had not provided full payment within thirty days after receiving written notice of the covered loss, as required by section 627.736(4)(b), Florida Statutes (1995)....

...It was only after the filing of the legal action and the completion of some discovery that Allstate finally paid the additional amount to which the doctor was actually entitled and for which Ivey had initially submitted a claim. Ivey then requested an award of attorney's fees pursuant to sections 627.736(8) and 627.428(1), Florida Statutes (1995), because Allstate had conceded and paid the additional amount actually due and owing....

...that the injured insured *684 may get on with his life without undue financial interruption." Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987) (citing Comeau v. Safeco Ins. Co., 356 So.2d 790 (Fla.1978)). To this end, section 627.736(4)(b), Florida Statutes (1995), clearly provides that PIP insurance benefits "shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." For over...

...Ivey to an award of attorney's fees." Ivey, 728 So.2d at 283. To the contrary, Florida law is clear that in "any dispute" which leads to judgment against the insurer and in favor of the insured, attorney's fees shall be awarded to the insured. See §§ 627.736(8), 627.428(1); see also Dunmore, 301 So.2d at 503....

...nt of the $1,250 in medical treatment expenses that were in excess of Masis's policy deductible. United asserted the affirmative defense that Masis's failure to appear for the scheduled medical examination was "unreasonable" as a matter of law under section 627.736(7), Florida Statutes (2001). The relevant portion of this statute provides: If a person unreasonably refuses to submit to an examination, the personal injury protection carrier is no longer liable for subsequent personal injury protection benefits. § 627.736(7)(b) (emphasis supplied)....

...The purpose of the no-fault statutory scheme is to "provide swift and virtually automatic payment so that the injured insured may get on with his life without undue financial interruption." Ivey, 774 So.2d at 683-84 (quoting Gov't Emps. Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987)). To this end, section 627.736(4)(b) provides that PIP insurance benefits "shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." After an insurance company receives notice of a claim, the insurer has the opportunity to evaluate a claim through procedures such as a medical examination. In pertinent part, section 627.736(7), Florida Statutes (2001), provides: (a) Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury p...

...11th Cir. Ct. June 19, 2001) ("Assuming arguendo that her failure to appear could be determined as a matter of law to be a `refusal' . . . ."). In addition, there are scenarios in which an insured could reasonably refuse to submit to an examination. See § 627.736(7)(b), Fla....

...to receive further subsequent PIP benefits. See U.S. Sec. Ins. Co. v. Cimino, 754 So.2d 697, 699, 701-02 (Fla.2000) (indicating that attendance at a PIP medical examination is a condition precedent to the receipt of subsequent PIP benefits and that section 627.736 contemplates "a situation . . . where the insured `reasonably refuses to submit'" to a medical examination). The plain text of section 627.736(7)(b), Florida Statutes (2001), supports the analysis presented in Cimino: "If a person unreasonably refuses to submit to an examination, the [PIP] carrier is no longer liable for subsequent [PIP] benefits." § 627.736(7)(b), Fla....

...examination is an affirmative defense, which the defensive pleader must establish if the case progresses to trial. See 661 So.2d at 948-49. Interestingly, United was also the insurer in Zulma and, in that case, this same insurer conceded that under section 627.736(7), Florida Statutes, "[the insurer] would have to prove that [the insured] unreasonably refused to submit to an examination," which is contrary to the position later adopted by the Third District in Custer II....

...examination when the insured is claiming an entitlement to continued benefits and the insurer is questioning the necessity for same. In order to continue receiving benefits the insured must comply with the requirements of the insurance contract and section 627.736....

...Despite repeated rescheduling, she ultimately failed to attend the exam. Under the PIP statute, "[i]f a person unreasonably refuses to submit to an examination, the personal injury protection carrier is no longer liable for subsequent personal injury protection benefits." § 627.736(7)(b), Fla....

...The attorney's fees provision in the PIP statute, entitled "Applicability of provision regulating attorney's fees," states that "[w]ith respect to any dispute under the provisions of [the PIP statute] between the insured and the insurer, the provisions of s. 627.428 shall apply." § 627.736(8), Fla....

...r of judgment statute the insurer will be awarded fees incurred after the offer. Given the lack of conflict between the statutes, the question becomes whether the expression of one thing (i.e., attorney's fees for insureds under sections 627.428 and 627.736) implies the exclusion of another (i.e., attorney's fees under the offer of judgment statute)....

...Weesner, 711 So.2d at 1194. Nichols attempts to distinguish PIP suits from these other insurance cases on the ground that section 627.428 applies to PIP suits through a separate provision in the PIP statute, which incorporates it by reference. See § 627.736(8), Fla....

...must have been to foreclose the application of any other attorney's fees provisions to PIP suits. Otherwise, she argues, the provision would be redundant with section 627.428. We find this argument unpersuasive. If the Legislature had enacted *1076 section 627.736(8) for the sole purpose of excluding all other attorney's fees provisions in PIP suits, then presumably it would have used exclusionary language, rather than the inclusive language it used. The words in the statute are the best guide to legislative intent. Here, section 627.736(8) gives no clue that the Legislature intended to prohibit application of the offer of judgment statute....

...ed Auto. Ins. Co. v. Rodriguez, 808 So.2d 82, 85 (Fla.2001). In my view, application of section 768.79 to PIP cases would completely circumvent and thwart the purposes of the No-Fault Act and the specific provisions relating to PIP benefits found in section 627.736....

...The Florida Legislature enacted the No-Fault Act to "provide for medical, surgical, funeral, and disability insurance benefits without regard to fault" and to limit "the right to claim damages for pain, suffering, mental anguish, and inconvenience." § 627.731, Fla. Stat. (2001). In order to accomplish this objective, section 627.736(1) requires that every owner of a motor vehicle obtain motor vehicle liability insurance that provides "personal injury protection ......

...nd his or her family will have access to necessary funds for family support to replace the income lost as a result of any debilitating injury suffered by the insured; and certain death benefits to ensure prompt payment of necessary funeral expenses. § 627.736(1), Fla....

...uption.'" Id. at 683-84 (emphasis added) (quoting Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987)). The assurance of swift and virtually automatic provision of PIP benefits is accomplished through the requirements of section 627.736(4)(b), which provides that PIP insurance benefits shall be overdue if not provided within thirty days after the insurer is furnished written notice of a covered loss and of the amount of same....

...ey's fees to the injured insured in achieving the purpose of the No-Fault Act: Florida law is clear that in "any dispute" which leads to judgment against the insurer and in favor of the insured, attorney's fees shall be awarded to the insured. See §§ 627.736(8), 627.428(1); see also Dunmore[ v....

...Co., 838 So.2d 604 (Fla. 5th DCA 2003). In Nationwide Mutual Fire Insurance Co. v. Pinnacle Medical, Inc., 753 So.2d 55 (Fla.2000), the court, in holding unconstitutional the requirement of mandatory arbitration and awards of attorney's fees to the prevailing party under section 627.736(5), again emphasized the importance of the provision for fees to the insured under section 627.428 by explaining: An objective of Florida's Motor Vehicle No-Fault Law was to provide persons injured in an accident with prompt payment of benefits....

..." § 627.733(1), Fla. Stat. (2001). Subsection (3) provides that "[s]uch security shall be provided: (a) [b]y an insurance policy ... which provides the benefits and exemptions contained in ss. 627.730-627.7405." § 627.733(3)(a), Fla. Stat. (2001). Section 627.736 contains the provisions that specify what the security requirements are: medical, disability and death benefits....

...read in context with the rest of the Florida Automobile Reparations Reform Act. In this context, the purpose of the required security is clearly to provide financial responsibility to pay any "no-fault" personal injury protection benefits due under Section 627.736....

...*1085 Section 768.79 is part of Chapter 768, Florida Statutes, wherein the Legislature included section 768.71(3), which provides that "[i]f a provision of this part is in conflict with any other provision of the Florida Statutes, such other provision shall apply." The PIP statute found in section 627.736 specifically provides that in PIP cases, "the provisions of s. 627.428 shall apply...." § 627.736(8), Fla. Stat. (2001) (emphasis added). This provision is significant because section 627.428 would apply to PIP cases regardless of the provisions of section 627.736(8). In my view, the Legislature intended that the specific provisions of section 627.428 should apply over the general provisions of section 768.79. In other words, specifically including section 627.428 in the provisions of section 627.736(8), to the exclusion of any other statutory provision for fees, clearly indicates the Legislature's intention that section 627.428 be the exclusive authority for an award of fees in PIP cases....

...te (the more general statute), which dictates that each party's liability is limited to that party's percentage of fault, so that the comparative fault statute had to yield to the wrongful death statute). I note that the Legislature recently amended section 627.736 by adding subsection (11), which requires that the insured provide the insurer with written notice of an intent to file a claim for benefits. Ch. 2001-271, § 6, at 1759, Laws of Fla.; § 627.736(11)(a), Fla. Stat. (2001). Section 627.736(11)(d) provides that "[t]he insurer shall not be obligated to pay any attorney's fees if the insurer pays the claim within the time prescribed by this subsection." In my view, this provision reaffirms the Legislature's intention that...

...§ 627.733(4), F.S.A., provides that an owner of a motor vehicle as to which security is required and who does not have such security in effect at the time of an accident has no tort immunity, but is personally liable for payment of the benefits under F.S. § 627.736, F.S.A., for personal injury and has all the obligations of an insurer under the no-fault insurance act....

...In contrast to the property damage tort immunity section, all right of recovery is not denied, but only recovery for particular intangible elements of damage in a few situations; there is no immunity from tort liability for tangible damages resulting from injury except where the benefits provided in F.S. § 627.736(1), F.S.A., are payable to the injured party by his insurer or would be so payable but for an authorized deduction or exclusion....

...[9] In computing the one thousand dollar figure, a person entitled to receive free medical *15 and surgical benefits is credited with the equivalent value of the services so provided him, as a part of the $1,000. § 627.737(2). We also deem worthy of note that § 627.736(1) and (1)(a) specify as to medical expenses that these must be such as are "reasonable" and that such expenses shall be "for necessary medical, etc." services....

...cation, a point later discussed more fully. It is also provided that even where these conditions are not present as a basis for suit by the injured party against the tortfeasor, the injured party is still entitled to receive the benefits provided by § 627.736(1) (medical bills, loss of income, etc.) from his own insurer, which benefits are payable regardless of fault....

...he prior tort law. F.S. § 627.737, F.S.A., grants an exemption from liability in tort for vehicular accidents, to persons meeting the insurance requirements of F.S. § 627.733, F.S.A., to the extent that benefits are payable under the provisions of § 627.736(1) and also to the extent that an injured party may not recover for pain, suffering, mental anguish and inconvenience unless certain threshold criteria have been met. The act also requires [14] persons within its ambit to provide and maintain security for the provision of the benefits required under § 627.736(1); failure to maintain such security results in revocation of the registrant's driving license and vehicle registration....

...Tort actions against persons not required to provide security are unaffected. F.S. § 627.740, F.S.A. Persons required to provide security and failing to do so have no tort immunity and are personally liable, under F.S. § 627.733(4), F.S.A., for the payment of benefits provided for in F.S. § 627.736, F.S.A....

...enough to vitiate a legislative classification based in reason. Lindsley v. National Carbonic Gas Co., supra . We have further above noted that the $1,000 "threshold" amount refers to "all reasonable expenses for necessary medical," etc., expenses (§ 627.736(1)(a)) and that § 627.736(5) indicates that "reasonable expenses" are not to be determined solely by the amount of the bill rendered by the physician or hospital, that section providing that the physician, hospital, etc., may charge only a reasonable amount for the...

...e compound, comminuted, displaced or compressed fracture, may properly be severed from the remainder of that section, and therefore that the remaining portions of that section are constitutionally valid and enforceable. Nor do the provisions of F.S. § 627.736(4), F.S.A., providing that workmen's compensation benefits received must be credited against the first-party benefits which are provided, violate equal protection, despite the fact that benefits received from other collateral sources need not be so credited....

...Where the "threshold" amount has not yet been reached, the cause of action cannot be said to accrue until such time as the "threshold" is crossed. Accordingly, we remand the cause to the Circuit Court in and for Broward County to proceed, upon any required amendment, based upon the benefits payable to appellants under F.S. § 627.736(1)(a), F.S.A., having now exceeded in amount the sum of one thousand dollars, in order to allow an opportunity to pursue a recovery in tort of damages for pain, suffering, mental anguish and inconvenience pursuant to F.S....

...It further provides that any person who is entitled to receive free medical and surgical benefits shall be deemed in compliance with the requirements of this subsection upon a showing that the medical treatment received has an equivalent value of at least $1,000. Fla. Stat. § 627.736, F.S.A., in explaining what is meant by "reasonable amount," explains that no charge may be in excess of the amount the person or institution customarily charges for like products, services and accommodations in cases involving no insurance....

...As used hereafter in this opinion, the term "insurance" refers to the security required to be maintained by F.S. § 627.733(3), F.S.A., whether the means by which such security is provided is insurance or some other approved method. [9] F.S. § 627.737(2), F.S.A., referring to benefits payable under F.S. § 627.736(1)(a), F.S.A....

...Rollins, 704 So.2d 630 (Fla. 4th DCA 1997), in which the district court recognized conflict with the opinion in Kokotis v. DeMarco, 679 So.2d 296 (Fla. 5th DCA 1996), and certified the following question to this Court: WHETHER THE TERM "PAID OR PAYABLE" IN SECTION 627.736(3), FLORIDA STATUTES (SUPP.1996), *296 SHOULD BE DEFINED AS "THAT WHICH HAS BEEN PAID, OR PRESENTLY EARNED AND CURRENTLY OWING" SO THAT THE STATUTORY LANGUAGE OF SECTION 627.736 WILL NOT BE INTERPRETED TO PERMIT ANY REMAINING PERSONAL INJURY PROTECTION BENEFITS TO BE USED FOR SETOFFS FOR FUTURE COLLATERAL SOURCES....

...was hit by another car driven by Dasha Marie Cates and owned by Jane Rollins. The Pizzarellis sued Rollins and Cates. Medical bills incurred prior to trial by the Pizzarellis in the amount of $13,212.60 were admitted into evidence without objection. Section 627.736(1)(a), Florida Statutes (1991), provides that personal injury protection ("PIP") benefits will cover 80% of medical bills....

...During the trial, the issue arose as to whether the jury should be advised that $524.78 in additional PIP benefits were available to the Pizzarellis to defray the cost of future medical expenses. The defendants, Rollins and Cates, argued that the plain language of section 627.736(3), Florida Statutes (1991), [1] required the court to instruct the jury not to compensate the Pizzarellis for PIP benefits that had been paid or were to be paid in the future....

...The jury awarded the Pizzarellis $5000 in future medical expenses and $48 in lost earnings. The jury also found that the victim suffered permanent *297 injury and awarded the Pizzarellis $20,000 for past and future pain and suffering. After trial, both parties stipulated that there remained $524.78 in available PIP benefits. Section 627.736(3) provides that "An injured party who is entitled to bring suit under the provisions of §§ 627.730-627.7405, or his legal representative, shall have no right to recover any damages for which personal injury protection benefits are...

...court concluded that the remaining $524.78 in PIP benefits fit the definition of "payable" and therefore set off the $524.78 from the $5000 future medical expense award. On appeal, the Fourth District Court of Appeal agreed with the trial court that section 627.736(3) applied rather than section 627.7372....

..."Ambiguity suggests that reasonable persons can find different meanings in the same language." Forsythe v. Longboat Key Beach Erosion Control Dist., 604 So.2d 452, 455 (Fla.1992). We find that because the term "payable," as used by the Legislature in section 627.736(3), is susceptible to more than one reasonable interpretation, it is necessary to resort to principles of statutory construction to ascertain legislative intent....

...d therefore do not represent a liability or a "payable" benefit of the PIP carrier. This definition is also consistent with the usage given to the term "payable" in the very next subsection of the PIP statute to describe when PIP benefits are "due." § 627.736(4). [4] That subsection provides that PIP benefits are " due and payable as loss accrues, upon receipt of reasonable proof of such loss." Id. (emphasis supplied). This use of the term "payable" in section 627.736(4) supports the construction of the term as referring to those medical expenses that have been already been incurred....

...Neither section uses the more limited term "payable." Just as the legislative use of different terms in different portions of the same statute is evidence that different meanings were intended, see State v. Mark Marks, P.A., 698 So.2d 533, 541 (Fla.1997), the use of the more limited term "payable" in section 627.736(3) is evidence that the Legislature did not intend to set off future benefits....

...et for PIP benefits. Instead, the PIP carrier received a pro rata share of the plaintiffs recovery based on an equitable distribution formula, but only PIP "payments made" to the insured were subject to reimbursement based on equitable distribution. § 627.736(3)(b), Fla....

...Thus, in Purdy there was an implicit assumption that "payable" was limited to those expenses already incurred. More recently, in Mansfield v. Rivero, 620 So.2d 987 (Fla.1993), we confronted the issue of whether a plaintiff, by failing to claim PIP benefits, could avoid the setoff provisions of section 627.736(3)....

...The issue presented in this case is whether an award of future medical damages should be set off by the amount of remaining personal injury protection (PIP) benefits, if such benefits remain at the time of judgment. The answer to this question depends on the definition of the term "payable" as found in section 627.736(3), Florida Statutes (Supp.1996)....

...injury protection benefits paid or payable. In all cases in which a jury is required to fix damages, the court shall instruct the jury that the plaintiff shall not recover such special damages for personal injury protection benefits paid or payable. § 627.736(3), Fla....

...he demand. Thus, after setting off the available PIP benefits, the judgment was no longer 25% greater than the demand and the trial court found the Pizzarellis were no longer entitled to reasonable costs and attorney's fees under section 768.79. [4] Section 627.736(4), Florida Statutes (1991), provides in relevant part: (4) BENEFITS; WHEN DUE.—Benefits due from an insurer under ss....

...Wellness sought payment of 80% of the amount it had billed Sanchez, but Allstate paid a lower amount based on its interpretation of Sanchez’s policy. Instead of paying 80% of the total amount billed, Allstate paid Wellness only 80% of certain amounts set out in the statutory fee schedule contained in Fla. Stat. § 627.736(5)(a). The general rule for PIP coverage in Florida is that an insurance policy must cover 80% of all reasonable costs for medically necessary treatment resulting from 2  Case: 14-10001 Date Filed: 02/14/2014 Page: 3 of 13 an automobile accident, subject to certain limits. See Fla. Stat. § 627.736(1)(a). That is the payment Wellness sought from Allstate. Florida law also provides, however, that an insurer may opt out of the general payment rule and instead limit payment to 80% of a statutory fee schedule. See id. § 627.736(5)(a)....

...Its complaint proposed the following class: Any and all health care providers and insureds who submitted claims for no-fault benefits under PIP policies which were in effect from March, 2008, where Allstate utilized the reimbursement methodology pursuant to Florida Statute 627.736(5)(a)2(a-f) (2008) (the fee schedule) to limit reimbursement to the provider or the insured where the policy did not expressly and unambiguously indicate Defendant’s election to limit reimbursement in accordance with Florida Statute 627.736(5)(a)2 as its sole methodology for payment of No Fault claims. 3  Case: 14-10001 Date Filed: 02/14/2014 Page: 4 of 13 The complaint seeks no monetary damages. It seeks only a declaration that the form language Allstate used in the class members’ PIP insurance policies did not clearly and unambiguously indicate that payments would be limited to the levels provided for in § 627.736(5)(a). Allstate removed the case to federal court in August 2013, asserting that the Class Action Fairness Act (CAFA), 28 U.S.C....

...or reimbursement” of medical expenses based on PIP coverage under Allstate Florida auto policies during the relevant time period. She calculated that Allstate had paid out $126,474,216.25 in benefits for those claims based on the fee schedule in § 627.736(5)(a). She also calculated that if Allstate had not limited payment based on § 627.736(5)(a), then the putative class members would have been entitled to $194,651,033.94 in benefits (80% of the billed amounts)....

...It contended that Allstate had not established that the amount in controversy exceeds $5 million because the complaint did not seek damages but only a declaration that the language of the Allstate insurance policies did not clearly and unambiguously adopt the coverage caps of § 627.736(5)(a), as Florida law requires for them to be effective....

...Under Florida law, a party seeking to file a suit to recover PIP benefits must first submit a pre-suit 8  Case: 14-10001 Date Filed: 02/14/2014 Page: 9 of 13 demand letter to the insurer for payment of benefits. Fla. Stat. § 627.736(10)(a)....

...If the insurer rejects that demand for payment, the party may file suit and may be entitled to additional payment, but only if the relevant factfinder determines that the treatment in question was (1) related to an accident, (2) medically necessary, and (3) billed at a reasonable rate. See id. § 627.736(4)(b)(6). Wellness argues that with all of those contingencies standing between any class member and recovery, valuing a declaratory judgment is far too speculative. That speculation argument rests on two premises....

