UNITED AUTOMOBILE INSURANCE COMPANY, PETITIONER,
v.
MED-PROUD GENERAL PRACTICE, A/A/O PEDRO A. TORRES, RESPONDENT
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Florida appellate court granted certiorari to overturn a trial court's order striking a peer review report, holding that the thirty-day deadline under section 627.736(4)(b) does not apply to claims for unrelated, unreasonable, or unnecessary treatment, allowing insurers to challenge such treatment and rely on peer review reports obtained after thirty days.
The thirty-day time period in section 627.736(4)(b) does not apply to claims for unrelated, unreasonable, or unnecessary treatment, and an insurer may challenge such treatment at any time using a peer review report obtained more than thirty days after claim submission.
[1] The thirty-day deadline for peer review reports under section 627.736(4)(b) does not apply to claims for unrelated, unreasonable, or unnecessary treatment, permitting ins…
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Join FLexlaw to unlock all legal intelligence“the thirty-day time period set forth in section 627.736(4)(b) does not apply to claims for unrelated, unreasonable, or unnecessary treatment. Therefore, an insurer may challenge such treatment at any time, and is permitted to rely on a report, obtained pursuant to section 627.736(7)(a), even if the report is obtained more than thirty days after the claim was submitted.”
The court's holding regarding the scope of the thirty-day deadline and insurer's rights to challenge treatment.
United Automobile Insurance Company sought to rely on a peer review report created more than thirty days after an insured submitted a claim to deny co…
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The insurer, United Automobile Insurance Company (“United”), petitions for a writ of certiorari to review a county court’s order, affirmed by the circuit court, striking a peer review report supporting United’s denial of an insured’s claim.
When, on November 8, 2006, the county court struck the report because it was *890created more than thirty days after the insured submitted its claim, and when, on May 4, 2009, the circuit court affirmed the trial court’s order, the courts were operating without the benefit of this Court’s decision in United Automobile Insurance Co. v. Millennium Diagnostic Imaging Center, Inc., 12 So.3d 242 (Fla. 3d DCA 2009). In Millennium, we answered the very question confronted by the trial court in this case and contrary to the trial court, concluded
that the thirty-day time period set forth in section 627.736(4)(b) does not apply to claims for unrelated, unreasonable, or unnecessary treatment. Therefore, an insurer may challenge such treatment at any time, and is permitted to rely on a report, obtained pursuant to section 627.736(7)(a), even if the report is obtained more than thirty days after the claim was submitted.
Accordingly, we grant the petition for a writ of certiorari, quash the order striking the peer review report, and remand to the county court for further proceedings consistent with this opinion.
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- United Auto. Ins. Co. v. Millennium Diagnostic Imaging Ctr., Inc., 12 So. 3d 242 (Fla. 3d DCA 2009)