Motion for Settlement in Presgar Imaging Of CMI North LC, et al Plaintiff vs. LM General Insurance Company Defendant| Trellis.Law

On June 19, 2020 a Request,Application was filed involving a dispute between Beaches Open Mri Of Tamarac Llc, Presgar Imaging Of Cmi North Lc, and Lm General Insurance Company, for 3 in the District Court of Broward County.

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Filing# 177380619 E-Filed 07/13/2023 04:35:35 PM

MORGAN & I'GAN

July 11, 2023

Class Administrator
LM General Class Administrator
P.O. Box 6175
Novato, CA 94948-6175

RE: Request to be excluded from the Class Action Settlement a) Presgar Imaging of CMI North,
LC eta/. v. LM General Insurance Company, Case No. CACE 20-010138; (b) Beaches Open MRI
of Tamarac, LLC v. Liberty Mutual Insurance Company, Case No. CACE 20-013306; (c) Presgar
Imaging of CMI North, L.C d/b/a CMI North v. LM Insurance Corporation',Case No. CACE 20-
014646 (d) Beaches Open MRI of the Treasure Coast, LLC v. The First LibertyInsurance
Corporation; Case No. CACE 20-014759".

Please the attached Opt-out Forms for medical providersrequesting to be excluded from the Class
Ackjon SeU\ement a) Presgar Imaging of CMI North, LC, eta/. v. LM General Insurance Company,
Case No. CACE 20-010138; (b) Beaches Open MRI of Tamarac, LLC v. LibertyMutual Insurance
Company, Case No. CACE 20-013306; (c) PresgarImaging of CMI North, L.C d/b/a CMI North v.
LM Insurance Corporation; Case No. CACE 20- 014646(d) Beaches Open MRI of the Treasure
Case No. CACE 20-014759".
Coast, LLC v. The First LibertyInsurance Corporation',

I and attest to the Court that the Settlement Class Member, on whose behalf this Opt-Out
certify
exclusion request is submitted, has been provided a copy of and an opportunity to read the class
notice and Settlement Agreement and thereafter specifically requested to be excluded from the
Settlement Class.

I further attest under penalty of perjury that I have also actuallyadvised the Class Member of
the salient terms of the Settlement Agreement, includingthe monetary terms of the Settlement
Agreement and a comparison of recovery based on the monetary terms of the Settlement and
what that proposed Settlement Class Member could expect without the Settlement set forth in
the Settlement Agreement and that after a full consultation of this information,the proposed
Settlement Class Member stilldesires to opt out of the Settlement

Hanskmnm
Authorized Representative Printed Name

Hans Kennon, ESQUIRE
Morgan & Morgan, P.A.
20 N. Orange Ave 7111123
Orlando, FL 32801 Date Signed
(407)-428-6243
Hkennon@forthepeople.com

*** FILED: BROWARD COUNTY, FL BRENDA D. FORMAN, CLERK 07/13/2023 04:35:35 PM.****
ORGAN & I'GAN
July 11, 2023

Counsel for Settlement Class
c/o J. Daniel Clark,Esq.
Clark & Martino,P.A.
3407 W. Kennedy Blvd.
Tampa, FL 33609

RE: Request to be excluded from the Class Action Settlement a) Presgar Imaging of CMI North,
LC, etal. v.LM Genera/Msurance Company,Case No.CACE 20-010138; Cb) Beaches OpenMRI
of Tamarac, LLC v. Liberty Mutual Insurance Company, Case No. CACE 20-013306; (c) Presgar
Imaging of CMI North, L.C. d/b/a CMI North v. LM Insurance Corporation',
Case No. CACE 20-
014646 (d) Beaches Open MRI of the Treasure Coast LLC v. The First Liberty Insurance
Corporation; Case No. CACE 20-014759".

Please the attached Opt-out Forms for medical providersrequesting to be excluded from the
Class Action Settlement a) Presgar Imaging of CMI North, LC, etal. v. LM General Insurance
Company,Case No.CACE 20-010138; Cb)Beaches OpenMRI of TamamLLC v. LibertyMutual
Insurance Company, Case No. CACE 20-013306; (c) Presgar Imaging of CMI North, L.C. d/b/a
CMI North v. LM Insurance Corporation',Case No. CACE 10- 014646 (d) Beaches Open MRI of
the Treasure Coast LLC v. The First LibertyInsurance CorporationtCase No. CACE 20-014759".

I certifyand attest to the Court that the Settlement Class Member, on whose behalf this Opt-
Out exclusion request is submitted, has been provided a copy of and an opportunity to read the
class notice and Settlement Agreement and thereafter specifically requested to be excluded
from the Settlement Class.