...the reasonableness of charges on 1,655,733 different bills. If that did not occur, however, the putative class members would have to request the additional payment from Allstate and wait for Allstate to deny the request before they could file suit. See Fla. Stat. § 627.736(10)(a). 10  Case: 14-10001 Date Filed: 02/14/2014 Page: 11 of 13 viewed in the aggregate, is too uncertain to satisfy the amount in controversy requirement.”)....

...[3] Accordingly, the Third District *876 reversed the summary judgment entered in favor of the insureds, leaving as the only issue to be litigated whether Progressive's letters constituted a denial of the claim, which would obviate the need to comply with the presuit notice provisions. See § 627.736(11)(a), Fla. Stat. (2001). ANALYSIS The dispositive issue before this Court is whether section 627.736(11), Florida Statutes (2001), can be applied retroactively to an insurance policy issued prior to the enactment of the statute....

...has been provided documentation or information at the insurer's request pursuant to subsection (6). Such notice may not be sent until the claim is overdue, including any additional time the insurer has to pay the claim pursuant to paragraph (4)(b). § 627.736(11)(a), Fla....

...rd to fault"). The No-Fault Law mandates security that can be established by alternative means, one of which is PIP insurance. See § 627.733, Fla. Stat. (2006). The "Required Personal Injury Protection" provision, or the PIP statute, is codified at section 627.736 and is "an integral part of the no-fault statutory scheme." Flores v. Allstate Ins. Co., 819 So.2d 740, 744 (Fla.2002). The statute requires motor vehicle insurance policies issued in Florida to provide PIP benefits for bodily injury "arising out of the ownership, maintenance, or use of a motor vehicle." § 627.736(1), Fla....

...hes new legal consequences to events completed before its enactment." Metro. Dade County, 737 So.2d at 499 (quoting Landgraf v. USI Film Prods., 511 U.S. 244, 270, 114 S.Ct. 1483, 128 L.Ed.2d 229 (1994)). In order to answer this question, we compare section 627.736 as it existed at the time the insureds' insurance *878 policy was issued with the 2001 amendment. Before the addition of the statutory presuit notice provision, section 627.736 did not require an insured to provide notice to an insurer before filing an action for overdue benefits. PIP benefits became overdue if the insurer failed to pay within thirty days after receiving notice from the insured of the fact of a covered loss and the amount of such loss. § 627.736(4)(b), Fla. Stat. (2000). Any overdue payment was subject to a ten percent simple interest rate per year. § 627.736(4)(c), Fla. Stat. (2000). However, if the insurer had reasonable proof to establish that it was not responsible for the payment, the payment was not overdue. § 627.736(4)(b), Fla. Stat. (2000). In contrast, the statute as amended in 2001 requires an insured to provide a presuit notice of intent to initiate litigation and provides an insurer additional time to pay an overdue claim. § 627.736(11)(a), (d), Fla. Stat. (2001). Second, the amendment mandates that the payment from the insurer must include interest and penalties not exceeding $250. § 627.736(11)(d), Fla....

...Third, if the insurer pays within the additional time provided by the statute, the payment precludes the insured from bringing suit for late payment or nonpayment and shields the insurer from a claim for attorneys' fees. Id. Finally, the amendment tolls the statute of limitations. § 627.736(11)(e), Fla....

...claim within thirty days after receiving notice of loss. Moreover, an insured had the right to bring suit for an overdue claim once the thirty days had expired. See Crooks v. State Farm Mut. Auto. Ins. Co., 659 So.2d 1266, 1268 (Fla. 3d DCA 1995) ("Section 627.736(4)(b) unambiguously states that an insurer, who fails to pay out benefits within thirty days of receiving proper notice, will be liable to the insured."). Yet, pursuant to the 2001 version of section 627.736, an insurer has an additional period of time [6] to meet its obligation under the statute, and an action for a claim of benefits cannot be initiated until the additional time for payment has expired. Thus, the statute substantively alters an insurer's obligation to pay and an insured's right to sue under the contract. In our view, the statute, when viewed as a whole, is a substantive statute. Pursuant *880 to the 2001 version of section 627.736, an insured must now take additional steps beyond filing an application for PIP benefits and beyond complying with section 627.727(4)....

...Consequently, we conclude that the Third District erred in holding that requiring the insureds to comply with the presuit notice requirements of the statute did not "violate the general rule against retrospective operation." Menendez, 979 So.2d at 331. CONCLUSION For the foregoing reasons, we hold that section 627.736(11), Florida Statutes (2001), does not apply retroactively to the insurance policy issued to the insureds, because it is a substantive statute....

...es for the proceedings at the district court and before this Court. It is so ordered. QUINCE, C.J., and CANADY, POLSTON, LABARGA, and PERRY, JJ., concur. LEWIS, J., concurs in result only. NOTES [1] The statutory requirements originally contained in section 627.736(11), Florida Statutes (2001), are now located in section 627.736(10), Florida Statutes (2009). Section 627.736(11) was renumbered as subsection (10) by chapter 2007-324, section 20, Laws of Florida, which became effective January 1, 2008. To avoid any confusion, we refer in this opinion to the text of section 627.736(11), as originally enacted in 2001, as the "statutory presuit notice provision." [2] Menendez's husband, Louis R....

...[3] As to the other issues on appeal, the Third District held: (1) that the trial court erred in granting the partial summary judgment because a material disputed issue of fact existed as to whether Progressive denied the insureds' claim; (2) that section 627.736(11) applied to all types of PIP benefit claims, including lost supplemental wages claims; and (3) that the insureds waived any argument on appeal that the claim for benefits could have been abated until the failure to comply with the...

...Article I, section 10, of the Florida Constitution states: "No bill of attainder, ex post facto law or law impairing the obligation of contracts shall be passed." [5] Under the 2001 version of the statute, the statute of limitations was tolled for fifteen business days. § 627.736(11)(e), Fla. Stat. (2001). The current version of the statute tolls the statute of limitations for thirty business days. § 627.736(10)(e), Fla....

...[6] The 2001 amendment to the statute allowed an additional seven days after receipt of the notice of intent to litigate for the insurer to pay the claim. Under the current version of the statute, an insurer has an additional thirty days to pay a claim after receiving the notice of intent to litigate. § 627.736(10)(d), Fla. Stat. (2009). Both the 2001 and the current version of the statute state that the notice of intent to litigate may not be sent until the claim for benefits is overdue. § 627.736(11)(a), Fla. Stat. (2001); § 627.736(10)(a), Fla....

...Petitioner relies on numerous cases where the automobile was found to be merely the situs of acts or incidents arising from completely independent causes. We find those cases to be inapposite and unpersuasive. The extent of the coverage is governed by the policy language and the statute regulating such policies. Section 627.736(1), Florida Statutes (1981), requires that automobile insurance policies provide personal injury protection benefits for any "loss sustained ......

...Holding the subjective intent of an assailant determinative as to the "use" of a vehicle for PIP entitlement would require insurers to guess whether particular assaults and resulting injuries are covered under the PIP policy language required by law. See § 627.736(1), Fla....

...read in context with the rest of the Florida Automobile Reparations Reform Act. In this context, the purpose of the required security is clearly to provide financial responsibility to pay any "no fault" personal injury protection benefits due under Section 627.736....

...With these basic principles in mind, we consider the general law regarding both PIP and UM coverage. PIP insurance is a statutorily required coverage for those policies complying with the security requirement of the Florida Motor Vehicle No-Fault law. See § 627.736(1), Fla. Stat. (1997); see also Allstate Ins. Co. v. Rudnick, 761 So.2d 289, 291 (Fla.2000). The purpose of PIP benefits is to provide up to $10,000 for medical bills and lost wages without regard to fault. See, e.g., §§ 627.731, 627.736, Fla....

...This coverage must be supplied in any "automobile liability insurance covering liability arising out of the ownership, maintenance, or use of any motor vehicle ..." Id. Likewise, personal injury protection "arising our of the ownership, maintenance, or use of a motor vehicle" is required in auto policies. Section 627.736(1), Florida Statutes (1979)....

...o third-party claims and thus already had been dismissed by the court's prior order. In this third order, the trial court first addressed and rejected the defendants' claim that section 817.234 was unconstitutionally vague because it conflicted with section 627.736(7)(b), Florida Statutes (1987), the personal injury protection benefits statute....

...denied, 279 So.2d 305 (Fla.1973). In personal injury protection claims, a party must turn over all medical records concerning a specific condition only after requesting and receiving a copy of medical reports from a medical examination requested by the insurer. § 627.736(7)(b), Fla....

...See Department of Legal Affairs v. District Court of Appeal, Fifth District, 434 So.2d 310 (Fla.1983). Statutory PIP coverage provides benefits for losses up to $10,000, as a result of bodily injury "arising out of the ownership, maintenance or use" of a motor vehicle. § 627.736(1), Fla....

...the uninsured/underinsured third party tortfeasor for damages for bodily injury. Id. at 634. Although Kilbreath involved an uninsured motorist claim, the Fladd court believed the Kilbreath rationale should apply to a cause of action for a PIP claim: Section 627.736(4)(d)4, Florida Statutes (1981), specifically provides that the insurer of the owner of the motor vehicle must pay PIP benefits for accidental bodily injury sustained in this state by any other person while occupying the owner's motor vehicle. Section 627.736(3), Florida Statutes (1981), provides that the injured party, or his legal representative, may not recover any damages for which PIP benefits are paid or are payable....

...asor for damages for bodily injury." Id. at 632, 633. The cause of action in this case is a first party claim in contract for failure to pay the contractual obligation for personal injuries sustained, regardless of fault. The coverage is mandated by section 627.736(1), Florida Statutes (1981), in all policies complying with the security requirements of section 627.733, Florida Statutes. With regard to the payment of PIP benefits, section 627.736(4)(b) provides: Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same....

...Fradley, 187 So.2d at 49. In determining when the insurance contract at bar was breached, when an action could have been brought, and thus, when the statute of limitations began to run, the statutory provision regarding PIP benefits is also relevant. Section 627.736(4)(b), Florida Statutes (1995), provides in part: "Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a...

...At the time, Carruthers was covered under an automobile insurance policy issued by GEICO General Insurance Company. Pursuant to Florida’s Motor Vehicle No- Fault Law, the policy provided him with $10,000 in personal injury protection (PIP) benefits. See Fla. Stat. § 627.736(1) (mandating that automobile insurers provide PIP benefits “to a limit of $10,000”)....

...To be entitled to the full $10,000, however, the statute required that Carruthers—like all PIP beneficiaries—be diagnosed by an authorized health care provider with an “emergency medical condition” (EMC); without such a diagnosis, he was limited to $2,500 in benefits. See id. at § 627.736(1)(a)(3)-(4); Robbins v....

...2  Case: 17-15606 Date Filed: 05/30/2019 Page: 3 of 23 neither Robbins’ nor Enivert’s claim was supported by [an EMC determination], neither Garrison nor Progressive violated Fla. Stat. § 627.736 by limiting benefits to $2,500”); accord, e.g., Progressive Am....

...Joseph had assigned his right to PIP benefits to the Provider at the time he received treatment. The No-Fault Law, however, appears to require some form of writing. A medical provider's authorization to receive payment directly from the insurer derives from section 627.736(5)(a), Florida Statutes (1999), which provides in part: Any physician, hospital, clinic, or other person or institution lawfully rendering treatment to an injured person for a bodily injury covered by personal injury protection insura...

...Hartford Ins. Co. of the S.E. v. St. Mary's Hosp., Inc., 771 So.2d 1210, 1212 (Fla. 4th DCA 2000) (holding that there was no *1289 evidence that the insured assigned PIP benefits to the hospital because the insured never signed a document described in section 627.736(5)(a))....

...In this case, the record contains nineteen documents dated between October 4, 1999, and November 29, 1999 — signed by Mr. Joseph — acknowledging the services provided to him on the dates specified. Arguably, a fact issue exists on whether these documents are "invoices" under section 627.736(5)(a), which, combined with parol evidence, establish that Mr....

...te provides that a cause of action exists only if there is a conviction, or that other causes of action are pre-empted.” Nationwide Mut. Co. v. Ft. Myers Total Rehab Ctr., Inc., 657 F.Supp.2d 1279, 1287 (M.D. Fla. 2009) (discussing Fla. Stat. Ann. § 627.736 (12), which similarly provides an insurer a “cause of action against any person convicted of, or who, regardless of adjudication of guilt, pleads guilty or nolo contendere to insurance fraud under s....

...2016) (violations of sections 5.1.0117 and 560.204(1)); State Farm Mutual Auto. Ins. Co. v. B & A Diagnostic, Inc., 104 F.Supp.3d 1366, 1372 (S.D. Fla. 2015) (violations of the Health Care Clinic Act and the Radiological Personnel Certification Act)) . See, e.g., Fla. Stat. Ann. § 627.736 (5)(b)(l)(c) ("An insurer or insured is not required to pay a claim or charges.....

...Rodriguez's medical bills for review to a doctor who issued a report to United Auto on January 19, 1998, outside the thirty-day statutory time period. Ms. Rodriguez sued [in county court] to recover the amount of the unpaid medical bills plus interest. § 627.736(4)(b), (c), Fla....

...5th DCA 1997), wherein the court noted that failure to pay within the thirty-day period exposes an insurer to the statutory penalties but does not bar the insurer from contesting the claim. [2] The instant cases present the following issue: If the payment of benefits for a PIP claim is "overdue" under section 627.736, *85 Florida Statutes (1997), are the penalties set forth in Florida Statutes the only penalties that may be levied against the insurer, or is the insurer also forever barred from contesting the claim....

...its, for motor vehicles required to be registered in the state and, with respect to motor vehicle accidents, a limitation on the right to claim damages for pain, suffering, mental anguish, and inconvenience. §§ 627.730, 627.731, Fla. Stat. (1997). Section 627.736 sets forth the benefits that are required for personal injury protection (PIP) and mandates coverage if the loss is sufficiently related, reasonable, and necessary: 627.736 Required personal injury protection benefits; exclusions; priority....

...ness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle as follows: (a) Medical benefits.—Eighty percent of all reasonable expenses for necessary medical, surgical, X-ray, dental, and rehabilitative services.... § 627.736(1)(a), Fla. Stat. (1997) (emphasis added). Section 627.736 also defines an "overdue" payment of benefits and sets forth the penalties that may be levied: (4) BENEFITS; WHEN DUE.— Benefits due from an insurer under ss....

...ear. . . . . (8) APPLICABILITY OF PROVISION REGULATING ATTORNEY'S FEES.—With respect to any dispute under the provisions of ss. 627.730-627.7405 between the insured and the insurer, the [attorneys' fees] provisions ofs. 627.428 shall apply. [ [4] ] § 627.736, Fla....

...thirty days, the insurer must pay the claim, i.e., the insurer can no longer contest the claim. The insurer also is liable for the statutory interest penalty. This holding violates the plain language of the Law. As noted above, the plain language of section 627.736 provides that an insurer is subject to specific penalties for an "overdue" payment: ten percent interest and attorneys' fees....

...Further, the district court held that in order to escape the thirty-day rule, an insurer must obtain a "medical report" showing that the insurer is not responsible for payment. [9] Amici Allstate Insurance Company and Geico Casualty Company point out that this requirement of a medical report is not mentioned anywhere in section 627.736(4) and they contend it is erroneous....

...CONCLUSION Under the language of the Florida No-Fault Law, an insurer is subject to specific penalties once a payment becomes "overdue"; the penalties include ten percent interest and attorneys' fees. The insurer, however, is not forever barred from contesting the claim. Our reading of section 627.736(4) is consistent with the decisions of other district courts that have addressed this statute, including the Third District Court of Appeal's own en banc decision in Fortune Insurance Co....

...LEWIS, J., dissents with an opinion, in which QUINCE, J., concurs. PARIENTE, J., concurring. I concur with the majority. I write to emphasize that this case involves an issue of statutory construction, which must be guided by the express language of section 627.736(4), Florida Statutes (1997), and not our own view of the best policy for resolving insurance disputes. See Rollins v. Pizzarelli, 761 So.2d 294, 299 (Fla.2000). Legislative intent must be determined primarily from the language of the statute. See id. at 297. Although the statutory language of section 627.736(4) may not be a model of clarity, reading the statute as a whole does not support either the Third District or the dissent's interpretation that the failure of the insurer to obtain reasonable proof within thirty days after the claim...

...Co., 774 So.2d 679, 683-84 (Fla.2000), the purpose of the no-fault scheme does not logically extend to require an insurer to automatically pay for bills for which the insurer is not responsible. I thus take issue with the dissent's suggestion that the majority opinion renders the "reasonable proof" language of section 627.736(4)(b) and the limitation on withdrawal of payment for treating physicians in section 627.736(7), Florida Statutes (1997), "meaningless and without any field of operation." Dissenting op. at 91. Section 627.736(4) provides in pertinent part: (b) Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss.......

...t written *89 notice has been furnished to the insurer.... (c) All overdue payments shall bear simple interest at the rate of 10 percent per year. (Emphasis added). I agree with Judge Klein's interpretation of the statute: [T]he thirty-day period in section 627.736(4) applies only to benefits which are reasonable and necessary as a result of the accident. Section 627.736(4), Florida Statutes begins with the words "benefits due" and states in subsection (b) that "personal injury protection benefits paid pursuant to this section shall be overdue if not paid within thirty days." If an insured submits a b...

...However, the penalty for "overdue" payments, which runs from the expiration of the thirty-day period, applies only if the insurer is ultimately found liable for the claim. The insurer does not forfeit its ability to contest payment by its failure to obtain reasonable proof in the thirty-day period. As for section 627.736(7)(a), this statute deals exclusively with the requirements for withdrawal of payment: An insurer may not withdraw payment of a treating physician without the consent of the injured person covered by the personal injury protection, unless the insurer first obtains a report by a physician licensed under the same chapter as the treating physician whose treatment authorization is sought to be withdrawn, stating that the treatment was not reasonable, related, or necessary. § 627.736(7)(a) (emphasis added). This statute requires that a PIP insurer obtain a medical report as a condition precedent to withdrawing benefits. Nothing in the language of section 627.736(4)(b) suggests that the "reasonable proof" necessary to avoid "overdue" status is limited to the "report" necessary to "withdraw" payment of a treating physician under section 627.736(7)(a). See § 627.736(4)(b). In my view, this interpretation of the "reasonable proof" requirement in section 627.736(4)(b) and the medical report requirement of section 627.736(7)(a) give meaning and effect to both statutory provisions, with each section operating independently of the other....

...ts within thirty days of receiving written notice of the fact of a covered loss and the amount of same, and that—absent reasonable proof establishing non-responsibility for payment—PIP benefits are overdue if not paid within those thirty days. See § 627.736(4), Fla. Stat. (1997). As a corollary, section 627.736(7), Florida Statutes (1997), requires that before *90 an insurer may withdraw payment of a treating physician on the basis that medical treatment was not reasonable, not related, or not necessary, it must obtain a report from a like-l...

...t so that the injured insured may get on with his life without undue financial interruption." Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987) (citing Comeau v. Safeco Ins. Co., 356 So.2d 790 (Fla.1978)). To this end, section 627.736(4)(b), Florida Statutes (1995), clearly provides that PIP insurance benefits "shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." For over...

...es to simply disregard the specific provisions of chapter 627 which require the payment of benefits to injured persons within thirty days, absent reasonable proof—obtained within that time period—that they are not responsible for payment. [15] See § 627.736(4), (7), Fla....

...view, the reasoning of the majority and concurring opinions today undermines the validity of the entire no-fault framework and places the legislative scheme at risk. In essence, the majority decision renders the "reasonable proof" language found in section 627.736(4) and the limitation on the withdrawal of payment for treating physicians in section 627.736(7) meaningless and without any field of operation. The statute specifically states: 627.736(4) BENEFITS; WHEN DUE.— ....

...he trial court ... shall adjudge or decree against the insurer and in favor of the insured or beneficiary a reasonable sum as fees or compensation for the insured's or beneficiary's attorney prosecuting the suit in which the recovery is had. [5] See § 627.736(4), Fla. Stat. (1997) (explaining that an insured must submit "reasonable proof of such loss and amount of expenses"). [6] See § 627.736(4)(b), Fla....

...nt of same.... However, any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding that written notice has been furnished to the insurer."). [7] See § 627.736(4)(c), Fla. Stat. (1997) (explaining that "[a]ll overdue payments shall bear simple interest at the rate of 10 percent per year"). This ten percent interest rate has been in force since the Law was enacted in 1971. See § 627.736(4)(c), Fla. Stat. (1971). In contrast, the statutory interest rate on judgments in 1971 was six percent. See § 55.03, Fla. Stat. (1971). [8] See § 627.736(8), Fla....

...ncorrect.") [9] See Perez, 746 So.2d at 1125 ("The PIP statute clearly requires that the insurer must obtain, within thirty days, a medical report providing `reasonable proof' that it is not responsible for payment." (Emphasis added.)). [10] But see § 627.736(7), Fla. Stat. (1997) (explaining that a physician's report is required for the non-consensual withdrawal of PIP benefits). [11] § 627.736(4), Fla....

