Preview
Filing # 200770236 E-Filed 06/18/2024 10:18:58 AM
IN THE COUNTY COURT OF THE THIRTEENTH JUDICIAL CIRCUIT
IN AND FOR HILLSBOROUGH COUNTY, STATE OF FLORIDA
CIVIL DIVISION
ETHOS HEALTH GROUP, LLC. as
assignee of WILLIE DIXON,
Plaintiff,
vs. CASE NO.:
GOVERNMENT EMPLOYEES
INSURANCE COMPANY,
Defendant.
___________________________________/
PLAINTIFF’S NOTICE OF SERVICE OF INTERROGATORIES TO DEFENDANT
Plaintiff, ETHOS HEALTH GROUP, LLC. as assignee of WILLIE DIXON, by and
through his undersigned attorney, pursuant to Rule 1.340 Florida Rules of Civil Procedure,
hereby gives notice and serves the Defendant, GOVERNMENT EMPLOYEES INSURANCE
COMPANY, Interrogatories number 1 through 25, to be answered under oath.
I HEREBY CERTIFY that a true and correct copy has been furnished the Defendant
together with the Summons and Complaint.
____/s/ Alexander Licznerski________
ALEXANDER LICZNERSKI, ESQUIRE
Florida Bar No.: 123873
ANTHONY T. PRIETO, ESQUIRE
Florida Bar No.: 195529
MORGAN AND MORGAN
P.O. BOX 451
St. Petersburg, FL 33731
Tel: 727/318-6344 / Fax: 727/318-6374
Attorneys for Plaintiff
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 1
INTERROGATORIES TO DEFENDANT,
GOVERNMENT EMPLOYEES INSURANCE COMPANY
(Definitions: “You(r)” as used in these Interrogatories mean your corporation, company or
partnership, or anyone who handles, adjusts, or investigates claims on its behalf.)
1. State your complete name, nature of your business, whether you are licensed to do
business in the State of Florida, whether you maintain agents for the transacting of your
customary business in Hillsborough County, and whether your name as it appears in the
Plaintiffs’ Complaint is correct.
2. List the names, addresses and telephone numbers of all persons (other than medical
witnesses, your agents, representatives, or employees) believed or known by you, your agents, or
attorneys to have any knowledge concerning any of the issues raised by the pleadings, specifying
the subject matter about which the witnesses may have knowledge and state whether you have
obtained any statements (oral, written and/or recorded) from any of said witnesses, list the dates
any such witness statements were taken, by whom and who has present possession, custody
and/or control of any statements.
3. List the names, residence addresses, business addresses, and telephone numbers of all
persons believed or known by you, your agents, or attorneys, to have heard the Plaintiff, make
any statement, remark, or comment concerning the treatment being received with regard to the
accident involved herein and the substance of any statement, remark or comment.
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 2
4. List the names, residence addresses, business addresses, and telephone numbers of all
persons who, on your behalf, or on behalf of your agents or representatives, have in any way
participated in the investigation, adjusting or handling of the claim for benefits involved herein
and specify the date the nature of the participation of each such person.
5. Describe in detail each fact known to you about the nature of the Plaintiff’s request for
PIP benefits by listing all information, the date the information was obtained, the form of that
information (from any source), the name, business address and business telephone numbers of
the source of the information indicating that the treatment for which benefits are claimed is “not
necessary”, “not reasonable” or “not related”.
a) List when you informed the Plaintiff you had the information and
when you provided this information to the Plaintiff in writing.
6. Please identify each potential expert witness that could be called to testify at trial;
describe his/her qualifications as an expert; state the substance of the opinions to which he/she is
expected to testify; give a summary of the factual grounds for each opinion; and, provide a list of
all claim’s files or court cases for which you have hired the same medical expert witness in the
last twelve (12) months.