Itars Kenmn
Authorized Representative Printed Name

Hans Kennon, ESQUIRE
Morgan & Morgan, P.A.
20 N. Orange Ave
Orlando, FL 32801 Date Signed
(407)-428-6243
Hkennon@forthepeople.com
MORGAN & ORGAN
July 11, 2023

Counsel for the Defendant
c/o Gary J. Guzzi, Esq.
Akerman LLP
Three Brickell CityCentre
98 Southeast Seventh St.,Suite 1100
Miami, FL 33131

of CMI North,
RE: Request to be excluded from the Class Action Set\ement a) Presgar Imaging
Lgetal.v.LM Generalmsurme Compm.Case No.CACE OpenMRI
of Tamarac, LLC v. Libeny Mutual Insurance Company, Case No. CACE 20-013306; (c) Presgar
Imaging of CMI North, L.C. d/b/a CMI North v. LM Insurance Corporation',
Case No. CACE 20-
014646 (d) Beaches Open MRI of the Treasure Coast, LLC v. The First Liberty Insurance
Corporation; Case No. CACE 20-014759".

Please the attached Opt-out Forms for medical providersrequesting to be excluded from the Class
Ad\on Se?ement a) Presgar Imaging of CMI North, LC, eta/. v. LM General Insurance Company,
Case No. CACE 20-010138; tb) Beaches Open MRI of Tamarac, LLC v. LibertyMutual Insurance
Company, Case No. CACE 20-013306; (o Presgar Imaging of CMI North, L.C d/b/a CMI North v.
LM Insurance Corporation',Case No. CACE 20- 014646 td) Beaches Open MRI of the Treasure
Coast, LLC v. The Fht Libeny Insurance Corporation;Case No. CACE 20-014759".

I further attest under penalty of perjury that I have also actuallyadvised the Class Member of

the salient terms of the Settlement Agreement, includingthe monetary terms of the Settlement
Agreement and a comparison of recovery based on the monetary terms of the Settlement and
what that proposed Settlement Class Member could expect without the Settlement set forth in
the Settlement Agreement and that after a full consultation of this information,the proposed
Settlement Class Member stilldesires to opt out of the Settlement

IHL
Authorized Representative
HanS Wemm
Printed Name

Hans Kennon, ESQUIRE
Morgan & Morgan, P.A.
20 N. Orange Ave
Orlando, FL 32801 Date Signed
(407)-428-6243
Hkennon@forthepeople.com
OR A & OR AN

OPT-OUT FORM

A&RSSHemmcweoforlominc
IiEIizdbethl.Ford Tax ID No. CE./Gg/EYP4
Full legalname and any aliases

Bhh. NGies @1714.OrargsAVRZUOBQionob,FLBZEOG
i *ldress

request to be excluded from the Class Action Settlement a) Presgar Imaging of CMI North, LC,
eta/. v. LM General Insurance Company; Case No. CACE 20-010138; (b) Beaches Open MRIof

Tamam,UCv.Ubemmuaimsunnceampany.CaseNo.CACE 20-013306; (c) Aesgar
Imaging of CMI North, L.C d/b/a CMI North v. LM Insurance Corporation',Case No. CACE 20-
014646 (d) Beaches Open MRI of the Treasure Coast, LLC v. The First Uberty Insurance
Co/po/at/on; Case No. CACE 20-014759".

I understand and have been advised of the material terms of the Class Action Settlement, the
monetary risks and benefits of the settlement,and specifically
request that I hereby be excluded
from the Settlement.

I understand that by opting out of this Class Action, I will not be eligible to receive any money
that may result from any trialor settlement of this i
lawsuit, f there is one. I do not wish to receive
compensation under the terms of any judgment or settlement or to otherwise participatein this

Class Action.

I HAVE READ AND UNDERSTOOD THE TERMS OF THE ATTACHED LETTER EXPLAINING THE
CLASS ACnON SETTLEMENT. I HEREBY CONFIRM MORGAN & MORGAN HAS THE AUTHORTTY
TO EXCLUDE MY PRACTICE AS PART OF THE CLASS ACTION SETTLEMENT. BY SIGNING I AM
REPRESENTING ON BEHALF OF MY PRACTICE THAT I HAVE AUTHORITY TO DO SO.