...To be sure, subsection (7) does not require insurance companies to obtain a similar report when its challenge is based on the bill itself (i.e., the amount being charged). [15] Senate Bill 1092, which was passed by our Legislature during the 2001 Session and approved by the Governor on June 19, 2001, adds language to section 627.736(4)....

...equal to the amount demanded in such claim of lien, plus interest thereon at the legal rate for 3 years, plus $500 to apply on any court costs which may be taxed in any proceeding to enforce said lien. [4] See § 627.756, Fla. Stat. (1987). [5] See § 627.736(8), Fla....

...ources for which no right of subrogation exists. See § 768.76(1), Fla. Stat. (2000). However, because this was a motor vehicle accident, the jury would not award damages for personal injury protection ("PIP") benefits that were paid or payable. See § 627.736(3), Fla....

...iropractic Wellness Center, and MedScan Open-MRI, Amici Curiae. WELLS, J. We have on appeal Delta Casualty Co. v. Pinnacle Medical, Inc., 721 So.2d 321 (Fla. 5th DCA 1998), a decision in which the Fifth District Court of Appeal declared a portion of section 627.736(5), Florida Statutes (1995), unconstitutional....

...Pinnacle submitted the medical bills to Delta, which refused to pay them. Pinnacle, as Raymond's assignee, brought an action for breach of the insurance contract. Delta moved to dismiss the case, claiming that the dispute had to be referred to binding arbitration in accordance with section 627.736(5), Florida Statutes (1995). The trial court denied Delta's motion to dismiss and to compel arbitration. The trial court found that section 627.736(5) was unconstitutional under Lasky v....

...1974), in which this Court held that the test used to determine whether a statute violates due process "is whether the statute bears a reasonable relation to a permissible legislative objective and is not discriminatory, arbitrary or oppressive." Id. at 15. The trial court determined that the legislative objective of section 627.736(5) was to deny the right to litigate certain claims in court based on who owns the claim and that, given the right to seek redress in court provided by article I, section 21 of the Florida Constitution, this could not be considered a legitimate government objective. The trial court concluded that the mandatory arbitration provision of section 627.736(5) violated the parties' due process rights in violation of article I, section 9 of the Florida Constitution. On appeal, the Fifth District affirmed. The district court determined that under *57 Lasky section 627.736(5) violated due process by arbitrarily discriminating against medical providers....

...The district court determined that if the legislative objective of the statute was to reduce court congestion, that objective could not be achieved in such an arbitrary and discriminatory manner. The Fifth District also considered the provision as to prevailing party attorney fees in section 627.736(5)....

...The district court found that the provision arbitrarily discriminates against medical providers by subjecting them to a prevailing party test of attorney fees, while allowing insureds to recover fees under section 627.428(1), Florida Statutes (1995). The district court concluded that section 627.736(5) violated article I, section 9 of the Florida Constitution. LAW AND ANALYSIS Under Florida's Motor Vehicle No-Fault Law, [1] motorists provide their own PIP insurance for medical payments and lost wages up to a statutorily mandated amount. Section 627.736(5) requires that any charges for medical services provided to a person covered by PIP be reasonable and allows for an insurer to pay benefits directly to those providing the services. The portion of section 627.736(5) declared unconstitutional by the district court states: Every insurer shall include a provision in its policy for personal injury protection benefits for binding arbitration of any claims dispute involving medical benefits arising...

...The provision shall specify that the provisions of chapter 682 relating to arbitration shall apply. The prevailing party shall be entitled to attorney's fees and costs.[ [2] ] We agree with the Fifth District that the mandatory arbitration provision of section 627.736(5) is unconstitutional. However, we reach this conclusion by finding that the provision violates the right of medical providers to access to courts provided under article I, section 21 of the Florida Constitution. We also find that the attorney-fee provision of section 627.736(5) violates the due process rights of medical providers in violation of article I, section 9 of the Florida Constitution. Section 627.736(5) prohibits medical provider-assignees from pursuing a breach of contract claim in court....

...re cannot abolish that right without providing a reasonable alternative unless the Legislature can show an overpowering public necessity for its abolishment and no alternative method of meeting such public necessity. Id. at 4. Petitioner argues that section 627.736(5) does not violate medical providers' access to courts because there is no preexisting right of medical providers to recover directly from insurers and that an alternative means of redress has been provided. We disagree. The right of an assignee to sue for breach of contract to enforce assigned rights predates the Florida Constitution. See Robinson v. Nix, 22 Fla. 321 (1886). As an alternative to seeking redress in the courts, section 627.736(5) provides for arbitration *58 pursuant to the provisions of Florida's Arbitration Code....

...We noted, however, that a statutory requirement that the arbitration board's decision be presumed correct in the trial de novo would raise serious concerns as to whether such a statute would violate access to courts because it would diminish the right to have the ultimate decision in a case made by a court. Id. at 714. Section 627.736(5) does not provide for a trial de novo in the circuit court. Section 627.736(5) states that the provisions of chapter 682, Florida's Arbitration Code, shall apply....

...Bonanno, 568 So.2d 24 (Fla.1990), or the *59 mediation or arbitration was a prerequisite to filing the cause of action in court. See Carter v. Sparkman 335 So.2d 802 (Fla. 1976). No such commensurate benefits or procedural safeguards exist for medical providers subject to arbitration pursuant to section 627.736(5)....

...Medical providers still must prove they are entitled to recover under the assigned contract, with limited appellate review of the issue, and are subject to additional liability due to the prevailing party standard of determining an award of attorney fees. Section 627.736(5) does not provide a reasonable alternative to medical providers having their claims heard in court, nor has the Legislature shown an overpowering public necessity for abolishing this right. Therefore, we conclude that the mandatory arbitration provision in section 627.736(5), Florida Statutes (1997), denies medical providers access to courts in violation of article I, section 21 of the Florida Constitution. We also find that the attorney-fee provision in section 627.736(5) violates medical providers' due process rights....

...nsurance companies from contesting valid claims and to reimburse successful insureds for their attorney fees when they are compelled to sue to enforce their insurance contracts. See State Farm Fire & Cas. Co. v. Palma, 629 So.2d 830, 833 (Fla.1993). Section 627.736(5) replaces section 627.428(1) attorney fees with an award of attorney fees based on who was the "prevailing party" at arbitration. [5] Under section 627.736(5), medical provider-assignees are subject to attorney fees, while insureds suing to enforce the exact same contract enjoy the one-way imposition of attorney fees against insurers provided in section 627.428(1). This distinction does nothing to further the prompt payment of benefits or to discourage insurers' denial of valid claims. The effect of the attorney-fee provision in section 627.736(5) is to further delay insureds from receiving medical benefits by encouraging medical providers to require payment from insureds at the time the services are rendered rather than risk having to collect through arbitration. Thus, the prevailing party attorney-fee provision of section 627.736(5) arbitrarily distinguishes between medical providers and insureds, violating medical providers' due process rights, and is unconstitutional under article I, section 9 of Florida's Constitution. Accordingly, we affirm the decision of Fifth District Court of Appeal below and hold to be unconstitutional the portion of section 627.736(5), Florida Statutes (1997), requiring mandatory arbitration for all medical provider assignees and requiring a prevailing party standard to apply with regard to attorney fees....

...It is so ordered. HARDING, C.J., SHAW, ANSTEAD, PARIENTE, LEWIS and QUINCE, JJ., concur. NOTES [1] §§ 627.730-627.7405, Fla. Stat. (1997). [2] The method used to determine whether a party is a "prevailing party" was added to the statute in 1998. § 627.736(5)(c)1-3, Fla....

...[5] In order to be considered a "prevailing party," a party seeking payment through arbitration must obtain an arbitration award that is greater than the amount the opposing party offered plus fifty percent of the difference between the amount offered and the amount that party was seeking. See § 627.736(5)(c)1-3, Fla....

...cted from his vehicle causing him further injury. The trial court ruled these allegations were insufficient to allege that appellant suffered bodily injuries arising out of the ownership, maintenance or use of his motor vehicle within the meaning of section 627.736(1), Florida Statutes (1979), relating to the personal injury protection benefits and of section 627.727(1), Florida Statute (1979), relating to uninsured motorist provisions of his automobile insurance policy and dismissed the complaint....

...American Arbitration Ass'n, 398 So.2d 469 (Fla. 4th DCA 1981). GEICO failed to take either course. (b) After the hospital withdrew its lien, it was then all the more incumbent on GEICO to pay the $10,000 in lost wages to Gonzalez, certainly within the 30 day period provided by section 627.736(4)(b), Florida Statutes (1983)....

...Gorgei Enters., 345 So.2d 412 (Fla. 2d DCA 1977); Salter v. Nat'l Indem. Co., 160 So.2d 147 (Fla. 1st DCA 1964). Finally, we approve the award of pre-judgment interest from November 11, 1985, thirty days after the PIP notice was sent, when the payments became overdue. See § 627.736(4)(b), (c). Affirmed. NOTES [1] The trial court also awarded $1,000 plus pre-judgment interest for the plaintiff's separate medical payments coverage. No error is demonstrated in these rulings. [2] Section 627.736(8), Florida Statutes (1983), makes section 627.428 applicable to controversies involving PIP benefits like this one. [3] This was GEICO's own practice when faced with competing hospital and lost wage claims on PIP coverage. There is no explanation why this policy was not followed in this instance. [4] § 627.736(4)(b) states: (b) Personal injury protection insurance benefits shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same....

...Respect for the separation of governmental powers requires no less. The decision of the Third District Court of Appeal is quashed, and the case is remanded for further proceedings consistent with this opinion. OVERTON, C.J., and BOYD and SUNDBERG, JJ., concur. ADKINS and HATCHETT, JJ., dissent. NOTES [1] § 627.736(4)(d), Fla....

...[5] Allstate put the word "owner" in its policy in order to effect what it perceived to be the legislative intent. Its refusal to pay is based on the policy term, which Heredia says cannot be substituted for the specific legislative directive. [6] See, e.g., §§ 627.736(8), and 627.738(4), Fla....

...tion he might have against this Defendant to his medical care provider, and the exclusive remedy of the medical care provider is binding arbitration." Contemporaneously with the motion to dismiss, Allstate filed a demand for arbitration, pursuant to section 627.736(5), Florida Statutes....

...mproperly considered the allegations of the motion to dismiss. Because the complaint itself makes no reference to an assignment, appellant reasons the trial court could not determine that a dispute was subject to arbitration pursuant to section *394 627.736(5), without reference to the motion to dismiss....

...Therefore, the absence of a transcript of proceedings in the lower tribunal does not require affirmance of the trial court's ruling on the motion to dismiss. See Doan v. Amelia Retreat Condominium Ass'n, Inc., 604 So.2d 1292, 1293 (Fla. 1st DCA 1992). The statute applicable, section 627.736(5), Florida Statutes, provides in pertinent part: (5) ......

...The provision shall specify that the provisions of chapter 682 relating to arbitration shall apply. The prevailing party shall be entitled to attorney's fees and costs. (Emphasis supplied). Florida courts have determined that arbitration is mandatory under section 627.736(5), "even in the event that the insurance policy between the insured and the insurance company does not include an arbitration provision with regard to the medical provider." See Omni Insurance Co....

...State Farm Mutual Automobile Insurance Co., 697 So.2d 988 (Fla. 4th DCA 1997). In U.S. Security Insurance Co. v. Magnetic Imaging Systems, I, Ltd., 678 So.2d 872, 873, fn. 2 (Fla. 3d DCA 1996), the court stated expressly "that this arbitration provision [§ 627.736(5)] should be read into the policy so that it complies with applicable Florida Law." In a related vein, "[m]edical service providers......

...nt upon which Allstate based its claim of entitlement to arbitration. [3] It is the assignment of the insured's interest in personal injury protection benefits to medical services providers which authorizes the insurer's demand for arbitration under section 627.736(5)....

...ed Auto. Ins. Co. v. Rodriguez, 808 So.2d 82, 85 (Fla.2001). In my view, application of section 768.79 to PIP cases would completely circumvent and thwart the purposes of the No-Fault Act and the specific provisions relating to PIP benefits found in section 627.736....

...The Florida Legislature enacted the No-Fault Act to "provide for medical, surgical, funeral, and disability insurance benefits without regard to fault" and to limit "the right to claim damages for pain, suffering, mental anguish, and inconvenience." § 627.731, Fla. Stat. (2001). In order to accomplish this objective, section 627.736(1) requires that every owner of a motor vehicle obtain motor vehicle liability insurance that provides "personal injury protection ......

...nd his or her family will have access to necessary funds for family support to replace the income lost as a result of any debilitating injury suffered by the insured; and certain death benefits to ensure prompt payment of necessary funeral expenses. § 627.736(1), Fla....

...uption.'" Id. at 683-84 (emphasis added) (quoting Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987)). The assurance of swift and virtually automatic provision of PIP benefits is accomplished through the requirements of section 627.736(4)(b), which provides that PIP insurance benefits shall be overdue if not provided within thirty days after the insurer is furnished written notice of a covered loss and of the amount of same....

...ey's fees to the injured insured in achieving the purpose of the No-Fault Act: Florida law is clear that in "any dispute" which leads to judgment against the insurer and in favor of the insured, attorney's fees shall be awarded to the insured. See §§ 627.736(8), 627.428(1); see also Dunmore, 301 So.2d at 503....

...Ivey, 774 So.2d at 684 (emphasis added). In Nationwide Mutual Fire Insurance Co. v. Pinnacle Medical, Inc., 753 So.2d 55 (Fla.2000), the court, in holding unconstitutional the requirement of mandatory arbitration and awards of attorney's fees to the prevailing party under section 627.736(5), again emphasized the importance of the provision for fees to the insured under section 627.428 by explaining: An objective of Florida's Motor Vehicle No-Fault Law was to provide persons injured in an accident with prompt payment of benefits....

..." § 627.733(1), Fla. Stat. (2001). Subsection (3) provides that "[s]uch security shall be provided: (a) [b]y an insurance policy ... which provides the benefits and exemptions contained in ss. 627.730-627.7405." § 627.733(3)(a), Fla. Stat. (2001). Section 627.736 contains the provisions that specify what the security requirements are: medical, disability and death benefits....

...read in context with the rest of the Florida Automobile Reparations Reform Act. In this context, the purpose of the required security is clearly to provide financial responsibility to pay any "no-fault" personal injury protection benefits due under Section 627.736....

...Section 768.79 is part of Chapter 768, Florida Statutes, wherein the Legislature included section 768.71(3), which provides that "[i]f a provision of this part is in conflict with any other provision of the Florida Statutes, such other provision shall apply." The PIP statute found in section 627.736 specifically provides that in PIP cases, "the provisions of s. 627.428 shall apply...." § 627.736(8), Fla. Stat. (2001) (emphasis added). This provision is significant because section 627.428 would apply to PIP cases regardless of the provisions of section 627.736(8). In my view, the Legislature intended that the specific provisions of section 627.428 should apply over the general provisions of section 768.79. In other words, specifically including section 627.428 in the provisions of section 627.736(8), to the exclusion of any other statutory provision for fees, clearly indicates the Legislature's intention that section 627.428 be the exclusive authority for an award of fees in PIP cases....

...te (the more general statute), which dictates that each party's liability is limited to that party's percentage of fault, so that the comparative fault statute had to yield to the wrongful death statute). I note that the Legislature recently amended section 627.736 by adding subsection (11), which requires that the insured provide the insurer with written notice of an intent to file a claim for benefits. Ch.2001-271, § 6, at 1759, Laws of Fla.; § 627.736(11)(a), Fla. Stat. (2001). Section 627.736(11)(d) provides that "[t]he insurer shall not be obligated to pay any attorney's fees if the insurer pays the claim within the time prescribed by this subsection." In my view, this provision reaffirms the Legislature's intention that...

...he paid a premium. [7] This is evident by the Legislature's *754 pronouncement that the purpose of PIP insurance is to "provide for medical, surgical, funeral, and disability insurance benefits...." § 627.731, Fla. Stat. (2001). Other provisions in section 627.736 support this view. Section 627.736(11)(a) provides that the insurer must provide written notice "[a]s a condition precedent to filing any action for an overdue claim for benefits under paragraph (4)(b)...." Section 627.736(4) provides that "[b]enefits due from an insurer ... shall be due and payable as loss accrues ..." and section 627.736(4)(b) provides that "[p]ersonal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." Section 627.736(7) applies to situations where an insurer seeks to withdraw benefits covering a treating physician's care because the treatment, as opposed to the amount of the charge for that treatment, is not reasonable, necessary or related....

...5th DCA 1996) (citing Bird Lakes Dev. Corp. v. Meruelo, 626 So.2d 234, 238 (Fla. 3d DCA 1993), review denied, 637 So.2d 233 (Fla.1994)). [7] In order to determine what the "required benefits" are that flow from the coverage provisions of a PIP insurance policy, we turn to section 627.736(1), which provides that "[e]very insurance policy complying with the security requirements of s....

...n the benefits the insured was otherwise entitled to. [8] See § 627.731, Fla. Stat. (2001) ("The purpose of ss. 627.730-627.7405 is to provide ... a limitation on the right to claim damages for pain, suffering, mental anguish, and inconvenience."); § 627.736(3), Fla....

...2  Case: 15-14415 Date Filed: 05/08/2018 Page: 3 of 28 extends to “medically necessary” services, including emergency transport, “to a limit of $10,000.” Fla. Stat. § 627.736(1)(a). The PIP statute, Florida Statutes § 627.736, permits an insured to choose one of two methods for calculating the reimbursement of medical claims under his automobile insurance policy. See Allstate Ins. Co. v. Orthopedic Specialists, 212 So. 3d 973, 976 (Fla. 2017). The first method requires the auto insurer to reimburse “[e]ighty percent of all reasonable expenses for medically necessary . . . services.” Fla. Stat. § 627.736(1)(a). To determine a reasonable amount, any “relevant” information may be considered. Id. § 627.736(5)(a)....

...Under this first method, a medical provider can bill the insured for the reasonable fee that remains after his auto insurance has paid its portion. The second method permits an insured and insurer to “limit reimbursement to 80 percent” of a schedule of charges that mostly 1 tracks Medicare rates. Id. § 627.736(5)(a)1. For example, an insurer may limit reimbursement for “emergency transport and treatment” to “200 percent of Medicare.” Id. § 627.736(5)(a)1.a....

...in excess of such limits, except for amounts that are not covered by the insured’s 1 As to emergency hospital care, the fee schedule restricts reimbursement to “75 percent of the hospital’s usual and customary charges.” Fla. Stat. § 627.736(5)(a)1.c. 3  Case: 15-14415 Date Filed: 05/08/2018 Page: 4 of 28 personal injury protection coverage due to the coinsurance amount or maximum policy limits.” Id. § 627.736(5)(a)4....

...Lenworth Bailey was a passenger in the vehicle at the time of the accident. Lemar Bailey received coverage under Hyde’s automobile insurance policy because he was a passenger in the vehicle at the time the accident occurred. See Fla. Stat. § 627.736(1)....

...We illustrate these consequences by walking through each method with an example. The first method requires an auto insurer to reimburse “[e]ighty percent of all reasonable expenses for medically necessary . . . services.” Fla. Stat. § 627.736(1)(a)....

...a medical provider is prohibited from charging the insured for any amount in excess of the fee schedule, “except for amounts that are not covered by the insured’s personal injury protection coverage due to the coinsurance amount or maximum policy limits.” Fla. Stat. § 627.736(5)(a)4....

...treatment was not “lawfully provided” since Silver Star did not comply with the licensing statute. Florida law provides that an insurer is not required to pay for medical treatment that is not “lawfully provided.” See id. §§ 400.9935(3), 627.736(1)(a)1....

...unenforceable.” Id. § 400.9935(3). In addition, Florida’s no fault statute provides that “[a]n insurer . . . is not required to pay a claim or charges . . . [f]or any service or treatment that was not lawful at the time rendered . . .,” id. § 627.736(5)(b)1.b., and it defines “lawful” as “in substantial compliance with all relevant applicable criminal, civil, and administrative requirements of state and federal law related to the provision of medical services and treatment,” id....

...orce in apprehending and arresting [petitioner], that [petitioner] was injured." Respondent admitted the above allegation but denied coverage on the basis that the injury did not arise out of the use, operation or maintenance of a motor vehicle. See § 627.736(1), Fla....

...Stat. (1983). Cross motions for judgment on the pleadings were filed and the trial court entered judgment for petitioner. On appeal the district court reversed, holding that tort concepts of causation were applicable in determinations of coverage under section 627.736(1)....

...nder the insurance policy issued by respondent. The insurance policy issued by respondent is required by statute to provide benefits for bodily injury, sickness, disease or death "arising out of the ownership, maintenance or use of a motor vehicle." § 627.736(1)....

...at 350 (quoting Royal Indemnity Co. v. Government Employees Insurance Co., 307 So.2d 458, 460 (Fla. 3d DCA 1975)). Both Lumbermens Mutual and Royal Indemnity dealt, however, with an aspect of the Florida Motor Vehicle No-Fault Law which is not at issue in this case. Section 627.736(4)(d)1, Florida Statutes (1983), requires payment of P.I.P....