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 3
7. Describe in detail the factual and legal basis for any defense based on the policy that
covers the insured’s PIP Benefits, and give complete names, residence addresses, business
addresses and telephone numbers of each and every person believed or known by you, your
agents, or attorneys, to have knowledge of the facts which would provide the basis for any such
defense.
8. Provide a complete list of all benefits which have been paid to/or on behalf of the
Insured/Plaintiff for injuries the Insured sustained on the date of the accident herein, specify the
nature of the services, the amount of the charges, the date the charges were incurred, the date you
first had notice of the charges, the date the charges were paid by you, and for each, whether you
agree that the benefits paid have been for “reasonable,” “related” and “necessary” medical,
rehabilitative, or remedial services.
9. For each doctor whom you have requested to conduct an “Independent Medical
Examination” of the Plaintiff, please state how many times said Doctor has been hired by you (or
by anyone on your behalf) to make and “Independent Medical Examination” of any of your
insured at any time in the last three (3) years, the identity of other cases wherein said Doctor has
been hired by you to perform “Independent Medical Examinations” on any of your insured and
the amount of fees you have paid said Doctor in the years:
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 4
10. Please provide the names and addresses of all the people who made the decision to
utilize, as a factor, the Medicare Fee Schedule and Workers Compensation Fee Schedule for
reimbursement of PIP and Medpay Benefits.
11. For each medical provider whom you have requested to conduct a “Peer Review” of the
Insured/Plaintiff’s records, please state how many times the medical provider was hired by you
(or by anyone on your behalf) to perform a “Peer Review” of any of your insureds at any time in
the last three (3) years, the case names that the medical provider was hired to work on, and the
amount of fees you have paid the medical provider in those years:
12. List every individual, corporation, or other entity who has obtained the services of
doctors or chiropractors on your behalf to perform “Peer Reviews” at any time within the last
twelve (12) months.
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 5
13. For each doctor or chiropractor who has examined the insured, or the insured’s records
on your behalf of whom you have hired to testify in this case, list all dates on which you
corresponded with said doctor or chiropractor with regard to the insured, list all materials
supplied by you to said doctor or chiropractor for any and all services rendered with regard to the
insured.
14. State whether you have undertaken any surveillance of the insured, made any
investigation of the insured’s background, made any investigation of the insured’s claim history
or otherwise investigated the insured, (as opposed to the Plaintiff’s claim) and give complete
details of the results of such investigation.
15. State the names, residence addresses and business addresses of any and all photographers,
investigators, or video operators which you have hired to take pictures, motion pictures, or
videos which are in anyway related to this lawsuit.
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 6
16. Describe in detail each claim which was submitted by the Plaintiff, or on behalf of the
Insured by any medical provider, which you are denying coverage or otherwise withholding
payment, specifying the date of the service of loss, the name of the provider of the service, the
amount of the charge or loss on which you are denying coverage or withholding payment, the
date you first received notice the portion of the claim on which you are denying coverage or
withholding payments, and the date you first informed the Plaintiff of the denied or withheld
payment.
17. For each denied, reduced or withheld payment of claim listed above, state in detail the
legal grounds and the factual basis upon which the claim was denied, including but not limited to
the exact wording of any opinion of any medical provider, the exact wording of any policy
provisions, and the exact wording of any statutory language or case law upon which you base
your denial or withholding for payment.
18. State the source of each legal ground, factual basis and opinion upon which claim was
denied, as referenced in interrogatory questions number 17.
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 7
19. List the names, addresses and official positions of each and every person in your employ
or in the employ of anyone on your behalf who has had any involvement in the review of the
denial or withholding of payment of the Plaintiff’s claim and state in what capacity they were
involved, the date(s) they were involved and the nature of their involvement.
20. State the exact remaining amount of personal injury protection benefits and extended
medical coverage benefits available under the policy for the subject accident.
21. For each and every request for information sent by you to anyone accompanied by a
medical authorization given by the Plaintiff, state the person or company from whom
information was requested, the date it was requested, the reason for the request, the date there
was a response, the nature of the response, and when, if ever, the same information was
requested from the Plaintiff or the Plaintiff’s attorneys.