AuthoMzed-R?presentative
f#'Eirrmbtwi'..
Position L./

EPHY Fglol
Printed Nalne Date
7/n/23
Si6ned
0 GAN & RGAN
'
1

OPT-OUT FORM

Access Injury& Primary Care LLC 81-1780476
I Tax ID No.
Full legalname and any aliases

2014 S Orange Avenue 200B Orlando, FI 32806
Address

request to be excluded from the Class Action Settlement a) Presgar Imag/hg of CMI No/th, LC
eta/. v. LM General Insurance Company, Case No. CACE 20-010138; tb) Beaches Open MRI of

Tamarac, LLC v. Libertr Mutual Insurance Company; Case No. CACE 20-013306; (c) Presgar
Imaging of CMI North, L.C. d/b/a CMI North v. LM Insurance Corporation',Case No. CACE 10-
014646 (d) Beaches Open MRI of the Treasure Coast, LLC v. The First Liberty Insurance
Corporation; Case No. CACE 20-014759".

Iunderstand and have been advised of the material terms of the Class Action Settlement, the
monetary risks and benefits of the settlement,and specifically
request that I hereby be excluded
from the Settlement.

I understand that by opting out of this Class Adion, I will not be eligible to receive any money
that may result from any trialor settlement of this lawsuit,if there is one. I do not wish to receive

compensation under the terms of any judgment or settlement or to otherwise participatein this

Class Adion.

IHAVE READ AND UNDERSTOOD THE TERMS OF THE ATTACHED LETTER EXPLAINING THE
CLASS ACTION SETTLEMENT. I HEREBY CONFIRM MORGAN & MORGAN HAS THE AUTHORITY
TO EXCLUDE MY PRACTICE AS PART OF THE CLASS ACTION SETTLEMENT. BY SIGNING I AM
REPRESENTING ON BEHALF OF MY PRACTICE THAT I HAVE AUTHORITY TO DO SO.

/411,-? Attorney

Authorized Representative Position

Hans Kennon 7/11/2023

Printed Name Date Signed
Jul 12 2023 09:OOAM Absolute Health Center 3525056655 page 3
omccwly,

ILLR-
SIGNATURE

Morgan & Margoo, PA.

2?UUQEM
AEEOUZ.te./+RF4?M.
EGMR.INC
?&..?A4a,?
Full
hbws name and any aliases
logal
TgxIDNo.
770708315

4/IONU 37+h P.Icoteo
Addm.
gwNZUIie,AL3jwoG
*om the Class Action
requestto bc oxoludcd Settlement a) ,Presgar
LMGene,otlw:ranc, Compoiv,Case No. CACr 20-010138, (b) Beoches
4a# Nora LC ,ml.
Imagi,?g V.

Open MRfqfTamarac, LLC v.
Jul 12 2023 09.OOAM Absolute Health Center 3525056655 page 4
Libert#Mutual
Inmt,ance Company, CasoNo,
CACE20-01330&,(*) PresgarImaglngofCMI North,LC.
d/Wa CM! Norgh v. IM Insurance Corporation',
Case No. CACE 20- 014646
tha 7)ea.ure
Co,ul LLC v, 77:e
0) Beaches Open MRI of
FiratLiber*Insi#-ance Corporation;
Ca,c No. CACE 20-014759'.

I undcntand and have been advised of the material
terms of tho Clasa Action
risks and benefits of ihc Settlement, the monetary
settlementand specifically request that I hereby be excluded from the
Settlement

I understand that
by optingout of this Class Action,I will not bo
result from any trial or settlement eligible
to receive any money that
may
of this lawsuit if there is one. I do not
wish to rcocivo compensation
under the terms of any or
judgment settlement or otherwise paftioipatc
to in this Class Action.

HAVE READ AND UNDERSTOOD THE TERMS OF
I
THE AFACHED LErTER EXPLAINING
THE CLASS ACTION SETrLEMENT. I
& MOROANHAS THE
AUTHORITY TO EXCLUDE MY PRACTICE AS PART OF THE
BY SIGNING I AM REPRESEITINO ON CLASS ACTIC)N SETTLEMENT.
BEHALF OF MY PRACHCE THAT I HAVE
AUTHORITY TO DO SO.

KI-

Authorized Reprcscntativc --OFEiceMmqer
Position

U
Gn,SeMireS 0.