...Supreme Court of Florida. March 31, 2005. *1092 Larry Mark Polsky, Daytona Beach, FL, for Appellant. Karen A. Barnett and Deborah L. Appel of Barnett and Associates, P.A., Tampa, FL, for Appellee. PER CURIAM. We have for review a challenge to the constitutionality of section 627.736(5)(b), Florida Statutes (1999), contained in Florida's Motor Vehicle No-Fault Law, which requires providers of non-emergency medical services and medical services not provided in and billed by a hospital to submit a statement of charges to insurers within thirty days of service....

...*1093 5th DCA 2002), the Fifth District summarized the facts as follows: State Farm Mutual Automobile Insurance Co. (State Farm), appeals a final judgment awarded to Dan Ray Warren, State Farm's insured, and Dr. Jack Rotstein, M.D., Warren's physician. The county court entered the judgment after holding section 627.736(5)(b), Florida Statutes (1999), unconstitutional as violative of Dr. Rotstein's rights to equal protection, due process and access to the courts. Section 627.736(5)(b) provides that "the insurer is not required to pay [for] charges for treatment or services rendered more than 30 days before the postmark date of the statement [of charges]....

...or Dr. Rotstein's tardy statements, he initiated an action for non-payment against State Farm and eventually joined Dr. Rotstein as a party plaintiff. The county court agreed with Dr. Rotstein's allegations that the thirty-day billing requirement of section 627.736(5)(b) is an "irrational legal hoop" and should be declared unconstitutional....

..."denies medical providers who are not hospitals and ambulance companies access to the courts." The court then entered judgment for $1,640.25 plus interest to Dr. Rotstein and awarded attorney's fees and costs in the amount of $12,699.26 pursuant to section 627.736(8), Florida Statutes (1999). Id. at 1076 (footnotes omitted) (alterations in original). State Farm appealed the county court's decision to the Fifth District Court of Appeal, which reversed the county court's ruling and held that section 627.736(5)(b) is constitutional under the federal and state constitutional provisions cited by petitioners....

...Rodriguez, 808 So.2d 82, 85 (Fla.2001). As a result, each motor vehicle owner or registrant required to be licensed in Florida is required to carry a minimum amount of personal injury protection, or PIP insurance, for the benefit of the owner and other designees. Section 627.736, Florida Statutes (1999), sets forth required PIP benefits, which are triggered if a loss is reasonable, necessary, and related to a motor vehicle accident. See Rodriguez, 808 So.2d at 85. Also included in the no-fault statute is a provision for a procedure through which medical providers may file claims and receive payment for services provided. See § 627.736(5)(a), Fla. Stat. (1999). Section 627.736(5)(b) sets forth the procedures with which treating medical providers must comply in order to receive payment from the no-fault insurer for services rendered....

...As a result, medical providers could potentially allow charges to mount, and submit charges for services rendered over a long period of time and distant from the time of the original accident. In 1998, pursuant to chapter 98-270, section 2, Laws of Florida, the Legislature amended section 627.736(5) to expressly provide a thirty-day limitation on medical provider billing. Section 627.736(5)(b), Florida Statutes (1999), requires medical providers to postmark claims no later than thirty days following the date of treatment, or be subject to automatic claim denial by the insurer....

...Under this test, a court must uphold a statute if the classification bears a rational relationship to a legitimate governmental objective. See Keys Title, 741 So.2d at 602. Our analysis in this case is governed by the rational relationship test because section 627.736(5)(b) does not implicate a fundamental right, nor do the petitioners claim to constitute a suspect class or claim that a fundamental right is at stake....

...nt is usually a straightforward process. We find that the different billing requirements are calculated to reduce unnecessary *1096 medical costs which in turn lowers the costs upon which insurers base PIP premiums and ultimately benefits consumers. Section 627.736(5)(b) is rationally related to this legitimate state purpose, and the classifications within the statute are reasonably designed to achieve that purpose....

...ch as a requirement for the timely submission of medical provider statements. Accordingly, as required by the applicable equal protection analysis, in a light deferential to the Legislature's action, we uphold the district court's determination that section 627.736(5)(b) does not offend equal protection....

...Additionally, the potentially oppressive aspect of the statute (from the petitioners' viewpoint), an inability to recover payment for services rendered, may be avoided by merely complying with the thirty-day requirement, of which the statute places medical providers on notice. Therefore, we hold that section 627.736(5)(b) does not violate due process....

...ts a valid use of legislative authority that does not interfere with the petitioners' equal protection or due process rights, nor does the statute violate the petitioners' rights of access to the courts. Therefore, we uphold the constitutionality of section 627.736(5)(b), Florida Statutes (1999), and approve the decision of the Fifth District Court of Appeal....

...PARIENTE, C.J., and WELLS, ANSTEAD and BELL, JJ., concur. PARIENTE, C.J., specially concurs with an opinion, in which ANSTEAD, J. concurs. LEWIS and QUINCE, JJ., dissent with opinions. CANTERO, J., recused. PARIENTE, C.J., specially concurring. I agree with the majority that section 627.736(5)(b), Florida Statutes (1999), is not an unconstitutional violation of due process or equal protection. I also agree that the statute does not unconstitutionally restrict access to courts on its face. However, in my view, there may be circumstances in which this statute results in an unconstitutional denial of access to the courts as applied. Section 627.736(5)(b) requires most providers of medical services to submit a statement of charges to insurers within thirty days of service or neither the insurers nor injured parties can be held liable for the charges....

...ion was unconstitutional as applied to a plaintiff who was financially unable to post the bond). Under these circumstances, the statute would result in an unconstitutional denial of access to the courts as applied. For these reasons, I conclude that section 627.736(5)(b) is not unconstitutional on its face but may be unconstitutional as applied to specific facts. In this case, because there is no allegation that Dr. Rotstein's failure to submit his bills within thirty days of treatment was a result of incorrect information provided by the insured, section 627.736(5)(b) was not unconstitutionally applied. ANSTEAD, J., concurs. LEWIS, J., dissenting. I respectfully dissent because, in my view, the very limited thirty-day billing deadline provided in section 627.736(5)(b) of the Florida Statutes unconstitutionally impinges upon medical providers' fundamental rights of property, due process and access to the courts....

...simply encourages, advances, and promotes the encroachment upon fundamental access to courts in the future. Accordingly, I dissent from the action taken by the majority today. QUINCE, J., dissenting. I dissent from the majority's determination that section 627.736(5)(b), Florida Statutes (1999), is constitutional; instead I would hold the section unconstitutional as violative of equal protection and access to the courts. Section 627.736(5)(b) provides: (b) With respect to any treatment or service, other than medical services billed by a hospital for services rendered at a hospital-owned facility, the statement of charges must be furnished to the insurer by the provid...

...Sims, 464 So.2d 251 (Fla. 4th DCA 1985). Thus, it is clear that one of the purposes of chapter 627 is to make sure that those persons injured in vehicle accidents receive prompt medical attention without having to put themselves into a dire financial position. Section 627.736(5)(b) does not further this legislative goal....

...h Amendment to the federal Constitution." Caldwell, 26 So.2d at 790-91 (quoting State ex rel. Spence v. Bryan, 87 Fla. 56, 99 So. 327, 329-30 (1924)) (citations omitted); accord DeAyala v. Florida Farm Bureau Cas. Ins. Co., 543 So.2d 204 (Fla.1989). Section 627.736(5)(b) treats medical providers that are similarly situated differently without any legitimate reason for the different treatment....

...No valid reasoning has been posited for more seriously abridging those rights of some providers while not others. For that reason, I would find the statute unconstitutional as a violation of the equal protection provision of our constitution. [11] I also agree with Justice Lewis's dissent to the extent that he finds section 627.736(5)(b) unconstitutional as a violation of the right of access to courts....

...These medical providers cannot get the fee from either the insurance company or the patient, thereby rendering any resort to the courts moot. For these reasons, I disagree with the majority's determination that the statute is constitutional. NOTES [1] Section 627.736(5)(b) of Florida's No-Fault Law reads as follows: With respect to any treatment or service, other than medical services billed by a hospital for services rendered at a hospital-owned facility, the statement of charges must be furnishe...

...ed without sale, denial or delay." [4] Although the applicable statute in this case is the statute as it existed in 1999, we note that the statute has undergone amendments since that time. The current version of the applicable statute is codified at section 627.736(5)(c), Florida Statutes (2004). [5] On separate issues, this Court has confronted the constitutionality of section 627.736(5) in Nationwide Mutual Fire Insurance Co....

...ions is met). [9] In 2001, the Legislature added a provision that allows a provider an extra thirty-five days to submit a bill if the provider was given incorrect information by the insured. See ch.2001-271, § 6, Laws of Fla. (currently codified at § 627.736(5)(c)(2), Fla. Stat. (2004)). [10] I recognize that the statute provides health care professionals who notify insurance companies within twenty-one days of the commencement of treatment sixty days to submit bills for payment. See § 627.736(5)(b), Fla....

...BOYD, Justice. This is an appeal from a judgment rendered by the circuit court in Manatee County awarding the appellants $7,937.20 for damages incurred as a result of an automobile accident. Because the trial judge upheld the constitutionality of sections 627.736(3) [1] and 627.7372, [2] Florida Statutes *1327 (1977), we have jurisdiction pursuant to article V, section 3(b)(1) of the Florida Constitution (1972)....

...was over. At the end of the trial the jury awarded Mr. Purdy $11,318.00 as compensation for his injuries and Mrs. Purdy $500.00 as compensation for the loss of her car. At a post trial hearing the trial judge upheld the constitutionality of sections 627.736(3) and 627.7372, Florida Statutes (1977)....

...and no alternative method of meeting such public necessity can be shown. Kluger v. White, 281 So.2d 1, 4 (Fla. 1973). This holding does not apply to these statutes since they do not abolish any previous right of access to courts. Basically, sections 627.736(3) and 627.7372 reduce the amount of damages injured plaintiffs can recover from tortfeasors by the amount of benefits they have received from collateral sources....

...886 (1932); Cappucio, Subrogation in Florida, 21 U.Miami L.Rev. 240, 247-49 (1966). This right of subrogation was statutorily recognized by the Florida Automobile Reparations Reform Act, sections 627.730-627.741, Florida Statutes (1971), when it was first enacted. Section 627.736(3) was previously a provision concerning an insurer's right to reimbursement of any payments made to an insured who subsequently recovered against a tortfeasor. § 627.736(3), Fla....

...[3] Its main purpose was to prevent injured plaintiffs from receiving double recovery. Cf. Aetna Casualty & Surety Co. v. Bortz, 271 So.2d 108 (Fla. 1972) (this was the purpose behind the Workmen's Compensation Subrogation Law, § 440.39(3), Fla. Stat. (1971), after which § 627.736(3), Fla....

...ly, other than yearly. We believe the statute refers to the costs incurred by claimants to secure the actual policies from which they received benefits for whatever period of time the policy is in effect. From this analysis we conclude that sections 627.736(3) and 627.7372, Florida Statutes (1977), do not deprive persons injured in automobile accidents of their right of access to the courts....

...Furthermore, there is nothing in the law which prevents injured persons from waiving their rights to receive insurance benefits and suing the tortfeasor for the full amount of their damages. Section 627.7372 sets off only those benefits which actually have been paid. Section 627.736(3) sets off benefits which are "paid or payable," which we interpret to include only those benefits a person is entitled to under his or her contract after he or she files a claim....

...An application for "no fault" benefits was filed by appellant on January 16, 1973, including an executed authorization for medical information and wage and salary information. Payment of the benefits were not made within thirty days as required by Section 627.736(4)(d) and appellant filed suit. A default judgment was entered but later set aside. Appellee did not contest appellant's entitlement to the $5,000.00 benefits but merely disputed the allowance of attorney's fees. Section 627.736(4)(b) provides that personal injury protection benefits shall be paid within thirty days of claim. Section 627.736(8) states that "With respect to any dispute under the provisions of §§ 627.730-627.741 between the insured and the insurer, the provisions of § 627.428 shall apply." Section 627.428 provides that upon the rendition of a judgment against an insurer in this state, the court shall award attorney's fees....

...Plaintiffs responded with the contention that section 627.737 is unconstitutional as a denial of access to courts, due process, and equal protection. The trial court issued an order holding for the defendants and finding the statute constitutional. On appeal, the district court found sections 627.736(1), [1] 627.737, [2] and 627.739 [3] of *15 the no-fault statute unconstitutional....

...rendered the alternative no longer reasonable. The two changes the district court was most concerned about were the lowering of the personal injury protection (PIP) benefits and the raising of the permissible PIP "deductible." When we decided Lasky, section 627.736(1) provided for recovery of 100% of medical expenses and 100% or 80% of lost income depending on whether the benefits were to be included in gross income for federal income tax purposes. Chapter 77-468, section 33, Laws of Florida, amended that section reducing the benefits to 80% of medical expenses and 80% or 60% of lost income. Other provisions in the no-fault act when Lasky was decided required PIP coverage of $5,000, section 627.736(1), Florida Statutes (1971), with a maximum deductible of $1,000....

...Thus the provisions of section 627.737 still provide a reasonable alternative to the traditional action in tort and therefore do not violate the right of access to courts guaranteed by article I, section 21 of the Florida Constitution. *18 DUE PROCESS OF LAW The district court found that sections 627.736(1), 627.737(1), and 627.739(1), Florida Statutes (1979), unconstitutionally denied due process in that they did not bear a reasonable relationship to permissible legislative objectives. The district court explained: The changes to sections 627.736, 627.737 and 627.739 noted above cause the 1979 no-fault act to no longer be reasonably related to several of the permissible legislative objectives noted in Lasky: (1) injured parties are able to initiate suits for expenses not payable by an...

...prolonged pain to recover damages to recompense them, while not granting such right of recovery to those substantially less likely to incur any prolonged pain. Lasky v. State Farm Insurance Co., 296 So.2d at 19. In conclusion, we find that sections 627.736(1), 627.737, and 627.739 of the Florida Statutes (1979), do not violate the rights of access to courts, due process, or equal protection....

...SUNDBERG, C.J., concurs in part and dissents in part with an opinion, in which ADKINS, J., concurs. OVERTON, Justice, concurring. I concur but find that the act as amended is at the absolute outer limits of constitutional parameters, particularly in the amendment of section 627.736(1), Florida Statutes (1979), which reduced personal injury protection for medical expenses and loss of earnings....

...Although I concur substantially with the majority opinion, I feel compelled to dissent from the holding that section 627.737(2), Florida Statutes (1979), is constitutional insofar as it eliminates all causes of action for intangible damages for nonpermanent injuries. Furthermore, I must observe that the provisions of section 627.736(1)(a) — (b), Florida Statutes (1979), reducing the medical expenses and lost income benefits come perilously close to "the outer limits of constitutional tolerance." Carter v....

...could the right to damages for permanent injuries. For this reason I dissent from the holding that section 627.737(2) is constitutional insofar as it prohibits recovery of intangible damages for nonpermanent injuries. ADKINS, J., concurs. NOTES [1] 627.736 Required personal injury protection benefits; exclusions; priority....

...missions, is hereby exempted from tort liability for damages because of bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use of such motor vehicle in this state to the extent that the benefits described in s. 627.736(1) are payable for such injury, or would be payable but for any exclusion or deductible authorized by ss....

...ment for repair work. — In order to prevent duplication with other private or governmental insurance or benefits for senior citizens and others with access to such insurance or benefits, each insurer providing the coverage and benefits described in s. 627.736(1) shall offer to the named insureds modified forms of personal injury protection as described in this section....

...(2) Insurers shall offer coverage wherein at the election of the named insured all benefits payable under 42 U.S.C. s. 1395, the federal "Medicare" program, or to active or retired military personnel and their dependent relatives shall be deducted from those benefits otherwise payable pursuant to s. 627.736(1). (3) Insurers shall offer coverage wherein at the election of named insured the benefits for loss of gross income and loss of earning capacity described in s. 627.736(1)(b) shall be excluded....

...Palma submitted the bill to her insurer, State Farm, which refused the claim. Palma brought suit against State Farm, which answered that it was not required to pay for the thermographic examination because this treatment did not constitute a necessary medical service consistent with section 627.736, Florida Statutes (1983)....

...In its judgment, the trial court summarized this counterclaim: "The action for declaratory relief asked the Court to declare that thermographic examinations in musculoskeletal injuries and nerve root impingement were not necessary medical treatment as defined under Florida Statute 627.736 (Personal Injury Protection) and, therefore, were not reimbursable to the plaintiff, or any plaintiff, under her PIP coverage in the insurance policy issued by State Farm. The policy language tracked F.S. 627.736....

...ter the date of the release of Quanstrom. For the reasons expressed, we approve the decision of the Fourth District Court of Appeal in this cause. It is so ordered. EHRLICH, C.J., and McDONALD, SHAW, BARKETT, GRIMES and KOGAN, JJ., concur. NOTES [1] Section 627.736, Florida Statutes (1983), states, in pertinent part: (1) REQUIRED BENEFITS....

...empt to "possess or use" the vehicle. He contends that under the facts of this case there was a sufficient connection between the maintenance and use of the vehicle and the resulting injury to justify PIP coverage. We agree. The controlling statute, section 627.736, Florida Statutes (1995), requires that motor vehicle insurance policies issued in Florida provide personal injury protection (PIP) benefits for bodily injury "arising out of the ownership, maintenance, or use of a motor vehicle": 627.736 Required personal injury protection benefits.......

...627.733 shall provide personal injury protection to the named insured ... to a limit of $10,000 for loss sustained by any such person as a result of bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle .... § 627.736, Fla....

...[3] The results under these standards, however, have not been consistent. [4] In an effort to resolve these inconsistencies, *1155 we now set forth the following guidelines. First, legislative intent—as always —is the polestar that guides an inquiry under section 627.736(1)....

...The motivation of the assailant—whether it be to "possess or use" the vehicle, or to steal the victim's wallet or purse, or simply to harm the victim—is a nonissue to the consumer. We note that insurance companies were placed on notice at the time of enactment of section 627.736(1)—and certainly by the time that Novak and Hernandez were decided—that the statute contemplates broad coverage....

...y confused, contradictory and badly in need of clarification."). [5] We disapprove Jun; Trott; Exilus; Furo; Parker; Doyle; Famigletti; and Reynolds. As explained above, the motivation of the assailant is not dispositive when deciding coverage under section 627.736(1).

...Accordingly, we reverse the trial court's order dismissing the amended complaint with prejudice and remand with instructions to reinstate count I for restitution and count II for fraud. Reversed and remanded. NOTES [1] The PIP lawsuits were brought pursuant to section 627.736, Florida Statutes, which provides personal injury protection benefits from an insurer to an insured. [2] On appeal, United Auto does not seek review of the decision to dismiss its claim for insurance fraud pursuant to section 627.736(4)(h), Florida Statutes.

...Additionally, there is no indication that any party was not "made or joined" in order to invoke diversity jurisdiction. E.g., Ambrosia Coal & Constr. Co. v. Morales, 482 F.3d 1309, 1313-16 (11th Cir.2007). Therefore, § 1359 does not preclude diversity jurisdiction in this case. *1286 Defendants next argue that FLA. STAT. § 627.736 gives Nationwide a right to individually challenge each PIP claim at issue, and that this statute does not allow for the aggregation of claims....

...1827, 104 L.Ed.2d 338 (1989); Brown v. Crawford County, 960 F.2d 1002, 1009-10 (11th Cir.1992). A. Statutory Preemption All defendants argue that plaintiff's causes of action for common law fraud, unjust enrichment, and negligent supervision are preempted by Florida Statute Section 627.736(12), which provides: An insurer shall have a cause of action against any person convicted of, or who, regardless of adjudication of guilt, pleads guilty or nolo contendere to insurance fraud under s....

...ilt, pleads guilty or nolo contendere to insurance fraud under s. 817.234, patient brokering under s. 817.505, or kickbacks under s. 456.054, associated with a claim for personal injury protection benefits in accordance with this section. FLA. STAT. § 627.736(12)....

...Defendants' reliance on Lasky v. State Farm Ins. Co., 296 So.2d 9 (Fla.1974) and Corfan Banco Asuncion Paraguay v. Ocean Bank, 715 So.2d 967 (Fla. 3d DCA 1998) is misplaced, since neither case addresses the statute at issue. The Court finds that the plain language of FLA. STAT. § 627.736(12) does not preempt plaintiff's common law claims, but rather provides a specific remedy under a particular set of facts....

..., and are anticipating submission of additional claims in the future, all of which are false, misleading and deceptive. Nationwide asserts that it is in doubt as to its rights under the terms of the applicable insurance policies and under Fla. Stat. § 627.736 as to whether or not any of the bills submitted by defendants are payable due to the facts and circumstances outlined in paragraphs 16a through 16i of the Complaint, and whether any future claims would be compensable....

...Cimino (Cimino) was injured in an automobile accident and sought benefits pursuant to her personal injury protection (PIP) automobile insurance policy with U.S. Security Insurance Company (Security). Security scheduled a medical examination for Cimino. Pursuant to section 627.736(7), Florida Statutes (1997), and as provided for in a provision in the insurance policy, Security chose the physician....

