News4Jax – Jim Saunders, News Service of Florida
TALLAHASSEE – In a defeat for medical providers, a divided Florida Supreme Court on Thursday sided with Allstate Insurance Company in a dispute about fees paid to care for auto-accident victims.
The 4-3 ruling focused on the personal-injury protection insurance system and attempts by Allstate to reimburse providers under fee schedules from the Medicare program. The fee schedules involve limits on payments for services.
Providers challenged the practice, arguing that insurance policies were “ambiguous” about whether Allstate would use the fee schedules to limit reimbursements. The 4th District Court of Appeal, in a 2015 ruling that involved 32 consolidated cases, backed the providers.
But the Supreme Court majority overturned that decision Thursday, finding that Allstate’s policies provided “legally sufficient notice” that the insurer would use the Medicare fee schedules. The 15-page decision, written by Justice Charles Canady and joined by Chief Justice Jorge Labarga and justices Peggy Quince and Ricky Polston, provided a detailed analysis of the policy wording and the personal-injury protection, or PIP, law.