PrintedName 7/12/23
Date Signed
MORGAN & MORGAN

OPT-OUT FORM

I ASUDENT
PLUS
name and anyaliases
Akiiegal
TaXIOM.-81.121845.4

IGIY S RDGEWOODAVR.SEZDD,SOUTHDAYMNA
Address

request to be excluded from the Class Adion Settlement a) Preear Imaging
of CMI Nom& LC
eta/. v. LM General Insurance Company, Case No. CkCE 20-010138; (b) Beaches Open MRI
of

Tamarac, LLC v. LibertyMutual Insurance Compan? Case No. CACE 20-013306; (c) Presgar
Case No. CACE 20-
Imaging of CMI North, L.C d/b/a CMI North v. LM Insurance Corporationt
014646 td) BeachesOpen MRI of the Treasure Coast, LLC v. The Fht Liberty Insurance
Case
Corporation; No. CACE 20-014759".

I understand and have been advised of the material terms of the Class Action Settlement,the
monetary risks and benefits of the
settlement, request that I hereby be excluded
and specifically
from the Settlement.

I understand that by opting out of this Class Action,I will not be eligible to receive any money

that may result from any trial or settlement of this lawsuit,ifthere is one. I do not wish to receive
to otherwise in this
compensation under the terms of any judgment or settlement or participate
Class Adion.

I HAVE READ AND UNDERSTOOD THE TERMS OF THE ATTACHED LETTER EXPLAINING THE
CLASS ACTION SETTLEMENT. I HEREBY CONFIRM MORGAN & MORGAN HAS THE AUTHORITY
TO EXCLUDE MY PRACTICE AS PART OF THE CLASS ACnON SETTLEMENT. BY SIGNING I AM
REPRESENTING ON BEHALF OF MY PRACTICE THAT I HAVE AUTHORITY TO DO SO.

OWNER
Authorized Representative Position

7?UXMKNNiss
Printed Name
7/7/23
Date Signed
ACLUraheHeaHNWR OPT-OUT FORM
GL.O.TP,P.A.dib/AACC,raxe
H&ZHncaregNUP
LJacub StiteleR Tax ID No. 26-0586115
legalname and any
Full aliases

YOicana?St newsmymaBEACh,FL32168
Address

of CMI North, LC,
from the Class Action Settlement a) PresgarImaging
request to be excluded Beaches Open MRIof
eta/. v. LM Generai Insurance Company,
Case No. CACE 20-010138;(b)
Comam Case No.CACE 20-013306;Cc)Aesgar
Tamarag UCv. Ubem Mutuaimsurance Case No. CACE 20-
Imaging of CMI North, L.C. d/b/a
CMI North v. LM Insurance Corporationt
LLC v. The First LibertyInsurance
014646 (d) Beaches Open MRI of the Treasure Coast
Corporat/on; Case No. CACE 20-014759".

terms of the Class Action Settlement,the
I understand and have been advised of the material
be
risks and benefits of the settlement, and specifically request that I hereby
monetary
excluded from the Settlement.

to receive any money
I understand that by opting out of this Class Action, I will not be eligible
if there is one. I do not wish to
that may result from any trial or settlement of this lawsuit,
or to otherwise
receive under the terms of any judgment or settlement
compensation
in this Class
participate Action.

EXPLAINING THE
I HAVE READ AND UNDERSTOOD THE TERMS OF THE ATTACHED LETTER
CLASS ACTION SETTLEMENT. I HEREBY CONFIRM MORGAN & MORGAN
HAS THE AUTHORITY
I AM
TO EXCLUDE MY PRACTICE AS PART OF THE CLASS ACTION SETTLEMENT. BY SIGNING
REPRESENTING ON BEHALF OF MY PRACTICE THAT I HAVE AUTHORITY
TO DO SO.

iDaw?Jwdeum B?Iling/Sui?
Authorized Rdpresentative Position
MN A-

W,Ilman
Dai,elle 7-10-23
Printed Name Date Signed
ORGA & IRGA

OPT-OUT FORM

Achu CCi.Nprc 6/7 C
LLC
I
-$
Case No. CACE 20-013306; (c) Aewar
Tamarac,
CMI North LM Insurance Corpora#ontCase No. CACE
2G
Imaging of CMI North, L.C d/b/a
v.

014646 ld) Beaches Open MRI of the Treasure Coast, UC
v. The First LibertyInsurance

Case No. CACE 20-014759".
Co/po?ation;

terms of the Class Action Settlement, the
I understand and have been advised of the material
request that I hereby be excluded
and specifically
risks and benefits of the settlement,
monetary
from the Settlement.

I will not be eligible to receive any money
I understand that by optlngout of this Class Action,
if there is one. I do not wish
to receive
of this lawsuit,
that may resultfrom any trial or settlement
or to otherwise partidpate in this
compensation under the terms of any judgment or settlement
Class Action.