...Security also advised Cimino that failure to attend the scheduled examination or failure to comply with the required *698 conditions would result in termination of her benefits. Cimino filed an action for declaratory judgment, seeking to have the trial court determine her rights under the insurance policy and under section 627.736....

...1st DCA 1994). Relying upon Klipper v. Government Employees Insurance Co., 571 So.2d 26 (Fla. 2d DCA 1990), where the district court found the insured was not entitled to have a court reporter present during a medical examination conducted pursuant to section 627.736, the trial court ordered the temporary injunction dissolved....

...'s attorney from a workers' compensation examination). On the other hand, there has been little litigation on the issue of third-party attendance at a medical examination conducted pursuant to the terms of the insured's contract with the insurer and section 627.736, Florida Statutes. See Cimino; Klipper. The examination requirements contained within section 627.736(7)(a)-(b), Florida Statutes (1997), are, in pertinent part, as follows: (a) Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for...

...A PIP examination is a potential step in the direction of litigation. The insured is claiming an entitlement to continued benefits and the insurer is questioning the necessity for same. In order to continue receiving benefits the insured must comply with the requirements of the insurance contract and section 627.736....

...aking of the examination. On the other hand, Cimino argues there is nothing in the insurance contract or the statute which prevents her from having her attorney present. Cimino's argument is persuasive. The language of the contract at issue here and section 627.736 contemplate a situation, such as this one, where the insured "reasonably refuses to submit" to an examination. By using the term "unreasonably refuses to submit" in both the conditions section of the policy and subsection 627.736(b), it is logical to deduce there are scenarios where the insured "reasonably refuses to submit" to the examination....

...The insured under the PIP policy was driving home when his tire blew out. When he stopped to fix it, he was assaulted by unknown persons. He sued for PIP benefits, claiming that they were due for his injuries "arising out of the ownership, maintenance, or use of a motor vehicle," as required both by the policy and section 627.736, Florida Statutes (1995)....

...5th DCA 1981) (citations omitted)). Noting the inconsistent ways in which these rules had been applied, the Blish court set forth guidelines for the "nexus" standard: First, legislative intent—as always—is the polestar that guides an inquiry under section 627.736(1)....

...y the items identified by the insured person were reasonable in amount and medically necessary, together with a sworn statement that the treatment or services rendered were reasonable and necessary with respect to the injury sustained. Id.; see also § 627.736(6)(b), Fla....

...cy for benefits that became due when their insured underwent medical treatment. State Farm's position not only disregards contract law, but also attempts through a policy provision impermissibly to alter Florida's comprehensive PIP statutory scheme. Section 627.736(5), Florida Statutes (2007), contemplates that an insured can authorize the insurer to pay the provider directly. Details of the payment obligation are closely regulated by the statute. Specifically, section 627.736(6)(b), Florida Statutes (2007), provides an elaborate mechanism for insurers to obtain information from health care providers concerning their treatment and expenses: Every physician, hospital, clinic, or other medical institution pro...

...ts; the majority fails to properly distinguish a condition precedent to recovery or suit that must be complied with by a claimant from a contract obligation that an assignee of benefits must otherwise agree to be bound by; the majority misinterprets section 627.736(6), Florida Statutes (2007), to require State Farm to obtain what is in essence a bill of discovery in order to receive information regarding the validity of a claim from the very person or organization making the claim or seeking pay...

...ent. See State Farm Mut. Auto. Ins. Co. v. Hyma Med. Ctr., Inc., 22 So.3d 699, 700 (Fla. 3d DCA 2009); United Auto. Ins. Co. v. Santa Fe Med. Ctr., 21 So.3d 60 (Fla. 3d DCA 2009) ("[T]he thirty-day period for the payment of PIP benefits contained in section 627.736(4)(b) only applies *341 to the payment of benefits that are reasonable, necessary, and related, and the insurer may contest the claim at any time....

...ely within the meaning of the EUO clause provisions. I believe that had the courts in Marlin and Advanced reviewed the policy provision at issue in the instant case, a different decision would have been rendered. Finally, I reject the assertion that section 627.736(6), Florida Statutes (2007), provides the exclusive means for a No-Fault insurer to obtain pre-suit discovery from a medical care provider who is the claimant. There is nothing in the provisions of section 627.736(6) that suggests insurers are prohibited from conducting an EUO of a medical care provider that is a claimant, and there is nothing in the statute that provides that the statute is the sole and exclusive means by which a No-Fault insurer may obtain the pre-suit information requested in an EUO....

...The majority's reliance on Marlin is once again misplaced. The court in Marlin, after holding that the particular provisions of the EUO clause at issue in that case only applied to the insured, simply recognized that the insurance company could acquire the requested information pursuant to section 627.736(6)(b)....

...t be used to create an ambiguity in the policy provisions. Itnor Corp. v. Markel Int'l Ins. Co., 981 So.2d 661 (Fla. 3d DCA 2008); Winter Garden Ornamental Nursery, Inc. v. Cappleman, 201 So.2d 479 (Fla. 4th DCA 1967). [6] "[Florida Statute section] 627.736(6)(c) has long been construed to empower insurers, upon good cause shown, to petition a court for a bill of discovery permitting the insurer to conduct discovery concerning a person's injuries, wages, medical treatment and costs of treatment." 7 Fla....

...This instruction assumes that the jury will be asked to decide the total amount of medical charges. It is anticipated that the judge will adjust this award in entering judgment to account for any payments previously made by the insurer, as well as for the effect of the 80% limitation in F.S. 627.736(1)(a), and any deductible....

...It is possible that the parties could agree upon a plainer and simpler definition. 3. The statutory description of what constitutes a reasonable amount may require a supplemental instruction for fee-capped diagnostic testing services as described in F.S. 627.736(5)(b) (2003)....

...after October 1, 1993, arising out of the ownership, operation, use, or maintenance of a motor vehicle, in which evidence is presented that personal injury protection benefits have been paid or are payable, instruction 501.8c should be given. See F.S. 627.736(3); Caruso v....

...Before FLETCHER, SHEVIN and SORONDO, JJ. SHEVIN, Judge. Colonial Penn Insurance Company appeals a class certification order. We affirm. Magnetic Imaging Systems I, Ltd. ["Magnetic"], a medical services provider, brought this action seeking statutory interest under section 627.736(4)(c), Florida Statutes (1995), [1] on behalf of itself and other providers and insureds who have received personal injury protection ["PIP"] benefit payments from Colonial Penn, the insurer, beyond the thirty-day period provided in section 627.736(4)(b), but with no added statutory interest....

...This case presents a question of common or general interest to all class members: statutory interest due on late PIP benefit payments. The class members have a similar interest in the relief sought: statutory interest due on late payments. The claims of class members present a common right of recovery under section 627.736(4)(c) based on Colonial Penn's conduct that raises common issues to all members: whether the statutory interest was paid when due....

...It is highly improbable that the class members would have the resources to challenge, individually, Colonial Penn's failure to pay interest under section 637.736(4)(c). Based on the foregoing reasons, and finding that appellant's remaining points lack merit, we affirm certification. Affirmed. NOTES [1] Section 627.736 provides: (4) Benefits; when due.—......

...unty. The county court certified the following question as an issue of great public importance pursuant to section 34.017, Florida Statutes (2010): MAY A PIP INSURER NEVERTHELESS ELECT TO USE THE MEDICARE PART B FEE SCHEDULES SET FORTH IN FLA. STAT. § 627.736(5)(a)(2) WHEN THE SUBJECT PIP POLICY SPECIFIES THAT THE PIP INSURER WILL PAY 80% OF MEDICALLY NECESSARY EXPENSES? This court accepted discretionary review pursuant to Florida Rule of Appellate Procedure 9.030(b)(4)(A)....

...After applying the deductible, Kingsway paid the bills for dates of service from April 16, 2008, through June 26, 2008, at 80% of 200% of the Medicare Part B fee schedule. This amount paid was less than payment at 80% of the billed amount. In making payment, Kingsway relied upon subsection 627.736(5)(a)2., Florida Statutes (2008), which went into effect on January 1, 2008....

...ured person: 1. 80% of medical expenses; .... Medical expenses means those expenses that are required to be reimbursed pursuant to Florida Motor Vehicle No Fault Law, as amended, and that are reasonable expenses for medically necessary ... services. Section 627.736, Florida Statutes (2008), sets out the provisions for "[r]equired personal injury protection benefits" and provides in pertinent part: (1) REQUIRED BENEFITS.—Every insurance policy complying with the security requirements of s....

...bulance, hospital, and nursing services. [2] Expanding on the subsection (1) requirement that the statute requires reimbursement of "reasonable expenses," the 2007 version of the statute provided a framework for the concept of "reasonableness" in subsection 627.736(5)(a): (5) CHARGES FOR TREATMENT OF INJURED PERSONS.— (a)1....

...in the community and various federal and state medical fee schedules applicable to automobile and other insurance coverages, and other information relevant to the reasonableness of the reimbursement for the service, treatment, or supply. In 2007, subsection 627.736(5)(a) was amended [3] to add subsections (5)(a)2....

...ly and unambiguously choose and identify its selected payment methodology. The trial court then reviewed the language in the policy and found that the policy established an agreement to reimburse 80% of medically necessary expenses as provided in subsection 627.736(1)(a) rather than the safe harbor amount found in subsection 627.736(5)(a)2.f., which the policy did not mention....

...Trust, 351 So.2d 14, 16 (Fla.1977)) (alteration in Knowles ) (emphasis removed). We agree with the trial court that these statutes are unambiguous and that their plain language allows an insurer to choose between two different payment calculation methodology options. Significantly, subsection 627.736(5)(a)2. provides that the insurer "may limit reimbursement," language that indicates that this option choice is not mandatory; subsection 627.736(5)(a)5. states "[i]f an insurer limits payment as authorized by subparagraph 2.," language that anticipates that an insurer will make a choice. The applicable policy made no reference to the permissive methodology of subsection 627.736(5)(a)2. The policy cites the No-Fault Act, states it will pay "80% of medical expenses," and defines medical expenses as those that it is required to pay "that are reasonable expenses for medically necessary ... services." That is the language of subsection 627.736(1)(a), which is amplified by subsection 627.736(5)(a)1. The policy does not say it will pay 80% of 200% of Medicare Part B Schedule as provided in subsection 627.736(5)(a)2....

...As in Nichols, the insurance policy in this case expressly states that the insurance company will pay for claims pursuant to a particular methodology (80% of incurred medically necessary expenses). The "reasonable amount" methodology corresponds to the mandatory language contained in § 627.736(1)(a) of the new PIP statute. Because the new PIP statute also states that a PIP insurer may apply the new fee schedule listed in [subsection 627.736(5)(a)2,] this provision is permissive, not mandatory, and the policy language that requires payment in accordance with the reasonable amount methodology specified in [subsection 627.736(1)(a)] is "not in conflict with the [permissive methodology set forth in the new] statute and is [therefore] binding on the parties to the insurance *68 contract." Nichols, 21 So.3d at 905....

...when the insurance policy provides greater coverage than the amount required by statute, the terms of the policy will control. The requirement that a PIP policy specify the applicable payment methodology is consistent with the requirement that a subsection 627.736(5)(d) health insurance claim form and subsection 627.736(10)(b)3....

...Such precision is not possible where the payment calculation methodology is in doubt. Affirmed. HAZOURI and CIKLIN, JJ., concur. NOTES [1] See Ch. 2007-324, §§ 20, 23, Laws of Fla. [2] This statutory language existed prior to and after the amendments to section 627.736 created by Chapter 2007-324. See § 627.736(1), Fla....

...Reserve Ins. Co., 299 So.2d 661 (Fla.App. 1st, 1974), cert. den., 308 So.2d 113 (Fla. 1975), this Court held that personal injury protection benefits paid by an insurer to its insured under the Florida Automobile Reparations Reform Act are reimbursable under § 627.736, F.S....

...665, 666. Appellees Stokeley and Graff, citing White , argue that the same reasoning applies here. Their argument, however, overlooks the significant difference between the two types of benefits: personal injury protection benefits are payable under § 627.736 in amounts determinable irrespective of fault in order to compensate the recipient for losses formerly assessable only against the party at fault; on the other hand, disability benefits payable under § 627.727 are not insurance against al...

...In concluding that Allstate had no duty to furnish PIP benefits to Tindall, the trial court found that "[u]nder the totality of the circumstances in this case as a matter of law, the Defendant's failure to undergo two independent medical examinations was unreasonable." Section 627.736(7)(a), Florida Statutes, expressly requires an injured person claiming PIP benefits to accede to an insurer's request that an independent physical examination be undertaken if the insured's mental or physical condition is "material to...

...rement is to provide the insurance company with an opportunity to evaluate whether the benefits should be paid. Thus, an unreasonable refusal of a claimant to submit to an examination alleviates the insurer of any further liability for PIP benefits. § 627.736(7)(b), Fla....

...Finally, Tindall asserts that the trial judge erred when he denied his motion for summary judgment because, as a matter of law, an eligible insured is entitled to PIP benefits until he unreasonably refuses to undergo independent medical examination. Two statutes, read together, provide some support for Tindall's assertion: Section 627.736(4)(b), Florida Statutes, provides in part: Personal injury protection benefits shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same... . However, any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding that written notice has been furnished to the insurer. Section 627.736(7), provides in part: (a) Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury protection insuran...

...Rudnick, 706 So.2d 389 (Fla. 4th DCA 1998), in which the Fourth District certified conflict with the decision in Kokotis v. DeMarco, 679 So.2d 296 (Fla. 5th DCA 1996), review denied, 689 So.2d 1068 (Fla.1997), on the issue of the definition of the term "payable" found in section 627.736(3), Florida Statutes (1993)....

...d owed at the time of trial, the trial court did not err in refusing to set off the remaining personal injury protection benefits and medpay benefits against the verdict. See id. In Rollins v. Pizzarelli, 761 So.2d 294 (Fla.2000), we held that under section 627.736(3), Florida Statutes (1991), an award for future medical damages should not be reduced by the amount of a plaintiff's remaining PIP benefits....

...Because we have jurisdiction in this case on the basis of a certified conflict, we have the discretion to address this issue. See PK Ventures, Inc. v. Raymond James & Assocs., Inc., 690 So.2d 1296, 1297 n. 2 (Fla.1997). [1] Allstate first maintains that the future medpay benefits are the equivalent of PIP benefits for section 627.736(3) purposes, and therefore must be set off from the verdict as "payable." Because we have determined in Rollins that the term "payable" does not include all remaining PIP benefits that are not currently payable, this argument is unavailing. However, even if we were to read "payable" more expansively, we would conclude that medpay benefits should not be treated as PIP benefits. In rejecting Allstate's argument, we need look no further than the actual language of section 627.736(3), which is limited by its express terms to "personal injury protection benefits." Further, while PIP is a statutorily required coverage, see section 627.736(1), medpay coverage is optional. See § 627.736(4)(f), Fla....

...Swearingen, 590 So.2d 506, 508 (Fla. 4th DCA 1991). In State Farm Mutual Automobile Insurance Co. v. Klinglesmith, 717 So.2d 569, 570 (Fla. 5th DCA 1998), the Fifth District addressed this precise issue: The basis for State Farm's equating medpay benefits with PIP benefits, section 627.736(4)(f), actually demonstrates that medpay benefits are a collateral source. That statute provides that if PIP medical benefits have paid 80 percent of an insured's medical expenses, see section 627.736(1)(a), medpay benefits, "if available in a policy of motor vehicle insurance," must be applied to the remaining 20 percent even if PIP benefits have not been exhausted....

...be applied first, rather than other medical insurance the insured may have. (Citations omitted.) We agree with the Fifth District's reasoning on this issue. We thus conclude that medpay benefits are not the equivalent of PIP benefits for purposes of section 627.736(3)....

...the future. We conclude that the trial court was correct in refusing to set off the remaining medpay benefits against the verdict. Accordingly, we approve the Fourth District's decision in Rudnick based on its interpretation of "payable" as found in section 627.736(3) and its interpretation of "available" within the meaning of section 768.76(1)....

...However, I agree with the majority that medpay benefits are a collateral source to which the general collateral source statute is applicable, and therefore I also agree that medpay benefits are not the equivalent of PIP benefits for the purposes of section 627.736(3), Florida Statutes (1993)....

...on benefits because the Fourth District found the record "insufficient to reverse the trial court's ruling." Allstate Ins. Co. v. Rudnick, 706 So.2d 389, 391 (Fla. 4th DCA 1998); see Bell v. U.S.B. Acquisition Co., 734 So.2d 403, 412 (Fla.1999). [2] Section 627.736(4)(f) provides in part: Medical payments insurance, if available in a policy of motor vehicle insurance, shall pay the portion of any claim for personal injury protection medical benefits which is otherwise covered but is not payable...

...Burch, 724 So.2d 1237 (Fla. 1st DCA 1999), addresses the application of this statute. We decline to address this issue because the basis for our jurisdiction in this case is the certification of conflict with Kokotis regarding the definition of the term "payable" in section 627.736(3), and because there is no conflict among the decisions on the application of section 627.727(1)....

...Section 627.737, Florida Statutes (1975) [3] *216 provides tort exemption for damages due to "bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use" of a motor vehicle only to the extent that the benefits described in Section 627.736 [4] (reasonable medical expenses and lost earnings) are payable....

...missions, is hereby exempted from tort liability for damages because of bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use of such motor vehicle in this state to the extent that the benefits described in s. 627.736(1) are payable for such injury, or would be payable but for any exclusion or deductible authorized by ss....

...uffering, mental anguish, and inconvenience because of bodily injury, sickness, or disease arising out of the ownership, maintenance, operation, or use of such motor vehicle only in the event that the benefits which are payable for such injury under s. 627.736(1)(a) or which would be payable but for any exclusion or deductible authorized by ss....

...Any person receiving ordinary and necessary services normally performed by a nurse from a relative or a member of this household shall be entitled to include the reasonable value of such services in meeting the requirements of this subsection. [4] Section 627.736, Florida Statutes, provides in pertinent part: (1) REQUIRED BENEFITS....

...e legislature's express intent. We question the supreme court's reliance on Rollins v. Pizzarelli, 761 So.2d 294, 300 (Fla.2000), to apply a narrow construction of section 768.76 in Rudnick. See 761 So.2d at 293. Rollins involved the construction of section 627.736(3), Florida Statutes (Supp.1996), which precluded the recovery of damages "for which personal injury protection benefits are paid or payable" from collateral sources and required the jury to be so instructed. The Rollins court did not construe section 768.76. Because it does not appear that section 627.736(3) is also remedial in nature, it was proper to narrowly construe that section....

...denied, 279 So.2d 305 (Fla. 1973). In personal injury protection claims, a party must turn over all medical records concerning a specific condition only after requesting and receiving a copy of medical reports from a medical examination requested by the insurer. § 627.736(7)(b), Fla....

PARIENTE, J. The issue presented to the Court is whether the Medicare fee schedules set forth in section 627.736(5)(a), Florida Statutes (2008), authorized an insurer to limit reimbursements for medical services rendered to an insured without giving notice in the insurance policy of the insurer’s election to use the Medicare fee schedules as the basis for calculating reimbursements....

...estion of great public importance to this Court. 2 *150 We rephrase the certified question 3 as follows: WITH RESPECT TO PIP POLICIES ISSUED AFTER JANUARY 1, 2008, MAY AN INSURER LIMIT REIMBURSEMENTS BASED ON THE MEDICARE FEE SCHEDULES IDENTIFIED IN SECTION 627.736(5)(a), FLORIDA STATUTES, WITHOUT PROVIDING NOTICE IN ITS POLICY OF AN ELECTION TO USE THE MEDICARE FEE SCHEDULES AS THE BASIS FOR CALCULATING REIMBURSEMENTS? We have jurisdiction....

...For the reasons more fully explained below, we agree with all of the appellate court decisions that have addressed this issue, and we therefore answer the rephrased certified question in the negative. We conclude that notice to the insured, through an election in the policy, is necessary because the PIP statute, section 627.736, requires the insurer to pay for “reasonable expenses ... for medically necessary ... services,” § 627.736(l)(a), Fla. Stat., but merely permits the insurer to use the Medicare fee schedules as a basis for limiting reimbursements, see § 627.736(5)(a)2., Fla....

...Because the GEICO policy has since been amended to include an election of the Medicare fee schedules as the method of calculating reimbursements, and the Legislature has now specifically incorporated a notice requirement into the PIP statute, effective July 1, 2012, see § 627.736(5)(a)5., Fla....

...et. In response to the $3600 charges submitted by Virtual Imaging, GEICO paid the bill on December 14, 2008, but limited its reimbursement to eighty percent of 200% of the applicable Medicare fee schedule, in accordance with the formula described in section 627.736(5)(a), Florida Statutes, which provides as follows: 1....

...The insurer may limit reimbursement to 80 percent of the following schedule of maximum charges: [[Image here]] f. For all other medical services, supplies, and care, 200 percent of the allowable amount under the participating physicians schedule of Medicare PartB. § 627.736(5)(a), Fla....