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 8
22. With regard to the Plaintiff’s First Request to Produce, for each item on the Request to
Produce of which you are withholding production claiming any privilege (work
product/attorney-client/etc.), please state, with respect to each such document.
(a) The date of the document; the number of pages of the documents;
the type of document involved and its general subject matter
without disclosing its content; and, the names, business addresses,
residence addresses and telephone numbers of all persons who
prepared the document or to whom the document was directed.
(b) The privilege upon the Defendant relies on withholding the
documents; all facts upon which Defendant relies in support of the
privilege; the names, business addresses, residence addresses,
telephone numbers, positions and occupations of all persons
known or believed by Defendant to have knowledge concerning
the factual basis for Defendant’s assertion of privilege with regard
to the documents.
(c) Any policy provisions, statutory language or case law which
Defendant relies upon in claiming the privilege.
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 9
23. If you claim that you were unable to pay Plaintiff’s claim because you had insufficient
information or the notice of claim did not have sufficient support, state: When you first realized
that you had insufficient information, each and every effort made by you to obtain the needed
information, when you informed the Plaintiff of the need for further information, and when you
gave up trying to obtain the needed information.
24. If you claim that you were unable to pay Plaintiff’s claim because you could not obtain
medical information for lack of cooperation of a medical provider or a lack of a medical
authorization from the Plaintiff, please state: When you first informed the Plaintiff that you need
additional medical authorizations.
25. If you claim that you did not pay Plaintiff’s claim because the insured did not attend one
or more IMEs, please state: The name and address of the IME provider(s) and the dates that the
IME was scheduled.
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 10
By:_________________________________
STATE OF ___________________
COUNTY OF _________________
BEFORE ME, the undersigned authority, personally appeared this _____ day of
______________, 20__, who is personally known to me or produced ____________________ as
identification, and after first being duly sworn, states that the above and foregoing Answers to
Interrogatories are true and correct.
____________________________________
NOTARY PUBLIC - State of Florida
My Commission Expires:
6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 11
Preview
Filing # 200770236 E-Filed 06/18/2024 10:18:58 AM IN THE COUNTY COURT OF THE THIRTEENTH JUDICIAL CIRCUIT IN AND FOR HILLSBOROUGH COUNTY, STATE OF FLORIDA CIVIL DIVISION ETHOS HEALTH GROUP, LLC. as assignee of WILLIE DIXON, Plaintiff, vs. CASE NO.: GOVERNMENT EMPLOYEES INSURANCE COMPANY, Defendant. ___________________________________/ PLAINTIFF’S NOTICE OF SERVICE OF INTERROGATORIES TO DEFENDANT Plaintiff, ETHOS HEALTH GROUP, LLC. as assignee of WILLIE DIXON, by and through his undersigned attorney, pursuant to Rule 1.340 Florida Rules of Civil Procedure, hereby gives notice and serves the Defendant, GOVERNMENT EMPLOYEES INSURANCE COMPANY, Interrogatories number 1 through 25, to be answered under oath. I HEREBY CERTIFY that a true and correct copy has been furnished the Defendant together with the Summons and Complaint. ____/s/ Alexander Licznerski________ ALEXANDER LICZNERSKI, ESQUIRE Florida Bar No.: 123873 ANTHONY T. PRIETO, ESQUIRE Florida Bar No.: 195529 MORGAN AND MORGAN P.O. BOX 451 St. Petersburg, FL 33731 Tel: 727/318-6344 / Fax: 727/318-6374 Attorneys for Plaintiff 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 1 INTERROGATORIES TO DEFENDANT, GOVERNMENT EMPLOYEES INSURANCE COMPANY (Definitions: “You(r)” as used in these Interrogatories mean your corporation, company or partnership, or anyone who handles, adjusts, or investigates claims on its behalf.) 1. State your complete name, nature of your business, whether you are licensed to do business in the State of Florida, whether you maintain agents for the transacting of your customary business in Hillsborough County, and whether your name as it appears in the Plaintiffs’ Complaint is correct. 2. List the names, addresses and telephone numbers of all persons (other than medical witnesses, your agents, representatives, or employees) believed or known by you, your agents, or attorneys to have any knowledge concerning any of the issues raised by the pleadings, specifying the subject matter about which the witnesses may have knowledge and state whether you have obtained any statements (oral, written and/or recorded) from any of said witnesses, list the dates any such witness statements were taken, by whom and who has present possession, custody and/or control of any statements. 