HAVE READ AND UNDERSTOOD THE TERMS OF THE
ATTACHED LETTER EXPLAINING THE
I
CLASS ACnON SE1TLEMENT. I HEREBY CONFIRM MORGAN
& MORGAN HAS THE AUTHORITY
BY SIGNING I AM
TO EXCLUDE MY PRACTICE AS PART OF THE CLASS ACTION SETTLEMENT.
AUTHORITY TO DO SO.
REPRESENTING ON BEHALF OF MY PRACTICE THAT I HAVE

OWNER
Position
C.Awtll@ized
Representative

MmlNameC-ANMN
Printed
71,1:/2023
JULY-12,2023
Date Sign?d
ORGAN & l'AN

OPT-OUT FORM
Giancarlo Perez, MD LLC
DBA APEX NEUROSURGICAL & ORTHOPEDIC CENTERS
I Tax ID No. 82-3416242
Full legalname and any aliases
3044-D S. MILITARY TRL
LAKE WORTH. FL 33463
Address

request to be excluded from the Class Adion Settlement a) Presgar Imagbw of CMI North, LC
etal. v.LM Generalmsurance Company Case No. CACE 20-010138.Cb) Beaches CpenMRIof
Tamarac, LLC v. LibertyMutual Insurance Company, Case No. CACE 20-013306; (c) Presgar
Imaging of CMI North, L.C d/b/a CMI North v. LM Insurance Corporation',Case No. CACE 20-
014646 td) Beaches Open MRI of the Treasure Coast, LLC v. The First LibertyInsurance
Corporation;Case No. CACE 20-014759".

I understand that by opting out of this Class Action, I will not be eligible to receive any money
that may result from any trial or settlement of this lawsuit,if there is one. I do not wish to receive
compensation under the terms of any judgment or settlement or to otherwise participatein this

Class Action.

I HAVE READ AND UNDERSTOOD THE TERMS OF THE ATTACHED LETTER EXPLAINING THE
CLASS ACTION SETTLEMENT. I HEREBY CONFIRM MORGAN & MORGAN HAS THE AUTHORITY
TO EXCLUDE MY PRACTICE AS PART OF THE CLASS ACTION SETTLEMENT. BY SIGNING I AM
REPRESENTING ON BEHALF OF MY PRACTICE THAT I HAVE AUTHORITY TO DO SO.

Lz-
Authorized Representative
Practice
Position
Manager

Lori Beatty 7/12/23
Printed Name Date Signed
** INBOUND **
NOTIFICATION : FAX RECEIVED SUCCESSFULLY

TIME RECEIVED REMOTE CSID DURATION PAGES STATUS
July 13, 2023 at 8:17:39 AM EDT 7725624855 422 1 Received
07/13/2023 07:10 7725624855 DR LABELLA PAGE 01

MORGAN & MORGAN

OPT-OUIJORM

ArtM GBel.Ia.TaxIDNo.- 59 179490:
-

I
name
Full legal and any aliases

. isgg 329?0
Hi,gniandAue Vero/?ach,FL ,

Address

of CMI North,LC,
the Class Action Settlement a) PresgarImaging
requestto be excluded from Beaches CpenmI of
Case No.CACE 20-010138; Cb)
etal. v.LM Generalmsurance Comank
No.CACE 20-013306; 4) Aesgar
Tamarac, LLCv.UbemmualmsuranceCmpm,Case Case No. CACE 20-
IMaging of CMI North, L.C. d/b/a CMI North v.
LM Insurance Corporatlont
LLC v. The Rrst LibertyInsurance
014646 (d) Beaches Open MRI of the Treasure Coast
Case No. CACE 20-014759".
Corporation;

the
the material terms of the Class Action Settlement,
I understand and have been advised of
and request that I hereby
be excluded
monetary risks and benefits of the settlement, specifically

from the Settlement.

I will not be eligible to receive any money
I understand that by opting out of this Class Action,
of this lawsuit,if there is one. I do not wish to receive
that may result from any trialor settlement
in this
or to otherwiseparticipate
compensation under the terms of any judgmentor settlement
Class Action.

LETTER EXPLAINING THE
IHAVE READ AND UNDERSTOOD THE TERMS OF THE ATTACHED
CLASS ACTION SE1TLEMENT. I HEREBY CONFIRM
MORGAN & MORGAN HAS THE AUTHORITY
BY SIGNING I AM
TO EXCLUDE MY PRACTICE AS PART OF THE CLASS ACnON SETTLEMENT.
I HAVE AUTHORITY TO DO SO.
REPRESENTING ON BEHALF OF MY PRACTICE THAT

A?LLW?J
Authorized Representative
- OFFIis
Position
.er
BmeNameJAHE.rsun 7-11-2023
Printed
Date Signed
ATianhccniropracEK
OPT-OUT FORM
ancz Tnera.e4

I.--5.05-E)i
IUIL-,
KQC ZC'-5753387
Full legalhame
.ANN
and any aliases
Tax ID No.