...ty court issued an order granting Virtual Imaging’s motion for final summary judgment and certifying the following question to the Third District: MAY AN INSURER LIMIT PROVIDER REIMBURSEMENT TO 80% OF THE SCHEDULE OF MAXIMUM CHARGES DESCRIBED IN F.S. 627.736(5)(a) IF ITS POLICY DOES NOT MAKE A SPECIFIC ELECTION TO DO SO? On appeal and in reliance on its previous decision in Virtual I, the Third District affirmed the county court’s order....

...The No-Fault Law’s stated purpose is “to provide for medical, surgical, funeral, and disability insurance benefits without regard to fault, and to require motor vehicle insurance securing such benefits.” See § 627.731, Fla. Stat. (2008). The PIP statute, codified in section 627.736, is “an integral part of the no-fault statutory scheme.” Flores v....

...This statutory provision “requires motor vehicle insurance policies issued in Florida to provide PIP benefits for bodily injury ‘arising out of the ownership, maintenance, or use of a motor vehicle.’ ” Holy Cross, 961 So.2d at 332 (quoting § 627.736(1), Fla....

...Co., 774 So.2d 679, 683-84 (Fla.2000) (quoting Gov’t Emps. Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987)). Since its inception in 1971, the PIP statute has required insurers to provide coverage for reasonable expenses for necessary medical services. See § 627.736(l)(a), Fla....

...beginning November 1, 2001, “allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services shall not exceed 175 percent of the allowable amount under Medicare Part B.” § 627.736(5)(b)5., Fla....

...Stat. (2008) (emphasis supplied). For emergency services and care provided by a licensed hospital, for instance, the 2008 amendments provided that an insurer could limit reimbursement to “75 percent of the hospital’s usual and customary charges.” § 627.736(5)(a)2.b., Fla. Stat. (2008). With respect to other medical services and care, such as the MRIs that are the focus of this case, the 2008 amendments provided that an insurer “may limit reimbursement” in accordance with the Medicare fee schedules. See § 627.736(5)(a)2.f., Fla....

...es specified in this paragraph. A policy form approved by the office satisfies this requirement. If a provider submits a charge for an amount less than the amount allowed under subparagraph 1., the insurer may pay the amount of the charge submitted. § 627.736(5)(a)5., Fla....

...cal benefits. — Eighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices, and medically neces *155 sary ambulance, hospital, and nursing services. § 627.736, Fla....

...nd rules adopted thereunder which are in effect at the time such services, supplies, or care is provided. Services, supplies, or care that is not reimbursable under Medicare or workers’ compensation is not required to be reimbursed by the insurer. § 627.736, Fla....

...ayments accepted by the provider involved in the dispute, and reimbursement levels in the community,” as well as “various federal and state medical fee schedules” and “other information relevant to the reasonableness of the reimbursement.” § 627.736(5)(a)l., Fla....

...This provision, adopted in the 2008 amendments, states that an insurer “may limit reimbursement” for certain services rendered, such as MRIs, to “200 percent of the allowable amount under the participating physicians schedule of Medicare Part B.” § 627.736(5)(a)2.f., Fla....

...medical expenses coverage mandate, but did not set forth the only methodology for doing so. The 2008 fee schedule amendments used the word “may” to describe an insurer’s ability to limit reimbursements based on the Medicare fee schedules. See § 627.736(5)(a)2., Fla....

...that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services shall not exceed 175 percent of the allowable amount under the participating physician fee schedule of Medicare Part B.” *157 § 627.736(5)(b)5., Fla....

...insureds as to whether to limit reimbursements based on the Medicare fee schedules or whether to continue to determine the reasonableness of provider charges for necessary medical services rendered to a PIP insured based on the factors enumerated in section 627.736(5)(a)l. In other words, we do not conclude that payment under section 627.736(5)(a)2. could never satisfy the PIP statute’s basic “reasonable expenses” coverage mandate, set forth in section 627.736(1). 8 Instead, what we conclude is that the fee schedule payment calculation methodology in section 627.736(5)(a)2....

...benefits in the insured’s policy— regarding the amount of PIP coverage the insurer will provide. Judge Gross cogently articulated this reasoning in Kingsway as follows: The applicable policy made no reference to the permissive methodology of subsection 627.736(5)(a)2....

...The policy cites the No-Fault Act, states it will pay “80% of medical expenses,” and defines medical expenses as those that it is required to pay “that are reasonable expenses for medically necessary ... services.” That is the language of subsection 627.736(l)(a), which is amplified by subsection 627.736(5)(a)l. The policy does not say it will pay 80% of 200% of Medicare Part B Schedule as provided in subsection 627.736(5)(a)2....

...s of the Florida Motor Vehicle No-Fault Law, as revived and amended by this act. § 627.7407(2), Fla. Stat. (2008). We disagree and adopt the reasoning set forth by the Fourth District in Kingsway. Because the fee schedule provision of sec *159 tion 627.736(5)(a)2.f....

...statute alters the fact that the insurer cannot take advantage of the Medicare fee schedules to limit reimbursements without notifying its insured by electing those fee schedules in its policy. In other words, the Medicare fee schedules set forth in section 627.736(5)(a)2. provide an option for insurers, not the method of how the insurer exercises this option. In order to exercise the option, the insurer must provide notice in the policy of its election to use the fee schedules. Subsection 5 of section 627.736(5)(a), Florida Statutes (2008), further supports this conclusion....

..., or care may not bill or attempt to collect from the insured any amount in excess of such limits, except for amounts that are not covered by the insured’s personal injury protection coverage due to the coinsurance amount or maximum policy limits. § 627.736(5)(a)5., Fla....

...to describe an insurer’s ability to limit reimbursements in accordance with the Medicare fee schedules indicates that an insurer is not required to use those schedules. As the Fourth District explained in Kingsway, 63 So.3d at 67 , the language in section 627.736(5)(a)5....

...Pete, Inc. (a health care services provider). . The question certified by the Third District was as follows: WITH RESPECT TO PIP POLICIES ISSUED AFTER JANUARY 1, 2008, MAY THE INSURER COMPUTE PROVIDER REIMBURSEMENTS BASED ON THE FEE SCHEDULES IDENTIFIED IN SECTION 627.736(5)(a), FLORIDA STATUTES, *150 EVEN IF THE POLICY DOES NOT CONTAIN A PROVISION SPECIFICALLY ELECTING THOSE SCHEDULES RATHER THAN "REASONABLE MEDICAL EXPENSES” COVERAGE BASED ON SECTION 627.736(l)(a)? Virtual II, 90 So.3d at 324 ....

...ical expenses" coverage, as the question certified by the Third District frames the issue, but whether the insurer can use the Medicare fee schedules as a method for calculating the "reasonable medical expenses” coverage the insurer is required by section 627.736 to provide, when the policy does not provide notice of the insurer’s election to use the fee schedules. . See ch.2012-197, § 10, Laws of Fla. . The Legislature subsequently amended section 627.736(5)(a)2.f....

...limit reimbursement according to the parameters of subsection (5)(a)(2).” Although we agree that there are two payment methodologies for satisfying the PIP statute’s coverage mandate, we emphasize that we do not conclude that limiting reimbursement pursuant to section 627.736(5)(a)2....

...al's decision in Nationwide Mutual Fire Insurance Co. v. Central Florida Physiatrists, P.A., 851 So.2d 762 (Fla. 5th DCA 2003) ( CFP ). [1] The conflict issue is whether a personal injury protection (PIP) insurer must comply with the requirements of section 627.736(10), Florida Statutes (2006), in order to pay PIP benefits based on a reduced rate that a medical provider contractually agreed to accept. The Fourth District aligned itself with the Second District Court of Appeal's decision in Nationwide Mutual Insurance Co. v. Jewell, 862 So.2d 79 (Fla. 2d DCA 2003), which concluded that compliance with section 627.736(10) is not a prerequisite to the payment of PIP benefits at reduced rates that the medical provider contractually agreed to accept....

...ot contracted directly with any health care provider, Allstate could not take advantage of any reduced rates and was required to pay eighty percent of all reasonable medical expenses, i.e., eighty percent of the full bill as charged, as set forth in section 627.736(1)(a), Florida Statutes (2006)....

...hich at that time was the only appellate court to have addressed the issue. [3] The county court also certified the following question as one of great public importance to the Fourth District: "Is an insurer required to comply with the provisions of section 627.736(10), Fla....

...Holy Cross and Allstate, and certified conflict with CFP. See Holy Cross, 895 So.2d at 1244-45. We accepted jurisdiction to resolve the conflict. ANALYSIS The issue we decide is whether an automobile PIP insurer must comply with the requirements of section 627.736(10) in order to pay PIP benefits based on a reduced rate that a medical provider contractually agreed to accept....

...rd to fault"). The No-Fault Law mandates security that can be established by alternative means, one of which is PIP insurance. See § 627.733, Fla. Stat. (2006). The "Required Personal Injury Protection" provision, or the PIP statute, is codified at section 627.736 and is "an integral part of the no-fault statutory scheme." Flores v. Allstate Ins. Co., 819 So.2d 740, 744 (Fla.2002). The statute requires motor vehicle insurance policies issued in Florida to provide PIP benefits for bodily injury "arising out of the ownership, maintenance, or use of a motor vehicle." § 627.736(1), Fla....

...As to medical benefits, which are the subject of this case, insurers must pay "[e]ighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including . . . medically necessary ambulance, hospital, and nursing services." § 627.736(1)(a), Fla. Stat. (emphasis supplied). PIP insurers are required to comply with subsection (1) and cover all medically necessary medical expenses at that percentage, unless one of the specific exclusions set forth in subsection (2) applies. See § 627.736(2), Fla. Stat (2006). Subsections (4) and (5) set forth strict guidelines for both PIP insurers and medical providers, including how and when charges must be submitted and benefits paid. See § 627.736(4)-(5), Fla....

...by [PIP] insurance may charge the insurer and injured party only a reasonable amount pursuant to this section. . . . In no event, however, may such a charge be in excess of the amount the person or institution customarily charges for like services." § 627.736(5)(a), Fla....

...As is evident from the language of subsection (10), the 1992 amendments authorized insurers to issue PPO policies in the context of PIP insurance. [5] Subsection (10) is the sole avenue by which insurers can modify the standard PIP policy as outlined in section 627.736 and when such policies are offered, the insurers clearly must comply with the statutory mandates of subsection (10)....

...Under subsection (10), if an insured purchases a PPO policy and chooses to use a preferred provider, then the PIP insurer may "pay medical benefits in excess of the benefits required [by statute] and may waive or lower the amount of any deductible that applies to such medical benefits." § 627.736(10), Fla....

...This provision allows PIP insurers to enter into contracts with preferred providers, issue PPO policies, and, most importantly, increase the "medical benefits in excess of the benefits required by this section" and "waive or lower the amount of any deductible that applies to such benefits." § 627.736(10), Fla. Stat. However, where the insurer is neither issuing PPO policies nor attempting to modify the standard PIP insurance policy as set forth in section 627.736, we conclude that there is nothing in the language of the statute that requires an insurer to comply with subsection (10)....

...That sentence states that "[a]n insurer may negotiate and enter into contracts with licensed health care providers for the benefits described in this section, referred to in this section as `preferred providers,' which shall include health care providers licensed under chapters 458, 459, 460, 461, and 463." § 627.736(10), Fla....

...ng the types of contractual relationships that Allstate allegedly negotiated in this case. We reject Holy Cross's argument in the alternative that a payment which is eighty percent of a contractually agreed-upon reduced rate is a per se violation of section 627.736....

...ract with a provider to create an agreed-upon fee schedule for reduced rates. See Jewell, 862 So.2d at 83. Second, payment at a reduced rate does not violate subsection (1)(a) so long as the insurer pays "eighty percent of all reasonable expenses. " § 627.736(1)(a), Fla. Stat. (emphasis supplied). What a provider customarily charges or has previously accepted are important factors for determining whether a fee is reasonable. See § 627.736(5)(a), Fla....

...Jewell, 862 So.2d at 86. Accordingly, "[i]f a provider has agreed in a valid and enforceable contract to accept payment for services at a particular rate, that rate would necessarily be a `reasonable amount for the services . . . rendered.'" Id. (quoting § 627.736(5)(a), Fla....

...nsured to use preferred providers, engaged in actions to the detriment of its insureds, or otherwise violated the statutory scheme. [6] CONCLUSION Based on the foregoing analysis, we conclude that an insurer, which neither violates the provisions of section 627.736 nor otherwise attempts to modify its responsibilities under the standard PIP policy, is not required to comply with the requirements of section 627.736(10) in order to pay PIP benefits based on a reduced rate that a medical provider contractually agreed to accept....

...fits set forth in the PIP statute. A PIP insurer that merely enters into a contract with a preferred provider to create an agreed-upon fee schedule for medical services and does not issue PPO policies or amend the standard PIP policy requirements in section 627.736 may do so without complying with the requirements of subsection (10)....

...We disagree with Perez and hold that the thirty-day period for payment in the PIP statute applies only to bills for treatment which is reasonable and necessarily incurred as a result of the accident. Inaction by the insurer does not result in the insurer having to pay a bill which it otherwise would not have to pay. In section 627.736(1)(a), Florida Statutes (1999), medical benefits are defined as follows: (a) Medical benefits. —Eighty percent of all reasonable expenses for necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices, and necessary ambulance, hospital, and nursing services. [emphasis added.] Section 627.736(1) requires insurers to provide these benefits for injury, etc. "arising out of the ownership, maintenance, or use of a motor vehicle." Further on, section 627.736(4), the subsection involved in Perez and this case, provides in part: BENEFITS; WHEN DUE— Benefits due from an insurer ......

...The fifth district reversed the summary judgment in favor of the insurer, finding issues of fact, but made it clear that the insurer did not "lose its right to contest the claim." In Fortune Insurance Co. v. Everglades Diagnostics, Inc., 721 So.2d 384, 385 (Fla. 4th DCA 1998), this court considered the provisions of section 627.736(4)(b) and (c) in determining whether the thirty-day overdue provision applied to demands for arbitration under section 627.736(5)....

...We construed subsection (4)(b) and (c) as "merely" making the insurer liable for interest if payment is not made within 30 days from the notice. We observed that: "the function of the statute is to define when interest begins to accrue on unpaid PIP benefits." Id. at 385. We conclude that the thirty-day period in section 627.736(4) applies only to benefits which are reasonable and necessary as a result of the accident. Section 627.736(4), Florida Statutes begins with the words "benefits due" and states in subsection (b) that "personal injury protection benefits paid pursuant to this section shall be overdue if not paid within thirty days." If an insured submits a b...

...sue: "an insurer is not liable for any medical expense to the extent that it is not a reasonable charge for a particular service or if the service is not necessary." Derius v. Allstate Indem. Co., 723 So.2d 271, 272 (Fla. 4th DCA 1998). We interpret section 627.736(4) to mean that if PIP benefits are payable, they are due within thirty days after notice....

...Every policy is required to provide for "binding arbitration of any claims dispute involving medical benefits arising between the insurer and any person providing medical services or supplies if that person has agreed to accept assignment of personal injury protection benefits." § 627.736(5), Fla.Stat....

...We hold that the interest claim is arbitrable, pursuant to the recent opinion of this court rendered in the case of U.S. Security Ins. Co. v. Magnetic Imaging Sys., 678 So.2d 872 (Fla. 3d DCA 1996)(holding that a statutory interest claim for late payment under section 627.736(4)(b)(c), Florida Statutes, is arbitrable to the same extent as any other portion of the claims dispute involving medical benefits)....

...insurer and any person providing medical services or supplies if that person has agreed to accept assignment of personal injury protection benefits. The provision shall specify that the provisions of chapter 682 relating to arbitration shall apply. § 627.736(5), Fla.Stat. (1995). It is clear that section 627.736(5) applies to Magnetic and Orion....

...As set forth above, Magnetic's suit for interest due to allegedly late payment of claims is a "claims dispute involving medical benefits." In addition, this claim arises between Orion, the "insurer," and Magnetic, a "person providing medical services." The scenario in this case is precisely what section 627.736(5), Florida Statutes (1995) anticipates....

..."[O]nce a medical provider receives *477 an assignment of benefits from an insured, disputed medical claims between the provider and the insurance company must be resolved by binding arbitration." State Farm Mut. Automobile Ins. Co. v. Gonnella, 677 So.2d 1355 (Fla. 5th DCA 1996). Magnetic concedes in its brief that section 627.736(5) of the Florida Statutes requires that insurance policies for personal injury protection benefits include a provision for arbitration between the medical service provider and the insurance company, but Magnetic contends that the statute does not specifically require arbitration per se. We refuse to hold that the Legislature intended to require specific language in insurance policies which would have no effect or meaning. "The legislative intent is clear. Section 627.736(5) requires arbitration to resolve disputes involving medical benefits." State Farm v. Gonnella, 677 So.2d 1355, 1356 (Fla. 5th DCA 1996). Arbitration is mandatory pursuant to section 627.736(5) even in the event that the insurance policy between the insured and the insurance company does not include an arbitration provision with regard to the medical provider....

...citations omitted). [2] Although arbitration can be waived, or be deemed to have been waived, depending on the facts of a particular case, nothing contained within the record herein suggests such a waiver. Magnetic attempts to escape the dictates of section 627.736(5) by challenging the constitutionality of that statute....

...and the No-Fault scheme may be avoided by refusing to do so. Third, the statutory No-Fault regime provides medical service providers like Magnetic with the ability to collect via assignment statutorily mandated PIP insurance benefits. In this view, Section 627.736(5) creates new rights and may not be challenged as taking away any existing rights which predate the state constitution....

...ellant's motion to compel arbitration. NOTES [1] The Florida Vehicle No-Fault Law also requires that automobile insurance carriers pay personal injury protection claims within thirty days of the date that the carrier is notified of the covered loss. § 627.736(4)(b), Fla.Stat. (1995). If the claim is overdue, the overdue amount bears interest at the rate of ten percent per year. § 627.736(4)(c), Fla.Stat....

...We agree that the issue is one of great public import and therefore have en banced this case to settle the law in this district; in so doing, we align ourselves with the First and Fourth districts. The Dade County Court certified the following question: WHETHER § 627.736(4)(B), FLA....

...accident report as specified in Chapter 316 of Florida Statutes; and c) all medical expenses incurred as a result of the accident and all supporting medical records. (Emphasis added.) The trial court entered summary judgment for Pacheco; we affirm. Section 627.736(4), Florida Statutes (1993), provides that PIP benefits "shall be due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered by the policy." (Emphasis...

...By so defining the term, Fortune sought to determine when the thirty-day period to pay the claim would begin to run, and thus circumvent long-established case law that once an insurer receives notice of a loss and medical expenses, it must pay within thirty days, unless, pursuant to section 627.736(4)(b), it has obtained reasonable proof to believe that it is not responsible for the payment....

...SCHWARTZ, C.J., and LEVY, GERSTEN, GODERICH, GREEN, SHEVIN and SORONDO, JJ., concur. COPE, J., specially concurs. COPE, Judge (specially concurring). In my view, the insurer is allowed to include within its insurance policy a definition of the statutory term "reasonable proof of such loss." § 627.736(4), Fla. Stat. (1993). Further, in deciding what is "reasonable" proof of loss, the insurer may consider the fact that benefits must be paid within thirty days after submission of the completed claim. See Id. § 627.736(4)(b)....

...hat a review of medical records is unnecessary in many, or even most, cases. That being so, requiring the submission of complete medical records in all cases is unreasonable, and goes beyond the statutory phrase, "reasonable proof of such loss." Id. § 627.736(4)....

...McAliley of Brennan, McAliley, Hayskar, McAliley & Jefferson, P.A., West Palm Beach, for appellee. DELL, Judge. Margarita Palma appeals from a decision of the trial court which declared that thermographic examinations do not constitute necessary medical services under the Florida No-Fault Act, section 627.736(1), Florida Statutes (1983)....

...declaratory relief as follows: The action for declaratory relief asked the Court to declare that thermographic examinations in musculoskeletal injuries and nerve root impingement were not necessary medical treatment as defined under Florida Statute 627.736 (Personal Injury Protection) and, therefore, were not reimbursable to the plaintiff, or any plaintiff, under her PIP coverage in the insurance policy issued by State Farm. The policy language tracked F.S. 627.736....

...es" instead of construing it broadly in her favor. She argues that the evidence established that the thermographic examinations performed in her case constituted a necessary medical service, and therefore she is entitled to reimbursement pursuant to section 627.736....

...lue in the diagnosis of musculoskeletal disease or nerve root impingement, and therefore do not constitute necessary medical services. The issue for our determination is whether thermographic examinations constitute a necessary medical service under section 627.736 which provides: (1) REQUIRED BENEFITS....

..." the trial court looked to the Workers Compensation Act, section 440.13, Florida Statutes (1983) and adopted three parts of the definition contained therein. The trial court concluded that a "medically necessary" diagnostic study as contemplated by section 627.736(1) must: 1....

