Background
Manuel V. Feijoo, M.D., P.A., acting as assignee of Elizabeth Taveras, sued Progressive American Insurance Company in Miami-Dade County Court concerning PIP benefits. Feijoo appealed from the county court’s disposition.
The appellate opinion does not detail the underlying services, the particular missed examination-under-oath request, or the county court’s reasoning. It identifies the dispute as one governed by the insured’s obligation to submit to an examination under oath.
The Court’s Holding
The Third District affirmed. In its per curiam decision, the court relied on its precedent holding that submission to an examination under oath is a condition precedent to receiving PIP benefits under section 627.736(6)(g) and the applicable policy.
The court also relied on decisions recognizing that an insurer need not prove prejudice when asserting noncompliance with that condition, and that sufficient evidence of an insured’s failure to attend an EUO can establish a policy breach. The court gave no further analysis.
Key Takeaways
- An EUO may be a condition precedent to PIP benefits.
- Prejudice is not an element of the insurer’s affirmative defense based on failure to submit to an EUO.
- The Third District affirmed the county court’s disposition in Progressive’s favor.
Why It Matters
The decision reaffirms the Third District’s application of its EUO precedents in PIP litigation. Providers pursuing assigned benefits must account for the insured’s compliance with policy conditions, including an examination-under-oath requirement.