1406 ZS+N 5 t ?.,+ PC
Address

request to be excluded from the Class Adion
34947
Settlement a) Presgar
etal. v. LM General
Insurance Company, Case No. CRCE Imaging of CMI North,LC
Tamarac, LLC 10-010138; (b) Beaches Open MRI of
v.
LibertyMutua/ Insurance Company, Case No. CACE
Imaging CMI North,L.C. d/Wa CMI North v. LM
of 20-013306;(c) Presgar
Insurance Corporation', Case No. CACE 10-
014646 ld) Beaches Open MRI of the
Treasure Coast, LLC v. The First
Corporation? Case No. CACE 20-014759". LibertyInsurance

I understand and have been advised of the
material terms of the Class Action
the
Settlement,
monetary risks and benefits of the and specifically
settlement, request that I hereby be
excluded from the Settlement.

I understand that by optingout of this Class
Adion, not be eligible
I will to receive any
that money
may result from any trial or settlement of this lawsuit, there is one. I do not wish to
if
receivecompensation under the terms of any judgment or settlement
or to otherwise
participate
in this Class Adion.

I HAVE READ AND UNDERSTOOD THE TERMS OF
THE ATTACHED LETTER EXPLAINING THE
CLASS ACTION SETTLEMENT. I HEREBY
CONFIRM MORGAN & MORGAN HAS THE AUTHORITY
TO EXCLUDE MY PRACTICE AS PART OF THE
CLASS ACTION SETTLEMENT. BY SIGNING I AM
REPRESENTING ON BEHALF OF MY PRACTICE THAT I HAVE
AUTHORITY TO DO SO.

bSP#TVI.770,i?c&
ESC CJWAC7
AutliorizedRepresentative
Position

Printed
SYoupl
Mn/Imud.PC
Namd
7.IZ-223
Date Signed
ORGAN & MO' GAN

OPT-OUT FORM

AssociatesMD Billing& Management
30-1006042
I LLC d/Wa AssociatesMD Tax ID No.
Full legalname and any aliases

4780 Sw 64th Avenue Suite 103 Davie, FL 33314
Address

request to be excluded from the Class Adion Settlement a) Presgar Imaging of CMI No/th, LC
eta/. v. LM General Insurance Company, Case No. CACE 10-010138; (b) Beaches Open MRI of

Tamara<> LLC v. L/berty Mutual Insurance Company; Case No. CACE 20-013306; (c) Presgar
Imaging of CMI North, L.C d/b/a CMI North v. LM Insurance Corporation', Case No. CACE 20-
014646 ld) Beaches Open MRI of the Treasure Coast, LLC v. The First Liberty Insurance
Co/porat/on; Case No. CACE 20-014759".

Iunderstand and have been advised of the material terms of the Class Adion Settlement, the
monetary risks and benefits of the settlement,and specifically
request that I hereby be excluded
from the Settlement.

compensation under the terms of any judgment or settlement or to otherwise participatein this

Class Adion.

IBEA-
Authorized Representative
Attorney

Position

Hans Kennon 7/11/2023

Printed Name Date Signed
MORGAN & MORGAN

Atlas Heamanu INUIY. OPT-OUT FORM
LLC dba ATLasiNury
TO neaM
IMichcLMN. WWS Tax ID No.
BM.4551254.
Full legalname and any aliases

42SNDiliardgt.Winx.ecGarden,FL34787 Address

request to be excluded from the Class Action Settlement a) Presgar Imaging of CMI North,LC,
etal. v. LM General Insurance
Company, Case No. CACE 20-010138; tb) Beaches Open MRI of
Tamarac, LLC v. Liberty Mutual Insurance Company, Case No. CACE 20-013306; (c) Presgar
Imaging of CMI North, L.C. d/Wa CMI North v. LM Insurance CorporationtCase No. CACE 20-
014646 (d) Beaches Open MRI of the Treasure Coast LLC v. The First
LibertyInsurance
Corporation5 Case No. CACE 20-014759".

I understand and have been advised of the material terms of the Class Action
Settlement,the
monetary risks and benefits of the settlement,and specifically request that I hereby be
excluded from the Settlement.