...The broad scope of the medical services covered by the No-Fault Act is highlighted by the inclusion of benefits for remedial treatment and services for an injured person who relies upon spiritual means through prayer alone for healing in accordance with his religious beliefs. § 627.736(1)(a)....

...missions, is hereby exempted from tort liability for damages because of bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use of such motor vehicle in this state to the extent that the benefits described in s. 627.736(1) are payable for such injury, or would be payable but for any exclusion authorized by ss....

...Worthy, 447 So.2d 998, 1001 (Fla. 5th DCA 1984), in which that court said that section 627.737(1) exempts "a tortfeasor from tort liability for damages because of bodily injury caused by a motor vehicle only `to the extent that benefits described in section 627.736(1) are payable for such injury, or would be payable but for any [authorized] exclusion.'" That court, as well as the Fourth District Court of Appeal, has also held that, although the exemption applies where there is coverage, the tortfeasor is liable only for medical expenses not payable under the PIP coverage....

...The majority's further attempt to distinguish Purdy by stating that it related only to a discussion of the collateral source rule, contained in section 627.7372, is equally unpersuasive. This is so because it is clear that the PIP coverage encompassed by section 627.736, and at issue in the instant case, is one of the enumerated collateral sources encompassed by the rule....

...For the reasons stated above I find Purdy and Matthews controlling and would affirm the analysis and decision below. BARKETT, C.J., and SHAW, J., concur. NOTES [1] We have jurisdiction. Art. V, § 3(b)(4), Fla. Const. [2] In accordance with sections 627.737(1) and 627.736(1), the Riveros should recover 80% of all their reasonable medical expenses from their own PIP carrier....

...laintiff in the eye. Claim was made for PIP benefits under the policy covering the minor plaintiff's father's vehicle. The sole question on this appeal is whether the loss sustained arose out of the ownership, maintenance, or use of a motor vehicle. Section 627.736(1), Florida Statutes (1977). Appellees attempt to sustain the summary judgment on the basis of Section 627.736(4)(d) 1 & 3 which require payment of PIP benefits by the insurer for accidental bodily injury sustained by the owner (or a relative of the owner residing in the same household) while occupying a motor vehicle....

...eview by interlocutory appeal of an order entered on a petition for equitable distribution determining payment to plaintiffs' personal injury protection insurance carrier, Leatherby Insurance Company, under Florida Automobile Reparations Reform Act, Section 627.736, Florida Statutes 1971, F.S.A....

...$1,412.80, which constituted all the personal injury protection benefits it paid the plaintiffs with no proration whatsoever. Pertinent parts of the trial court's order on petition for equitable distribution appear as follows: "The Court finds that Section 627.736(3)(a) provides for subtraction by the insurer before payment, or repayment to the insurer after payment, of the full amount of PIP benefits due or paid the insured, less the insured's attorney's fees and expenses, where the amount of the tort recovery exceeds, exclusive of attorney's fees and expenses, the amount of benefits paid or payable." The trial court interpreted Section 627.736(3)(a), Florida Statutes, F.S.A., to foreclose "equitable distribution" where the plaintiff (the insured under the no-fault policy) settled the tort claim for an amount, exclusive of attorneys' fees and costs, in excess of the dollar amount of no-fault benefits paid. In such circumstances the trial court determined that the carrier is entitled to reimbursement of one hundred per-cent on the dollar out of settlement proceeds. The trial court further determined that § 627.736(3)(b), Florida Statutes, F.S.A., *41 provided for equitable distribution only where the net recovery was less than the no-fault benefits paid. We conclude that the trial court was in error. The applicable sections of F.S. 627.736, F.S.A....

...herefor and notice to the carrier." (Emphasis supplied.) In State Farm Automobile Insurance Co. v. Hauser, 281 So.2d 563 (Fla.App. 1973), our sister court of the third district made the following determination at page 565: "Paragraphs (a) and (b) of § 627.736(3) Fla....

...(less the prorata share of costs), with provision for the `probation of the reimbursement' to be made `by the judge of a trial court handling the suit to recover.'" We agree with our sister court of the third district that paragraphs (a) and (b) of § 627.736(3), F.S.A., resist reconciliation....

...City of St. Petersburg v. Pinellas County Power Co., 87 Fla. 315, 100 So. 509, 510 (1924). Thus the insurer's rights of reimbursement shall be based upon equitable distribution in accordance with paragraph (b). The equitable distribution provisions of § 627.736(3)(b), Florida Statutes, F.S.A., are taken almost verbatim from the equitable distribution provisions of § 440.39(3)(a), Florida Statutes, F.S.A., the Workmen's Compensation Statute....

...accident and total damages amounting to $19,647.71 ($6,247.71 in past medical expenses; $8,400 in future medical expenses; $2,500 for past pain and suffering; and $2,500 for future pain and suffering). The parties agreed at pretrial that pursuant to section 627.736(3), Florida Statutes (2003), the defendant was entitled to a setoff for "damages for which personal injury protection benefits are paid or payable" to the plaintiff, which would be implemented by the trial judge after the jury returned a verdict....

...This Court accepted jurisdiction on the basis of conflict with Assi. [2] ANALYSIS The issue raised in this case involves the calculation of damages when a plaintiff has received PIP benefits but is also comparatively negligent. Thus, we consider the PIP statute and the comparative negligence statute. Section 627.736(3) addresses how recovery in tort claims is to be impacted by an insured plaintiff's receipt of PIP benefits....

...ts paid or payable. In all cases in which a jury is required to fix damages, the court shall instruct the jury that the plaintiff shall not recover such special damages for personal injury protection benefits paid or payable. (Emphasis added.) Thus, section 627.736(3) dictates that an insured plaintiff has "no right to recover" damages paid or payable by PIP benefits....

...(Emphasis added.) A plain reading of section 768.81(2) is that "the amount awarded as economic and noneconomic damages" to the plaintiff is what is to be reduced by the percentage of the plaintiff's comparative fault. Reading these statutes in conjunction, [5] we find that pursuant to section 627.736(3), which bars all recovery of damages paid or payable by PIP benefits, the amount for which PIP benefits have been paid or payable is to be deducted by the trier of fact [6] from the amount awarded as economic damages in the verdict....

...[2] The petitioner alleged in his jurisdictional brief to this Court that conflict exists between the decision below and this Court's decision in Rollins. However, this Court did not accept jurisdiction on that basis because Rollins addressed the issue of whether section 627.736 was properly construed as including only those PIP benefits already paid or also unused benefits believed to be available....

...Law] ... is hereby exempted from tort liability for damages because of bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use of such motor vehicle in this state to the extent that the benefits described in s. 627.736(1) are payable for such injury ......

...of indemnity and provides in pertinent part that in any negligence action the court shall reduce the amount of damages awarded "by the total of all amounts which have been paid for the benefit of the claimant... from all collateral sources." Because section 627.736(3) more specifically addresses PIP benefits, it controls the present case. [5] We find it unnecessary to look to the legislative history of section 627.736 for resolution of this case; rather, we apply a plain meaning reading of these two statutes. [6] See Caruso v. Baumle, No. SC03-127, 880 So.2d 540 at 544, 2004 WL 1403170 (Fla. June 24, 2004) (holding that trier of fact, whether judge or jury, is to offset collateral source amount under section 627.736(3))....

...personal injury protection coverage for material misrepresentation; [and] as such, Defendant's common law right to rescind personal injury *598 protection coverage is abrogated by the Florida Statutes." The trial court further reasoned that, because section 627.736(9)(a), Florida Statutes (2003), mandated United to report cancellation or nonrenewal of PIP coverage to the Department of Highway Safety Motor Vehicles within forty-five days from the effective date of cancellation or non-renewal, Uni...

...As such, we conclude that an insurer's failure to rescind a policy in accordance with statutory cancellation procedures does not preclude or abrogate an insurer's ability to void the policy ab initio pursuant to section 627.409. VI. APPLICATION OF SECTION 627.736(9)(a) We turn now to Salgado's argument that section 627.736(9)(a) abrogates an insurer's right to rescission....

...t of Highway Safety and Motor Vehicles within 45 days from the effective date of the renewal, cancellation, or nonrenewal. *603 Based on the plain and unambiguous language of this section, we find Salgado's argument unpersuasive. First, we find that section 627.736(9)(a) applies only to "renewal[s], cancellation[s] or nonrenewal[s]." While section 627.728(1)(b) defines the term "renewal," [6] which is not applicable in this case, the term "cancellation" is undefined by chapter 627....

...that between divorce and annulment. 2 Lee R. Russ & Thomas F. Segalla, Couch on Insurance § 30:3 (3d ed. 1995). Because "the effect of a rescission is to render the contract abrogated and of no force and effect from the beginning," we conclude that section 627.736(9)(a) does not apply where—as here—the policy was rescinded as opposed to cancelled....

...notice of cancellation accompanied by the reason therefore shall be given. No notice of cancellation of a policy to which this section applies shall be effective unless the reason or reasons for cancellation accompany the notice of cancellation. [5] Section 627.736(9) was amended in 2007 and moved to section 324.0221, Florida Statutes (2008)....

...ompelled transaction. We suspect that in exercising its police powers to dictate state-imposed commerce, the legislature would carefully craft a set of laws to be applied in carrying out its mandate, as it has in other insurance contexts. See, e.g., § 627.736, Fla....

...Miller was not one of the doctors listed in Garcia's letter. On that same date, Allstate wrote Graham reserving the right to deny coverage under the PIP policy reciting the language in the Allstate policy that essentially follows the relevant portion of section 627.736(7)(b), Florida Statutes (1985)....

...ounsel. The trial court entered a final summary judgment in favor of Graham on the issue of liability and a subsequent final judgment awarding Graham specified amounts for unpaid medical expenses and lost wages, as well as attorney's fees and costs. Section 627.736(7), Florida Statutes (1985), as did Graham's insurance policy, clearly provided for physical examination by a physician if Graham was claiming PIP benefits under her policy. Section 627.736(7)(b) states in part: "[I]f a person unreasonably refuses to submit to an examination, the personal injury protection carrier is no longer liable for subsequent personal injury protection benefits." The trial court erred in ruling the refusal of Graham to submit to an IME was reasonable based upon the advice of her attorney. As this court stated in Tindall v. Allstate Ins. Co., 472 So.2d 1291 (Fla. 2d DCA 1985), review denied, 484 So.2d 10 (1986): Section 627.736(7)(a), Florida Statutes, expressly requires an injured person claiming PIP benefits to accede to an insurer's request that an independent physical examination be undertaken if the insured's mental or physical condition is "material to...

...rement is to provide the insurance company with an opportunity to evaluate whether the benefits should be paid. Thus, an unreasonable refusal of a claimant to submit to an examination alleviates the insurer of any further liability for PIP benefits. § 627.736(7)(b), Fla....

...therefore, it had not yet breached any contractual obligation to the plaintiff. In addition, in the Fladd case, as in the case at bar, the manner in which payments under the policy were to be made was governed by the Florida Statutes. See FLA.STAT. § 627.736(4)(b) and FLA.STAT....

...The court entered a final judgment in favor of Carlson in the amount of $3,024.77, the difference between the verdict of $10,543.05 and the net setoff of $7,518.28. The court denied McKenna's motion for attorney fees and her motion to tax costs. In considering the setoff issue the initial question is whether section 627.736(3), [2] Florida Statutes (dealing with setoff of PIP benefits which are "paid or payable") or section 768.76, Florida Statutes, the collateral source rule, applies to the setoff of PIP benefits. Rollins v. Pizzarelli, 761 So.2d 294 (Fla.2000) holds that section 627.736(3) applies to the setoff of PIP benefits....

...Likewise, the amount of PIP benefits actually paid (or submitted and *558 pending payment) were properly ordered set off. The purpose of such setoff is to prevent a plaintiff from obtaining a double recovery, i.e., receiving as damages sums for which PIP benefits were paid. § 627.736(3), Fla....

...ently payable or owed by the PIP carrier as a result of expenses incurred by the plaintiff should be set off from a verdict that, as here, includes an award of future medical expenses. Rollins thus rejects the view that the term "payable" as used in section 627.736(3), includes all remaining PIP benefits that are not currently payable....

...on behalf of the claimant or members of his immediate family to secure his right to any collateral source benefit which he is receiving as a result of his injury. [Emphasis supplied]. McKenna argues that subsection 768.76(1) does not apply and that section 627.736, which is the applicable statute, does not provide for a reduction from any setoff for automobile insurance premiums....

...The issue presented for review is whether an injury sustained by an insured while alighting from an insured motor vehicle is a "bodily injury ... arising out of the ownership, maintenance, or use of a motor vehicle" to which the insured is entitled to personal injury protection benefits under Section 627.736(1), Florida Statutes (Supp. 1976), of the Florida Automobile Reparations Reform Act. We hold that such an injury arises out of the use of such a motor vehicle for which the insured is entitled to personal injury protection benefits under Section 627.736(1), Florida Statutes (Supp....

...opedic surgeon. Insured saw the internist as scheduled; however, her attorney notified GEICO that she would not submit to the I.M.E. by the orthopedic surgeon. Thereafter, insured's counsel sent a letter to GEICO [1] stating her position that, under section 627.736(7)(a), Florida Statutes (1987), [2] the medical examination was to be conducted by a physician "under the same licensing chapter as the treating physician whose treating authorization is sought to be withdrawn." Insured, at the time, was under the care of an internist and a chiropractor....

...*103 Considering insured's actions and the clear language of the instant policy, we conclude that the insurer was entitled to the summary judgment ordered in its favor. The requested I.M.E. was in no way unreasonable in terms of location, frequency, or type of examination requested. The limitation imposed by the amendment to section 627.736(7)(a), relied upon by insured's counsel, clearly related only to the type of physician whose report could be used to terminate benefits and placed no limitation on the type of physician an insurer could reasonably choose to perform an I.M.E....

...For the foregoing reasons, the summary judgment is affirmed. NOTES [1] That letter stated: Dear [GEICO representative], Your request for an examination with an orthopedic surgeon is unreasonable in light of the fact that Mrs. De Ferrari has never been examined or treated by an orthopedic surgeon. Section 627.736(7)(a) F.S., specifically states that I.M.E....

...at my position is incorrect, we will gladly submit to an I.M.E. by an orthopedic. Until such time as you can cite such language or case law, we consider the I.M.E. with the orthopedic to be null and void. Very truly yours, [De Ferrari's counsel] [2] Section 627.736(7), Florida Statutes (1987) provided: (a) Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury pr...

...Allstate cannot legally, moreover, diminish [2] the extent of its PIP and medpay undertakings by adding or amending policy provisions. See generally Young v. Progressive Southeastern Ins. Co., 753 So.2d 80 (Fla.2000) (holding uninsured motorist policies must conform [3] to statutory requirements). Section 627.736(4), Florida Statutes (1997) makes PIP and medpay benefits "due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered by the policy." As the Ivey court...

...ed insured may get on with his life without undue financial interruption.' Government Employees Ins. Co. v. Gonzalez, 512 So.2d 269, 271 (Fla. 3d DCA 1987)(citing Comeau v. Safeco Ins. Co., 356 So.2d 790 (Fla. 1978))." Ivey, 774 So.2d at 683-84. See § 627.736(4)(b), Fla....

...period. To rule otherwise would render the recently enacted "nofault" insurance statute a "no-pay" plan—a result we are sure was not intended by the legislature. Dunmore v. Interstate Fire Ins. Co., 301 So.2d 502, 502 (Fla. 1st DCA 1974). See also § 627.736(4)(f), Fla....

...ng they were properly due, [5] State Farm had effectively breached their contract with [the Lees]."). While "payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment," § 627.736(4)(b), Fla....

...fails to conform to the requirements of sections 627.730-7405, Florida Statutes (1997), or of article I, section 21 of the Florida Constitution. See generally Nationwide Mut. Fire Ins. Co. v. Pinnacle Med., 753 So.2d 55, 59 (Fla.2000) (holding that section 627.736(5), Florida Statutes (1995), "denies medical providers access to courts" and "arbitrarily distinguishes between medical providers and insureds").

...e, a procedural rule, or a constitutional provision may be the basis for granting certiorari review." Kaklamanos, 843 So.2d at 890. Because we conclude that: (1) the circuit court [appellate division] has incorrectly interpreted and applied sections 627.736(4)(b) and 627.736(7)(a), Florida Statutes (2003); (2) the circuit court's interpretation and application of sections 627.736(6)(4)(b) and 627.736(7)(a) are a departure from the essential requirements of law; and (3) the "circuit court's decision establishes a rule of general application" for future county court cases, "thus exacerbating the effect of the [circuit court appellate panel's] legal error," Progressive Express Ins....

...Chiropractic, 913 So.2d 1281, 1287 (Fla. 2d DCA 2005), we grant certiorari review. See also Gould v. State, 974 So.2d 441 (Fla. 2d DCA 2007); State Farm Fla. Ins. Co. v. Lorenzo, 969 So.2d 393, 398 (Fla. 5th DCA 2007). ANALYSIS Our analysis involves the application of two subsections of section 627.736—subsections (4)(b) and (7)(a)....

...Subsection (4)(b) pertains to circumstances where "the insurer has either reduced, omitted, or declined" payment of PIP claims that are reasonable, necessary, and related, whereas subsection (7)(a) sets forth the necessary requirements that an insurer must satisfy before it may withdraw future PIP benefits. A. Application of section 627.736(4)(b): The circuit court's failure to consider Dr....

...The circuit court agreed with the trial court, finding that because Dr. Millheiser's affidavit was obtained more than thirty days after Santa Fe submitted its claim to United Auto, it was untimely. The trial court and the circuit court's findings are based upon an incorrect interpretation of section 627.736(4)(b)....

...rmitted under, or in violation of, subsection (5). Such assertion by the insurer may be made at any time, including after payment of the claim or after the 30-day time period for payment set forth in this paragraph. (Emphasis added). The language of section 627.736(4)(b) is clear and unambiguous. Section 627.736(4)(b) imposes on the insurer a thirty-day time period in which to pay PIP benefits, if the claim is reasonable, related, and necessary....

...Under subsection (4)(b), a claim is due within the thirty-day period only if it is reasonable, related, and necessary. The statutory penalty for failing to pay a claim that is later determined to have been reasonable, related, and necessary, is an assessment of interest against the insurer, see § 627.736(4)(d), and potentially an award of attorney's fees, see § 627.736(8)....

...er the thirty-day period, that the treatment was not reasonable, necessary, or related. See United Auto. Ins. Co. v. Millennium Diagnostic Imaging Ctr., Inc., 12 So.3d 242, 246 (Fla. 3d DCA 2009) (finding that the thirty-day time period set forth in section 627.736(4)(b) applies to the payment of claims that are necessary, reasonable, and related, and the failure to contest a claim within this thirty-day period does not serve to forever bar a contest to the claim); Bermudez, 980 So.2d 1213, 1216-17 (Fla. 3d DCA 2008) (concluding that "section 627.736(4) ... deals with timing as to when PIP benefits that are properly due must be paid by an insurer before they are considered overdue.... [S]ection 627.736(4) expressly provides that `[t]his paragraph does not preclude or limit the ability of the insurer to assert that the claim was unrelated, was not medically necessary, or was unreasonable'"); AIU Ins. Co. v. Daidone, 760 So.2d 1110, 1112 (Fla. 4th DCA 2000) (holding "that the thirty-day period in section 627.736(4) applies to benefits which are reasonable and necessary as a result of the accident"). Because the thirty-day period for the payment of PIP benefits contained in section 627.736(4)(b) only applies to the payment of benefits that are reasonable, necessary, and related, and the insurer may contest the claim at any time, we conclude that the trial court departed from the essential requirements of the law in refusing to consider Dr. Millheiser's affidavit when ruling on Santa Fe's motion for summary judgment, even though it was generated more than thirty days after Santa Fe submitted the PIP claim. *65 B. Application of section 627.736(7)(a): The circuit court's failure to consider Dr....

...ted Auto was required to obtain a "valid report" before it could deny payment. The circuit court agreed with the trial court's refusal to consider Dr. Millheiser's affidavit because the affidavit did not constitute a "valid report" as required under section 627.736(7)(a)....

...er reasonable proof at any time to establish that the insurer is not responsible for payment of the claim. "[A]ny payment shall not be deemed overdue when an insurer has reasonable proof to establish that the insurer is not responsible for payment." § 627.736(4)(b)....

...It is important to note that the statute does not require the insurer to obtain a report or proof under subsection (4)(b) before denying a claim. In United Automobile Insurance Co. v. Rodriguez, 808 So.2d 82, 87 (Fla.2001), the Florida Supreme Court noted that nowhere in section 627.736(4)(b) does it require that a medical report (let alone a "valid [medical] report") be obtained showing that the insurer is not responsible for payment: Amici Allstate Insurance Company and Geico Casualty Company point out that this requirement of a medical report is not mentioned anywhere in section 627.736(4) and they contend it is erroneous....

