News & Events

Recently, the Coalition Against Insurance Fraud (CAIF) released updated numbers that show the cumulative impact of insurance fraud. CAIF estimated that insurance fraud costs the economy upwards of $300 billion each year, and this figure may be a conservative estimate. Fraudsters get the upper hand because they tend to stay one step ahead of the authorities.

On April 26, 2023, the Fourth District Court of Appeal addressed the ever expanding litigation over the proper Medicare Fee Schedule, overturning a trial court’s ruling that insurers must pay the higher 2007 Non-Facility Limiting Charge, and holding the proper reimbursement rate was the lower 2007 non-facility participating price, in Progressive Select Insurance Company v. In House Diagnostic Services, Inc., a/a/o Darryl Frazier, No. 4D21-2581. In doing so, the entire Court, not just a three-judge panel, officially receded from its own prior precedent.

Jesse C. Dyer and Augusto M. Vaccaro recently prevailed on a motion for final summary judgment in a homeowner’s insurance case in Miami-Dade County, in which the Plaintiffs alleged that the insurer materially breached the insurance policy by failing to make payment for property damage resulting from a plumbing failure. The Court agreed with the insurer that a $10,000 sublimit applied to the entirety of Plaintiffs’ insurance claim and that coverage under the sublimit had been exhausted. Plaintiffs contended that the $10,000 sublimit did not apply because the plumbing failure resulted in mold, but the Court rejected this argument both because there was not any timely, competent evidence supporting it and Plaintiffs’ mold theory was not alleged in the Complaint.

Attorney Tylar Heintz of our Orlando office won a summary judgment for a residential homeowner in a trip and fall sidewalk case in Orange County, Florida.  Plaintiff alleged he tripped due to underground tree roots buckling the concrete sidewalk adjacent to the homeowners’ residence. Plaintiff brought suit against the homeowners, the HOA, the management company and Orange County. Based on case law presented from the 1st, 3rd, and 4th DCAs, the Court agreed with Mr. Heintz’s argument that a property owner has no duty to maintain or repair a public sidewalk, and therefore granted final summary judgment in favor of the Defendant homeowners.