I understand that by opting out of this Class Action,I will not be to receive any money
eligible
that may result from any trial or settlement of this
lawsuit,if there is one. I do not wish to
receive compensation under the terms of any judgment or settlement or to otherwise
in this Class Action.
participate

I HAVE READ AND UNDERSTOOD THE TERMS OF THE ATTACHED LETTER EXPLAINING THE
CLASS ACTION SETTLEMENT. I HEREBY CONFIRM MORGAN & MORGAN HAS THE
AUTHORITY
TO EXCLUDE MY PRACTICE AS PART OF THE CLASS ACTION SETTLEMENT. BY SIGNING I AM
REPRESENTING ON BEHALF OF MY PRACTICE THAT I HAVE AUTHORITY TO DO SO.

17nielGFTCGL%
Authorized Representative
OwneR
Position

MiuhACISLGUSDL
Name
Printed
71d,
23
Date Signed
M 1 RGA N & O RGA N

OPT-OUT FORM

BACK IN BALANCX
82-1956581
ICHIRDPRACTIC+MCPA
name
legal
Full and any aliases
Tax ID No.

SOJTH MTONAE FL32119
2006 S.RIDGEWOODAVEI. 1
Address
of CMI
A/odh, LC
from the Class Action Settlement a) PresgarImag/>,g MRI of
request to be excluded (b) Beaches Open
Case No. CACE ?0-010138;
eta/. v. LM General Insurance Company
No. CACE 20-013306;(c) Presgar
Mutual Insurance Company, Cdse
Tamarac, LLC v. Ubedy LM Insurance Corporationt Case No. CACE 20-
of CMI North, L.C. d/Wa CMI North v.
Imaging v. The First Uberty Insurance
014646 ld) Open
Beaches MRI of the Treasure Coas4 LLC
Comora#on; Case No. CACE 20-014759".

Class Adion Settlement, the
of the material terms of the
I understand and have been advised be excluded
requestthat I hereby
and specifically
monetary risks and benefits of the settlement,

from the Settlement.

be eligible to receive any money
of this Class Action,I will not
I understand that by optingout to receive
if there is one. I do not wish
trialor settlement of this lawsuit,
that may result from any in this
or settlement or to otherwise participate
compensation under the terms of any judgment
Class Adion.

EXPLAINING THE
TERMS OF THE ATTACHED LETTER
IHAVE READ AND UNDERSTOOD THE & MORGAN HAS THE AUTHORITY
I HEREBY CONFIRM MO@GAN
CLASS ACTION SETTLEMENT. BY SIGNING I AM
MY PRACTICE AS PART OF THE CLASS AdTION SETTLEMENT.
TO EXCLUDE TO DO SO.
PRACTICE THAT I HAVE AUTHORITY
REPRESENTING ON BEHALF OF MY

Owmr
ADU-LdmltA
Authorized Representative
Position

Stgci L. Snith 7/IZ/23
DaHSigne'd
Printed Name
ORGA & ORGAN

OPT-OUT FORM
Basis Medical

Gardens Health & Wellness, Inc. 47-2370346
I Tax ID No. 51 -0494113
Full legalname and any aliases

4794 Northlake Blvd., Suite B 33418
Address

request to be excluded from the Class Adion Settlement a) Presgar Imag/ng of CMI North, LC
eta/. v. LM General Insurance Company, Case No. CACE 20-010138; (b) Beaches Open MRIof

Tamarac> LLC v. Libeny Mutua/ Insurance Company; Case No. CACE 20-013306; (c) Presgar
Imaging of CMI North, L.C d/b/a CMI North v. LM Insurance Corporation',
Case No. CACE 10-
014646 ld) Beaches Open MRI of the Treasure Coast LLC v. The First Liberty Insurance
Corporation;Case No. CACE 20-014759".

Iunderstand and have been advised of the material terms of the Class Action Settlement, the
monetary risks and benefits of the settlement,and specifically
request that I hereby be excluded
from the Settlement.

compensation under the terms of any judgment or settlement or to otherwise participatein this

Class Action.

I HAVE READ AND UNDERSTOOD THE TERMS OF THE ATTACHED LETTER EXPLAINING THE
CLASS ACTION SETTLEMENT. I HEREBY CONFIRM MORGAN & MORGAN HAS THE AUTHORITY
TO EXCLUDE MY PIV\CTICE AS PART OF THE CLASS ACTION SETTLEMENT. BY SIGNING I AM
REPRESENTING ON BEHALF OF MY PRACTICE THAT I HAVE AUTHORITY TO DO SO.

Attorney
Authorized Representative Position

Hans Kennon 7/13/23
Printed Name Date Signed
OPT-OUT FORM
Backin motion,P.A.

