News & Events

This morning, the Florida Supreme Court issued its long-awaited ruling in MRI Associates of Tampa v. State Farm  No. SC18-1390.  On appeal from The Second District Court of Appeal, the Court accepted jurisdiction in this matter to determine whether State Farm’s policy of insurance properly elected of the schedule of maximum charges. The Court agreed with the Second, finding the PIP policy permitted the insurer to utilize the schedule of maximum charges even though the policy refers to other statutory factors used to determine reasonableness.

In its ruling, the Supreme Court held that an election of the schedule of maximum charges does not prohibit an insurer from determining proper reimbursement using statutory reasonableness standards. The ruling clarifies that the fee schedule is “simply as an optional method of capping reimbursements rather than an exclusive method for determining reimbursement rates. By its very nature, a limitation based on a schedule of maximum charges establishes a ceiling but not a floor.”  

It appears today’s ruling will have broad implications for carriers currently facing fee schedule litigation.  If you would like to discuss this case and its impact further, please feel free to contact us.