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Filing # 65585141 E-Filed 12/19/2017 02:10:31 PM
IN THE COUNTY COURT OF THE
ELEVENTH JUDICIAL CIRCUIT IN AND FOR
MIAMI-DADE COUNTY, FLORIDA.
LUIS GARCIA,
CASE NO. 2017-001430-CC-21
Plaintiff,
vs.
GEICO GENERAL INSURANCE COMPANY,
Defendant
/
PLAINTIFF'S MOTION FOR FINAL SUMMARY JUDGMENT
COMES NOW, the Plaintiff, LUIS GARCIA, by and through its undersigned attorneys,
pursuant to Rule 1.510, Florida Rules of Civil Procedure and files this Motion for Summary
Judgment in favor of the Plaintiff on the ground that there is no genuine issue as to any material
fact and the Plaintiff is entitled to judgment as a matter of law as appears from the pleadings,
depositions, admissions on file, and states as follows:
STATEMENT OF FACTS
This matter concerns a claim for assigned PIP insurance benefits arising out of an automobile
accident. The total amount billed is $6,550.00. The policy limit is $10,000.00. The Defendant has
paid other medical providers and has not alleged exhaustion of benefits. The remaining amount
owed is $5,240.00. The Plaintiff propounded initial Admissions on the Defendant at the
inception of this case (see attached as Exhibit A). The Defendant did not respond. (as attached
as Exhibit B). The Plaintiff has relied on the admissions and would be prejudiced if the
Defendant granted relief from admissions.
MEMORANDUM OF LAW
According to Rule 1.510 of the Florida Rules of Civil Procedure, summary judgment isappropriate when there are no genuine issues of material facts that exist and the moving party is
entitled to judgment as a matter of law. The Florida Rules of Civil Procedure authorize a party
to obtain a summary judgment. FLA. R. CIV. PRO. 1.510. The Plaintiff is permitted to rely on a
“technical admission” in support of summary judgment. Asset Management Consultants of
Virginia, Inc., v. City of Tamarac, 913 So.2d 1179 (Fla. 4th DCA 2005); Love Those Pets,
Inc. v. Cocker Rescue of Fort Lauderdale, (FLWSUPP 1701LOVE) 17 Fla. L. Weekly Supp
13a ((Fla. Cir. Ct, 17th Jud. Cir. (App.) Broward Cty.) Sept. 3, 2009, Reh’r ng Den. Sept. 30,
2009); Affiliated Healthcare Centers. Inc. (Claudia Witkowski) v. United Auto. Ins. Co.,
(FLWSUPP 1702WITK)17 Fla. L. Weekly Supp. 122a (Fla. Cty. Ct., (11th Jud. Cir. Miami-
Dade Cty. 2009)) (Miller, J); Hallandale Open MRI, LLC, (Christopher Williams) v. State
Farm. Mut. Auto. Ins. Co., (FLWSUPP 2107WIL2) 21 Fla. L. Weekly Supp. 711a (Fla. Cty.
Ct., (17th Jud. Cir., Broward Cty., 2014) (DeLuca, J.); Phoenix Emergency Medicine of
Broward, LLC (Chervl Wright) v. Equity Ins. Co., (FLWSUPP 2106WRIG) (21 Fla. L
Weekly Supp. 593b (Fla. Cty. Ct., (18th Jud. Cir. Seminole County, Cnty. Ct., 2014)(Collins, J.);
United Auto. Ins. Co. v. West Hollywood Pain & Rehabilitation Center a/a/o Kathleen Jean,
(FLWSUPP 2009KJEA) 20 Fla. L. Weekly Supp. 889a (Fla. Cty. Ct., 17th Cir. Ct., 2013) (App.)
(as attached as Exhibit C).
Tn the case at Bar, the admissions are deemed admitted and the matters of the admissions
are conclusively established. Further, any relief prior to hearing on Plaintiff's Motion for
Summary Judgment would substantially prejudice as well as being untimely and not attributable
to “excusable” neglect but rather “inexcusable” neglect.
At the filing of this lawsuit, the Plaintiff served this complaint and various discovery
requests with the Florida Department of Financial Services. To date, the Defendant has beenserved with interrogatories, requests for production and requests for admissions. Defendant has
not complied with the Florida Rules of Civil Procedure regarding all discovery, including
responding to Plaintiff's Requests for Admissions. Due to Defendant’s default on the Plaintiff’ s
admissions, the admissions are deemed admitted without further action of the Court. The
following are admitted without further action of the Court:
The personal injury protection insurance benefits which are the subject matter of this
litigation are not exhausted.
The Plaintiff provided to the Defendant a pre-suit demand letter prior to the filing of
this matter that substantially complied with the statutory requirements of Section
627.736(10), Fla. Stat.
The Defendant had a contract of automobile insurance with the policy holder on the
date of the motor vehicle accident which is the subject matter of this litigation.