I 00/M Dun Cmltpid.RR Tax ID No. B86138642
name
Iegaf
Full and any aliases

32092
309 KMGSIEGELABEDRSAY9.015?.AUg Address

of CMI/Vorth, LC
request to be excluded from the Class Action Settlement a) Presgar Imag/ng
ela/. v. LM General Insurance Companh Case No. CACE 20-010138; (b) Beaches Open MRIof
Tamarac, LLC v. LibertyMutual Insutance Company, Case No. CACE 20-013306; (c) Aesgar
Imaging of CMI North, L.C d/b/a CMI North v. LM Insurance Case No. CACE 10-
Corporation',
014646 Beaches
Cd) OpenMRI of the Treasure Coast LLC v. The First LibertyInsurance
Comomtion; Case No. CACE 20-014759".

I understand and have been advised of the material terms of the Class Action Settlement,the
monetary risks and benefits of the settlement, request that I hereby be excluded
and specifically
from the Settlement.

I understand that by opting out of this Class Action,I will not be eligible to receive any money

that may result from any trial or settlement of this lawsuitifthere Is one. do not wish to
I receive
this
compensation under the terms of any judgment or settlement or
to otherwise participate
in

Class Action.

I HAVE READ AND UNDERSTOOD THE TERMS OF THE ATTACHED LETTER EXPLAINING THE
CLASS ACTION SEITLEMENT. I HEREBY CONFIRM MORGAN & MORGAN HAS THE AUTHORITY
TO EXCLUDE MY PRACTICE AS PART OF THE CLASS ACnON SETTLEMENT. BY SIGNING I AM
REPRESENTING ON BEHALF OF MY PRACTICE THAT I HAVE AUTHORITY TO DO SO.

S, DMZLD.C
Authorized Representative
CEO
Position

Printed
7/7/2023
DLFMBGHRidef.-T)CL
N?me Date Signed

-
MORGAN & ORGAN

OPT-OUT FORM
Bailey.S.0.?..L.A,0,
'WiNMG.LLL

?2Iia?tame*Jblnhl
Full
81-47@0314
legalname and any al?ases
Tax ID No.

224 SOUAmpanlsjre.ciJ?.AuglstineFLBZBOG
Address

request to be excluded from the Class Action Settlement a) Presgar Imagingof CMI
eta/. v. LM General Insurance
NoMK
Company, Case No. CACE 20-010138; (b) Beaches Open MRI of
Tamarac, LLC v. LibertyMutual Insurance Company, Case No. CACE 20-013306; lc) Presgar
Imaging of CMI North, L.C d/b/a CMI North v. LM Insurance Corporation',
Case No. CACE10-
014646 (d) Beaches Open MRI of the Treasure Coast, LLC v. The First
LibertyInsurance
Co/pomt/on; Case No. CACE 20-014759".

Iunderstand and have b

Case Info

Judge

Bowman, John B. Track Judge’s New Case

Case No.

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Document Filed Date

July 13, 2023

Case Filing Date

June 19, 2020

County

Parties

Beaches Open MRI of Tamarac LLC Plaintiff
Guzzi, Gary Attorney for the Defendant
LM General Insurance Company Defendant
Presgar Imaging Of CMI North LC Plaintiff
Wenzel, Thomas J Attorney for the Plaintiff
Antonio Morin Attorneys for Defendants
David Caldevilla Attorneys for Plaintiffs
Chad Barr Attorneys for Plaintiffs
Kimberly Simoes Attorneys for Plaintiffs
James Betts Attorney
J Clark Attorney
John Fry Attorney
Aaron Draizin Attorney
Kevin Jackson Attorneys for Defendants
Lorca Divale Attorneys for Plaintiffs
Nelson Guerra Attorney
Neil Gonzalez Attorney
Julie Barranco Attorney
Christina Coello Attorney
Alexis Gonzalez Attorney
Luis Huguet Attorney
David Alexander Attorney
Daniel Clark Attorney
David McDonald Attorney
Pamela Rakow-Smith Attorneys for Plaintiffs
John Orrick Attorney
Chris Kasper Attorney
Christopher Calkin Attorneys for Plaintiffs
Mike Koulianos Attorneys for Plaintiffs
Gary Johnson Attorney
Edward Zebersky Attorney
Hans Kennon Attorney
Gary Jodat Attorney
William Kennedy Attorneys for Defendants

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Request,Application: Presgar Imaging Of CMI North LC, et al Plaintiff vs. LM General Insurance Company Defendant

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Case Info

Parties