...proof" to mean only a medical report, the district court has rewritten the statute. This too was error. (Footnotes omitted). Additionally, Justice Pariente, in her concurring opinion in Rodriguez, explained that the "reasonable proof" requirement in section 627.736(4)(b) is not synonymous with the "valid report" requirement of section 627.736(7)(a), and that the "reasonable proof" requirement of section 627.736(4)(b) (relating to the denial of benefits), is only necessary to avoid "overdue" status. This statute [section 627.736(7)(a)] requires that a PIP insurer obtain a medical report as a condition precedent to withdrawing benefits. Nothing in the language of section 627.736(4)(b) suggests that the "reasonable proof" necessary to avoid "overdue" status is limited to the "report" necessary to "withdraw" payment of a treating physician under section 627.736(7)(a). See § 627.736(4)(b). In my view, this interpretation of the "reasonable proof" requirement in section 627.736(4)(b) and the medical report requirement of section 627.736(7)(a) give meaning and effect to both statutory provisions, with each section operating independently of the other....

...Rodriguez, 808 So.2d at 89 (Pariente, J., concurring). In State Farm Mutual Automobile Insurance Co. v. Rhodes & Anderson, D.C., P.A., 18 So.3d 1059 (Fla. 2d DCA 2008), Judge Canady (now Justice Canady) authored a comprehensive opinion addressing the identical question: whether a "valid report" under section 627.736(7)(a) is required before an insurer may deny payment of a claim for PIP benefits. The Second District answered the question in the negative, holding that the insurer's refusal to pay for certain tests was a denial, not a withdrawal, of payment, and thus the "valid report" requirement in section 627.736(7)(a) did not apply. The court found, instead, that because the claim was denied, the insurer was only required to provide reasonable proof that the insurer was not responsible for the claim. Id. at 1064. Our interpretation of section 627.736(7)(a) is consistent with this Court's earlier opinion in United Automobile Insurance Co. v. Viles, 726 So.2d 320 (Fla. 3d DCA 1998). Unlike the instant case, Viles was a withdrawal case. Thus, section 627.736(7)(a) applied, and the insurer was required to obtain a valid report before withdrawing or refusing to pay any further PIP benefits....

...This Court concluded that prior to withdrawing payment, the insurer was required to obtain a valid report. [W]e agree with the trial court's well reasoned analysis concluding that United Auto was required to first obtain a physician's report before refusing to pay further medical bills. The statute [section 627.736(7)(a)] plainly provides that an insurer must first obtain the referenced report before electing to withdraw payment....

...independent physical examination of the insured. 980 So.2d at 1214. This Court concluded that a valid report for the withdrawal of benefits may be based upon the reporting physician's review of another physician's examination. "[W]e hold that under section 627.736(7)(a) a medical report issued for the withdrawal of PIP benefits may be based on a physical examination of the insured that is conducted by either the physician preparing the report or another physician's examination." Bermudez, 980 So.2d at 1215. Although Bermudez, in dicta, suggests that Viles also applies the section 627.736(7)(a) valid medical report requirement to the denial of PIP benefits, a careful reading of the case demonstrates that it does not. Viles only applies section 627.736(7)(a) to the withdrawal or termination of authorization for further treatment, not to an initial outright denial of benefits. "The statute plainly provides that an insurer must first obtain the referenced report before electing to withdraw payment." Viles, 726 So.2d at 321 (emphasis added). "[S]ection 627.736(7)(a) sets up a procedural requirement that an insurer cannot withdraw payment of a treating physician unless the decision is supported by an expert that the treatment does not comply with the statutory criteria." Id....

...or termination of payments or to the withdrawal or termination of authorization for treatment"; holding that "denial of a single claim for payment does not constitute the withdrawal of a physician's `treatment authorization'" and does not implicate section 627.736(7)(a) because that section "does not address situations in which one charge for treatment has been denied by the insurer"). We, therefore, recede from that portion of Bermudez suggesting that the holding in Viles also applies to denial of benefits cases. Because this is a denial case, section 627.736(7)(a) is not implicated. Therefore, United Auto was not required to obtain a "valid medical report" to deny payment of Santa Fe's claim, and the circuit court erred in granting Santa Fe's motion for summary judgment based upon United Auto's failure to comply with section 627.736(7)(a). CONCLUSION We grant the instant petition because the circuit court departed from the essential requirements of law by incorrectly interpreting the language of subsections (4)(b) and (7)(a) of section 627.736, and by failing to apply the correct law set forth in subsection (4)(b)....

...In this state, owners of private passenger automobiles are required to obtain "no fault" insurance covering their vehicles as provided in the Florida Automobile Reparations Reform Act, Sections 627.730-627.741, Florida Statutes (1977) (the Act). Under Section 627.736, every insurance policy complying with the Act must provide personal injury protection (PIP) benefits to the extent of $5,000 covering medical expenses, disability (loss of earnings and loss of earning capacity) [1] and $1,000 of funeral expenses....

...Defendants' policies provide PIP benefits. However, if an injured party is the owner of a motor vehicle required to be insured under the Act, he can recover PIP benefits only under his own policy — not the policy of the owner of the motor vehicle in which he is riding when injured. Section 627.736(4)(d) 4....

...orida Statutes (1977): An owner of a motor vehicle with respect to which security is required by this section who fails to have such security in effect at the time of an accident . . shall be personally liable for the payment of [PIP] benefits under Section 627.736....

...Safeco Insurance Company, 144 N.J. Super. 506, 366 A.2d 695 (1976). Reversed with instructions in each case to reinstate plaintiff's complaint and for further proceedings not inconsistent with this opinion. GRIMES, C.J., and BOARDMAN, J., concur. NOTES [1] In 1977, Section 627.736 was amended to reduce PIP benefits to 80% of medical expenses and 80% of disability, subject to the same maximum.

...y judgment in an action to recover personal injury protection ["PIP"] benefits. In that judgment the Dade County Court certified the following question of great public importance: IN AN ACTION TO RECOVER MEDICAL BENEFITS IN A LAWSUIT UNDER FLA.STAT. § 627.736 WHERE THE ONLY DEFENSE BY AN INSURER IS THAT THE MEDICAL TREATMENT WAS NOT RELATED, NOT REASONABLE AND/OR NOT NECESSARY, MUST AN INSURER OBTAIN THE REPORT REQUIRED UNDER FLA. *1124 STAT. § 627.736(7) CONSTITUTING "REASONABLE PROOF" WITHIN 30 DAYS OF RECEIVING WRITTEN NOTICE OF THE FACT OF A COVERED LOSS AND OF THE AMOUNT OF SAME BEFORE IT CAN DEFEND ON THE BASIS THAT THE MEDICAL BILLS ARE NOT REASONABLE, NOT RELATED AND/OR NOT NECESSARY? We accept jurisdiction and affirm the judgment....

...On January 16, United Auto submitted Ms. Rodriguez's medical bills for review to a doctor who issued a report to United Auto on January 19, 1998, outside the thirty-day statutory time period. Ms. Rodriguez sued to recover the amount of the unpaid medical bills plus interest. § 627.736(4)(b), (c), Fla.Stat....

...Perez's petition demonstrates that the Appellate Division decision is a "violation of a clearly established principle of law resulting in a miscarriage of justice," Haines City Community Dev. v. Heggs, 658 So.2d 523, 528 (Fla.1995), we grant certiorari and quash the Appellate Division decision. Section 627.736(4)(b), Florida Statutes (1997), provides that PIP insurance benefits "shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same." This section als...

...However, this court held that this interpretation would totally obliterate the thirty-day statutory provision. Pacheco goes on to advise that "once an insurer receives notice of a loss and medical expenses, it must pay within thirty days unless, pursuant to Section 627.736(4)(b), it has obtained reasonable proof to believe that it is not responsible for the payment." Pacheco, 695 So.2d at 395 (emphasis added)....

...lds, P.A., West Palm Beach, for appellee. GROSS, Judge. The county court has certified two questions to this court pursuant to Florida Rule of Appellate Procedure 9.160(d), which we rephrase as follows: TO RECOVER MEDICAL BENEFITS IN A LAWSUIT UNDER SECTION 627.736, FLORIDA STATUTES (SUPP. 1994), MUST THE PLAINTIFF PROVE BY THE GREATER WEIGHT OF THE EVIDENCE THAT THE EXPENSES SOUGHT ARE BOTH REASONABLE AND FOR NECESSARY MEDICAL SERVICES? IN AN ACTION FOR PIP BENEFITS, WHERE A TRIAL COURT CHARGES THE JURY USING THE LANGUAGE OF SECTION 627.736(1)(a), MUST THE COURT FURTHER DEFINE THE *272 TERM "NECESSARY" AS USED IN THE STATUTE? We have accepted jurisdiction pursuant to Rules 9.030(b)(4)(A) and 9.160(d)....

...chiropractic treatment after June 7, 1994. Derius continued to treat with her chiropractor until September, 1994. Derius filed suit under the no-fault statute in the county court seeking, inter alia, to recover for her chiropractic treatments under section 627.736(1)(a), Florida Statutes (Supp.1994)....

...ity Company, for the total amount of those reasonable and necessary chiropractic expenses incurred after June 7, 1994 and for the interim examination dated May 11, 1994. After a lengthy trial, the jury returned a verdict for Allstate on both issues. Section 627.736(1), Florida Statutes (Supp.1994), requires an insurer to provide personal injury protection (PIP) benefits for "loss sustained ......

...as a result of bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle." Personal injury protection benefits include "[e]ighty percent of all reasonable expenses for necessary medical ... services." § 627.736(1)(a), Fla....

...There is nothing in the PIP statute suggesting a legislative intent to alter the normal dynamics of a lawsuit by placing the burden on the defendant in a PIP case to prove that a proposed charge was unreasonable or that a given service was not necessary. *273 Derius points to the language of section 627.736(7)(a), which provides that [a]n insurer may not withdraw payment of a treating physician without the consent of the injured person covered by the personal injury protection, unless the insurer first obtains a report by a physician lic...

...d under the same chapter as the treating physician whose treatment authorization is sought to be withdrawn, stating that treatment was not reasonable, related, or necessary. This language is part of the independent medical examination requirement of section 627.736(7) which is "intended to give insurers an opportunity to determine the legitimacy of a claim so that an appropriate decision can be made as to whether benefits should be paid." U.S. Security Ins. Co. v. Silva, 693 So.2d 593, 596 (Fla. 3d DCA 1997). The quoted language from section 627.736(7)(a) sets up a procedural requirement that an insurer cannot withdraw payment of a treating physician unless the decision is supported by an expert that the treatment does not comply with the statutory criteria....

...relies upon spiritual means through prayer alone for healing in accordance with his religious beliefs. Id. at 149; see also Hunter v. Allstate Ins. Co., 498 So.2d 514, 515-16 (Fla. 5th DCA 1986). Whether a given medical service is "necessary" under section 627.736(1)(a) is a question of fact for the jury....

...On the remaining issues, we find no error in the trial court's rulings on Derius' motions for directed verdict and mistrial. Allstate's reliance on the IME chiropractor's letter to withdraw payment to Derius' chiropractor was in compliance with the requirements of section 627.736(7)(a)....

...We have concluded and so hold that the trial court's construction of the Florida Automobile Reparations Reform Act was correct and proper in all respects and, therefore, the judgment appealed herein is affirmed. RAWLS, C.J., and CARROLL, DONALD K., J., concur. NOTES [1] F.S. §§ 627.730-627.741, F.S.A. [2] F.S. § 627.736, F.S.A. [3] F.S. § 627.736, F.S.A. [4] F.S. § 627.736(4), F.S.A....

...Govan, 502 So.2d 913 (Fla. 4th DCA 1986), approved, 521 So.2d 1086 (Fla. 1988). The issue presented in Govan was whether the deductible amount was to be deducted from the total medical expenses incurred before or after calculating the eighty percent figure authorized under section 627.736(1)(a), Florida Statutes (1983)....

...In the instant case, believing that this Court approved its construction of the section 627.739(2) when we approved its decision in Govan and disapproved Thibodeau and Cowan, the district court held that the term "benefits otherwise due" relates to the "`Required Benefits' mandated by section 627.736 et seq....

...policy limits mandated by the PIP statute. In Govan, the sole issue with which we were presented was the interrelationship of the deductible amounts authorized under section 627.739(2) and the coinsurance percentages by which eligible benefits under section 627.736(1) are to be reduced....

...ict with Thibodeau and Cowan and we disapproved those cases to the extent they conflicted with our decision, neither of those decisions involved the application of the deductible to eligible benefits after reduction by the coinsurance percentages of section 627.736(1)....

...policy limits. The Department has approved PIP policies, such as those at issue, which provide that the deductible amount authorized under section 627.739(2) is to be deducted from the lesser of the recoverable lost wages and medical expenses under section 627.736(1) or the policy limits....

...reduce coverage." Arnone, 528 So.2d at 919. However, the legislature has prescribed the manner in which deductibles may be utilized in a PIP policy. Under the statutory scheme, the deductible amounts are to be deducted from "benefits otherwise due." Section 627.736(1) defines "Required [PIP] Benefits." Reading these sections in pari materia, it is plain that the statutorily defined "required benefits" are the benefits otherwise due from which the deductible amount is to be subtracted. Section 627.736(1) defines the parameters of the benefits otherwise due under a PIP policy as including eighty percent of certain medical expenses and sixty percent of lost wages "to a limit of $10,000" (emphasis added). [5] In construing the term "benefits otherwise due," the district court below overlooked the fact that "required benefits" are eligible benefits set forth in section 627.736(1) "to a limit of $10,000." Based on the plain language of sections 627.736(1) and 627.739(2), we hold that these provisions provide for the authorized deductible amounts to be subtracted from the lesser of the eligible benefits after application of the coinsurance percentages of sections 627.736(1)(a) and (b) or the statutorily mandated coverage limit of $10,000....

...If the total amount of such loss and expense exceeds such deductible, the total limit of benefits the Company is obligated to pay shall be the difference between such deductible amount and the applicable limit of the Company's liability. (Emphasis added.) [2] Sections 627.736, 627.739, Florida Statutes (1975 and Supp....

...[3] The 1977 personal injury protection scheme at issue in Thibodeau v. Allstate Insurance Co., 391 So.2d 805 (Fla. 1980), disapproved, Govan v. International Bankers Insurance Co., 521 So.2d 1086 (Fla. 1988), provided for a maximum deductible of $4,000 and coverage up a limit of $5,000. §§ 627.736(1), 627.739(1), Fla. Stat. (1977). [4] The coinsurance percentages became part of Florida's PIP scheme in September 1977. Ch. 77-468, § 33, Laws of Fla. Cowan involved the 1975 and 1976 versions of sections 627.736 and 627.739. Although the 1977 scheme was employed in Thibodeau, the relationship between the deductible and the coinsurance percentages was not at issue. [5] Benefits for funeral and burial expenses which are provided for in section 627.736(1)(c) are exempt from application of the deductible, pursuant to section 627.739(2).

protection (including the medical benefits), see § 627.736(1), Fla. Stat. (1983), the policy provides that

expressly upholding the constitutional validity of Section 627.736(4)(d)(1), Florida Statutes (1975). We have

court denied the fees because, pursuant to section 627.736, the insurance company paid the balance within

the policy did in fact provide for coverage. Section 627.736(1), Florida Statutes (1981), requires that

within which the insurer must pay pursuant to section 627.736(4)(b), Florida Statutes. However, United Auto

"subsequent personal injury protection benefits." § 627.736(7)(b), Fla. Stat. (2010). There is no similar

interpretation of the applicable statute, section 627.736(1)(b), Florida Statutes (1979), as it related

rather than medical benefits, as provided by section 627.736(1)(b), Florida Statutes (1981). Bankers began

precedent to a suit upon the policy. Pursuant to Section 627.736(7)(a), Florida Statutes (1975), the policy

of the Florida Motor Vehicle No-Fault Law, section 627.736, Florida Statutes (2001). Malu alleged that

facially insufficient claim. See § 627.425; cf. § 627.736(4)(b); Ivey v. Allstate Ins. Co., 774 So.2d 679

benefits in the amount of $10,000 pursuant to section 627.736, Florida Statutes. Plaintiffs propose a subclass

amount State Farm determined was reasonable. See § 627.736(1)(a), Fla. Stat. (2010) (requiring PIP insurers

200% of the Medicare fee schedule pursuant to section 627.736(5)(a)2., Florida Statutes (2008). Northwoods

municipality where the insured is seeking treatment." § 627.736(7)(a), Fla. Stat. (1993). Jones is a resident

necessary or related to the automobile accident. See § 627.736, Fla. Stat. (1997). The fact that an insurance

treatment a reimbursable medical benefit under section 627.736(1)(a), Florida Statutes? The question arose

"medical" expenses to medical doctors. Rather, Section 627.736, Florida Statutes, provides for payment to

PIP benefits under the provisions of Fla. Stat. § 627.736(4)(d)(4), F.S.A., which reads: "(d) The insurer

the injury and therefore affirm. Pursuant to section 627.736(1), Florida Statutes (1987), State Farm's policy

allegedly owed statutory interest pursuant to section 627.736(4), Florida Statutes (1994), on PIP benefits

independent medical examination as permitted under section 627.736(1)(a) and (7)(a), Florida Statutes. Based on

original 1972 "no-fault" statutes provided in section 627.736(1), Florida Statutes, for PIP benefits of 100

EXAMINATION (I.M.E.), UNDER THE PROVISIONS OF SECTION 627.736(a) and (b), FLORIDA STATUTES, DOES THE TERM

examined Lebrun purportedly as required by section 627.736(7)(a) of the Florida Statutes. Summary judgment

action below Reserve took the position that F.S. 627.736(3)(a), F.S.A., requires that it be reimbursed

accepted the respondent's argument and held that Section 627.736(4), Florida Statutes (1975), only required

covered loss and of the amount of same," under section 627.736(4)(b), Florida Statutes (2004). Concluding

Statutes (1991), the tort exemption statute. Section 627.736(3) provides that an injured party shall have

regardless of fault. The coverage is mandated by section 627.736(1), Florida Statutes (1981), in all policies

request for such documents was authorized by section 627.736(6)(b), Florida Statutes (2010). 1

for each of three vehicles). Florida Statutes § 627.736(2)(a) provides in pertinent part: "Required personal

conclude that the residence requirement in section 627.736(4)(d)(4), Florida Statutes (1993), is intended

under the policy. This exclusion is authorized by § 627.736 (2), Fla. Stat., 18A F.S.A. After the parties

determine whether Florida’s PIP Statute, Fla. Stat. § 627.736, permits EUOs as a prerequisite to receiving PIP

("PIP") Statute, Fla. Stat. § 627.736 (2012 to date). Fla. Stat. § 627.736 sets forth a basic coverage

be one of great public importance: WHETHER SECTION 627.736(4)(b), FLORIDA STATUTES, REQUIRES A PIP INSURER

Miami, for respondents. FARMER, Judge. In section 627.736(4)(b), the legislature has provided that personal

received, Millennium Diagnostic, pursuant to section 627.736(11), Florida Statutes (2003), sent a demand

injury protection (PIP) carrier pursuant to section 627.736(7), Florida Statutes (1995). Dr. Phillips concluded

insured, as provided for in subsection (3)(a) of § 627.736 Fla. Stat., F.S.A. Instead, as indicated above

Felgenhauer's motion to set off $10,000 PIP benefits. Section 627.736(3), Florida Statutes (2001), provides for a

the resolution of disputed PIP claims. Under section 627.736(5), Florida Statutes (1993), a health care

tests before obtaining a valid report under section 627.736(7)(a), Florida Statutes (2003), which requires

Appellee, to the contrary, maintained that section 627.736, Florida Statutes (1991), was controlling.

maintenance or use of a motor vehicle." See also § 627.736(1)(a), Fla. Stat. (1995) (requiring PIP carriers

insurance issued in a foreign state in view of section 627.736(3), Florida Statutes (1981), which prohibits

provision, or the PIP statute, is codified at section 627.736 and is "an integral part of the no-fault statutory

protection benefits, as set forth in Florida Statute § 627.736(5)(a), is entitled to recover *447 PIP benefits

permissive Medicare fee schedules identified in section 627.736(5)(a)2., Florida Statutes (2009), to limit

issued by appellant. Appellant contends that under § 627.736, Florida Statutes, relating to required personal

medical report, produced in accordance with section 627.736(7)(a), Florida Statutes (2005), as a precondition

coverage is optional, its scope is established by section 627.736(4)(f), Florida Statutes (1989), which reads

constituted bad faith, as contemplated by Section 627.736, Florida Statutes (1977), which entitled him

concerning personal injury protection benefits, § 627.736(4)(d)2., Fla. Stat. (1981), provides that the

000 for any single accident, as mandated by section 627.736(1)(a), Florida Statutes (1983). A $2,000 deductible

of a motorcycle and thus was precluded by Section 627.736, Florida statutes (Supp. 1976), from coverage

services. Millennium claimed that pursuant to section 627.736(5)(b)5, Fla. Stat. (2001), it should have been

the accrual of the cause of action. Citing section 627.736(4)(b), Florida Statutes (1981), which provides:

injury protection coverage required to satisfy section 627.736, Florida Statutes (2000), and *466 the uninsured