The CPT codes submitted by the Plaintiff on the medical bills which are the subject
matter of this litigation follow the Physicians’ Current Procedural Terminology (CPT)
or Healthcare Correct Procedural Coding System (HCPCS) in effect for the year in
which services are rendered.
Defendant’s contract of automobile insurance was in full force and effect on the date
of the motor vehicle accident, which is the subject matter of this litigation.
Plaintiff complied with all statutory conditions precedent to recover under the above-
referenced policy
Plaintiff was involved in a motor vehicle accident in the State of Florida.
Coverage is not in dispute in this matter.
The Defendant, received notice of this claim after the accident and that such notice
complied with the requirements of Florida Statute 627.736(4)(b).
The Defendant owes the Plaintiff personal injury protection insurance benefits which
is the subject matter of this litigation under the above-referenced contract.
Defendant’s non-payment of the Plaintiff's bills at issue violates Section 627.736, Fla.
Stat.
Defendant has not made any payment for any of the bills sued upon in the Complaint
as of the date of the filing of this lawsuit.
The policy of automobile insurance which is the subject matter of this litigation was
sold by an agent of the Defendant in Florida.
Defendant has no medical report with regard to any treatment for which benefits are
sought by Plaintiff specifically stating that the treatment was "not reasonable", "not
related", and "not necessary"
Venue lies in Dade County, Florida for this action.
The above-styled Court, in and for Dade County, Florida, has jurisdiction over the
claim of the Plaintiff against Defendant.
Charges for the services which are the subject matter of the present litigation are
reasonable charges for the communitye Defendant’s policy of insurance which are the subject matter of the present litigation is
required to conform to all requirements of Sections 627.730 - 627.7405, Florida
Statutes.
e The provisions of Florida Statute 627.428 apply to any dispute between Plaintiff and
Defendant concerning the coverage and the provisions of Florida Statute 627.730 -
627.7405.
WHEREFORE, based upon the authorities cited herein and the argument of counsel, the
Plaintiff respectfully requests an order from the Court entering Final Summary Judgment against
the Defendant as to all issues
CERTIFICATE OF SERVICE
THEREBY CERTIFY that a true and correct copy of the foregoing Motion For Entry Of
A Final Judgment on the pleadings and To Determine Entitlement To And To Tax Attorney’s
Fees And Costs was served pursuant to Rule 2.516, Fla. R. Jud. Admin to the person designated
by Defendant on the Florida Courts E-Serve at the stated contact email on the 19TH day of
December 2017.
Paul K. Schrier, PA
11098 Biscayne Blvd, Suite 208
Miami, Florida 33161
Phone: 305.893.5500
Facsimile: 305.893.8626
Designated primary e-mail: Paul@paulschrierpa.com
Designated secondary e-mail: David@paulschrierpa.com
/s/ Paul K. Schrier, Esq.
Paul K. Schrier, Esquire
Florida Bar No.: 622590IN THE COUNTY COURT OF THE
ELEVENTH JUDICIAL CIRCUIT IN AND FOR
MIAMI-DADE COUNTY, FLORIDA.
LUIS GARCIA,
CASE NO. 2017-001430-CC-21
Plaintiff,
VS.
GEICO GENERAL INSURANCE COMPANY,
Defendant.
/
PERSONAL INJURY PROTECTION REQUEST FOR A.
ISSIONS
COMES NOW, the Plaintiff, LUIS GARCIA, by and through his undersigned counsel,
requests that the Defendant, GEICO GENERAL INSURANCE COMPANY, admit that the
following are true no later than thirty days as provided in Rule 1.370, Florida Rules of Civil
Procedure:
1, Admit that the personal injury protection insurance benefits which are the
subject matter of this litigation are not exhausted.
2 Admit that the Plaintiff provided to the Defendant a pre-suit demand letter
prior to the filing of this matter that substantially complied with the statutory
requirements of Section 627.736(10), Fla. Stat.
3 Admit that the Defendant had a contract of automobile insurance with the
policy holder on the date of the motor vehicle accident which is the subject
matter of this litigation.
4 Admit that the CPT codes submitted by the Plaintiff on the medical bills
which are the subject matter of this litigation follow the Physicians’ Current
Procedural Terminology (CPT) or Healthcare Correct Procedural Coding
System (HCPCS) in effect for the year in which services are rendered.10.
11
12.
14
Admit that Defendant’s contract of automobile insurance was in full force
and effect on the date of the motor vehicle accident, which is the subject
matter of this litigation.
Admit that the assignor complied with all statutory conditions precedent to
recover under the above-referenced policy.
Admit that the assignor was involved in a motor vehicle accident in the State
of Florida.
Admit that coverage is not in dispute in this matter.
Admit the Defendant, received notice of this claim after the accident and that
such notice complied with the requirements of Florida Statute 627.736(4)(b)
Admit that the Defendant owes the Plaintiff personal injury protection
insurance benefits which is the subject matter of this litigation under the
above-referenced contract.