3. List the names, residence addresses, business addresses, and telephone numbers of all persons believed or known by you, your agents, or attorneys, to have heard the Plaintiff, make any statement, remark, or comment concerning the treatment being received with regard to the accident involved herein and the substance of any statement, remark or comment. 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 2 4. List the names, residence addresses, business addresses, and telephone numbers of all persons who, on your behalf, or on behalf of your agents or representatives, have in any way participated in the investigation, adjusting or handling of the claim for benefits involved herein and specify the date the nature of the participation of each such person. 5. Describe in detail each fact known to you about the nature of the Plaintiff’s request for PIP benefits by listing all information, the date the information was obtained, the form of that information (from any source), the name, business address and business telephone numbers of the source of the information indicating that the treatment for which benefits are claimed is “not necessary”, “not reasonable” or “not related”. a) List when you informed the Plaintiff you had the information and when you provided this information to the Plaintiff in writing. 6. Please identify each potential expert witness that could be called to testify at trial; describe his/her qualifications as an expert; state the substance of the opinions to which he/she is expected to testify; give a summary of the factual grounds for each opinion; and, provide a list of all claim’s files or court cases for which you have hired the same medical expert witness in the last twelve (12) months. 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 3 7. Describe in detail the factual and legal basis for any defense based on the policy that covers the insured’s PIP Benefits, and give complete names, residence addresses, business addresses and telephone numbers of each and every person believed or known by you, your agents, or attorneys, to have knowledge of the facts which would provide the basis for any such defense. 8. Provide a complete list of all benefits which have been paid to/or on behalf of the Insured/Plaintiff for injuries the Insured sustained on the date of the accident herein, specify the nature of the services, the amount of the charges, the date the charges were incurred, the date you first had notice of the charges, the date the charges were paid by you, and for each, whether you agree that the benefits paid have been for “reasonable,” “related” and “necessary” medical, rehabilitative, or remedial services. 9. For each doctor whom you have requested to conduct an “Independent Medical Examination” of the Plaintiff, please state how many times said Doctor has been hired by you (or by anyone on your behalf) to make and “Independent Medical Examination” of any of your insured at any time in the last three (3) years, the identity of other cases wherein said Doctor has been hired by you to perform “Independent Medical Examinations” on any of your insured and the amount of fees you have paid said Doctor in the years: 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 4 10. Please provide the names and addresses of all the people who made the decision to utilize, as a factor, the Medicare Fee Schedule and Workers Compensation Fee Schedule for reimbursement of PIP and Medpay Benefits. 11. For each medical provider whom you have requested to conduct a “Peer Review” of the Insured/Plaintiff’s records, please state how many times the medical provider was hired by you (or by anyone on your behalf) to perform a “Peer Review” of any of your insureds at any time in the last three (3) years, the case names that the medical provider was hired to work on, and the amount of fees you have paid the medical provider in those years: 12. List every individual, corporation, or other entity who has obtained the services of doctors or chiropractors on your behalf to perform “Peer Reviews” at any time within the last twelve (12) months. 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 5 13. For each doctor or chiropractor who has examined the insured, or the insured’s records on your behalf of whom you have hired to testify in this case, list all dates on which you corresponded with said doctor or chiropractor with regard to the insured, list all materials supplied by you to said doctor or chiropractor for any and all services rendered with regard to the insured. 14. State whether you have undertaken any surveillance of the insured, made any investigation of the insured’s background, made any investigation of the insured’s claim history or otherwise investigated the insured, (as opposed to the Plaintiff’s claim) and give complete details of the results of such investigation. 15. State the names, residence addresses and business addresses of any and all photographers, investigators, or video operators which you have hired to take pictures, motion pictures, or videos which are in anyway related to this lawsuit. 