News & Events

John Viggiani and Jesse Dyer recently prevailed on a motion for final summary judgment in a personal injury action arising from a trucking accident in Duval County, Florida, in which the plaintiff was rendered paraplegic. The defendant was an international transportation services company, against whom the plaintiff alleged theories of negligent brokering and vicarious liability. The Court concluded that the plaintiff’s vicarious liability claim failed as a matter of law because the entity that brokered the shipment was acting outside the scope of any agency relationship which may have existed with the defendant. The Court concluded that the plaintiff’s negligent brokering claim failed as a matter of law because the defendant did not act as a broker for the specific transaction at issue.

In the past, insurance fraud detection consisted of employees manually poring over data and investigating potentially fraudulent claims. While the human element was sometimes effective, many instances of fraud got past gatekeepers and cost insurance companies large amounts of money. As insurance fraudsters have gotten more sophisticated, insurance companies have needed to stay one step ahead of them. At the very minimum, they need to keep pace with modern criminality.

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.

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