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 6 16. Describe in detail each claim which was submitted by the Plaintiff, or on behalf of the Insured by any medical provider, which you are denying coverage or otherwise withholding payment, specifying the date of the service of loss, the name of the provider of the service, the amount of the charge or loss on which you are denying coverage or withholding payment, the date you first received notice the portion of the claim on which you are denying coverage or withholding payments, and the date you first informed the Plaintiff of the denied or withheld payment. 17. For each denied, reduced or withheld payment of claim listed above, state in detail the legal grounds and the factual basis upon which the claim was denied, including but not limited to the exact wording of any opinion of any medical provider, the exact wording of any policy provisions, and the exact wording of any statutory language or case law upon which you base your denial or withholding for payment. 18. State the source of each legal ground, factual basis and opinion upon which claim was denied, as referenced in interrogatory questions number 17. 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 7 19. List the names, addresses and official positions of each and every person in your employ or in the employ of anyone on your behalf who has had any involvement in the review of the denial or withholding of payment of the Plaintiff’s claim and state in what capacity they were involved, the date(s) they were involved and the nature of their involvement. 20. State the exact remaining amount of personal injury protection benefits and extended medical coverage benefits available under the policy for the subject accident. 21. For each and every request for information sent by you to anyone accompanied by a medical authorization given by the Plaintiff, state the person or company from whom information was requested, the date it was requested, the reason for the request, the date there was a response, the nature of the response, and when, if ever, the same information was requested from the Plaintiff or the Plaintiff’s attorneys. 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 8 22. With regard to the Plaintiff’s First Request to Produce, for each item on the Request to Produce of which you are withholding production claiming any privilege (work product/attorney-client/etc.), please state, with respect to each such document. (a) The date of the document; the number of pages of the documents; the type of document involved and its general subject matter without disclosing its content; and, the names, business addresses, residence addresses and telephone numbers of all persons who prepared the document or to whom the document was directed. (b) The privilege upon the Defendant relies on withholding the documents; all facts upon which Defendant relies in support of the privilege; the names, business addresses, residence addresses, telephone numbers, positions and occupations of all persons known or believed by Defendant to have knowledge concerning the factual basis for Defendant’s assertion of privilege with regard to the documents. (c) Any policy provisions, statutory language or case law which Defendant relies upon in claiming the privilege. 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 9 23. If you claim that you were unable to pay Plaintiff’s claim because you had insufficient information or the notice of claim did not have sufficient support, state: When you first realized that you had insufficient information, each and every effort made by you to obtain the needed information, when you informed the Plaintiff of the need for further information, and when you gave up trying to obtain the needed information. 24. If you claim that you were unable to pay Plaintiff’s claim because you could not obtain medical information for lack of cooperation of a medical provider or a lack of a medical authorization from the Plaintiff, please state: When you first informed the Plaintiff that you need additional medical authorizations. 25. If you claim that you did not pay Plaintiff’s claim because the insured did not attend one or more IMEs, please state: The name and address of the IME provider(s) and the dates that the IME was scheduled. 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 10 By:_________________________________ STATE OF ___________________ COUNTY OF _________________ BEFORE ME, the undersigned authority, personally appeared this _____ day of ______________, 20__, who is personally known to me or produced ____________________ as identification, and after first being duly sworn, states that the above and foregoing Answers to Interrogatories are true and correct. ____________________________________ NOTARY PUBLIC - State of Florida My Commission Expires: 6/18/2024 10:18 AM Electronically Filed: Hillsborough County/13th Judicial Circuit Page 11