Admit that the Florida Motor Vehicle No-Fault Law does not permit the
Defendant to first reduce reimbursements to the permissive reimbursement
rate and subsequently apply the deductible to the claim.
Admit that the Defendant’s non-payment of the Plaintiff's bills at issue
violates Section 627.736, Fla. Stat
Admit that the Defendant has not made any payment for any of the bills sued
upon in the Complaint as of the date of the filing of this lawsuit.
Admit that the policy of automobile insurance which is the subject matter of
this litigation was sold by an agent of the Defendant in Florida.15.
16.
17.
18.
19.
20.
21
22.
Admit that the Defendant has no medical report with regard to any treatment
for which benefits are sought by Plaintiff specifically stating that the
treatment was "not reasonable", "not related", and "not necessary"
Admit that venue lies in Dade County, Florida for this action
Admit that the above-styled Court, in and for Dade County, Florida, has
jurisdiction over the claim of the Plaintiff against Defendant.
Admit that the Defendant has provided Plaintiff with a report stating that the
reimbursement for treatment for which Plaintiff seeks PIP benefits was "not
reasonable", "not related", or "not necessary"
Admit that the Defendant did not apply the policy deductible to 100% of the
amounts charged.
Admit that upon receipt of the first set of medical bills, the Defendant
reduced the charges and after reducing the charges applied the policy
deductible to the medical bills at issue in this litigation.
Admit that Plaintiff’ s charges for the services which are the subject matter of
the present litigation are reasonable charges for the community.
Admit that the Defendant failed to contact the Plaintiff to inquire as to the
usual and customary charges and payments accepted by the Plaintiff when the
Defendant made payment to the Plaintiff.
Admit that the Defendant’s policy of insurance which are the subject matter
of the present litigation is required to conform to all requirements of Sections
627.730 - 627.7405, Florida Statutes.24. Admit that under the Insured’s policy with Defendant, the provisions of
Florida Statute 627.428 apply to any dispute between Plaintiff and Defendant
concerning the coverage and the provisions of Florida Statute 627.730 -
627.7405.
25. Admit that Defendant has not requested a "peer review" or records review of
any of the Plaintiff(s) medical records or medical expenses related to
Assignor's medical treatment pertaining to the subject claim:
26. If the Defendant paid only a portion of the subject claim or rejected the
subject claim, admit that the Defendant did not provide at the time of the
partial payment or rejection an itemized specification of each item that the
Defendant/insurer had reduced, omitted, or declined to pay pursuant to §
627.736(4)(b)
CERTIFICATE OF SERVICE
THEREBY CERTIFY that a true and correct copy of the foregoing was filed with the
original complaint and served with same through the Florida Department of Financial Services.
Paul K. Schrier, PA
11098 Biscayne Blvd, Suite 208
Miami, Florida 33161
Phone: 305.893.5500
Facsimile: 305.893.8626
Designated primary e-mail: Paul@paulschrierpa.com
Designated secondary e-mail: David@paulschrierpa.com
Scheduling: Jacqui@paulschrierpa.com
By: /s/
Paul K. Schrier, Esq
Fla. Bar No. 62259012/19/2017
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HARVEY RUVIN
CLERK of ote COUTTS
MAREBDE CORNTY, FLORIDE
Miami-Dade County Civil, Family and Probate Courts Online System
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LUIS GARCIA VS GEICO GENERAL INSURANCE COMPANY C/O FDFS
Local Case Number: 2017-001430-CC-21
Filing Date: 06/16/2017
State Case Number: 132017CC001430000021
Case Type: Personal Injury Protection ($5,001 - $15,000)
Consolidated Case No.: N/A
Judicial Section: HI01
Case Status: OPEN
| tg Parties
Number of Parties: 2
Hearing Details
Number of Hearing: 0
3 Dockets
Dockets Retrieved: 12. =
Export tow
Docket
Number Date Book/Page Entry
12 12/18/2017 Request for
Admissions
1 12/18/2017 Motion to
Compel
10 10/17/2017 Motion for
Final
Judgment
9 10/16/2017 Motion for
‘Summary
Judgment
8 10/12/2017 Motion for
‘Summary
Judgment
https:/Avww2.miami-dadeclerk.com/ocs/Search.aspx
Event
Type
Event
Event
Event
Event
Event
Comments
12OCS Search
RECEIPT#:2980003 AMT PAID:$10.00 ALLOCATION CODE QUANTITY UNIT AMOUNT
2139-SUMMONS ISSUE FEE 1 $10.00 $10.00 TENDER TYPE:CHECK TENDER
AMT:$30.00 RECEIPT DATE:07/19/2017 REGISTER#:298 CASHIER:NORRIS2
RECEIPT#:2210004 AMT PAID:$300.00 NAME:PAUL K SCHRIER 11098 BISCAYNE BLVD
‘STE 208 MIAMI FL 33161-7486 ALLOCATION CODE QUANTITY UNIT AMOUNT 2100-
COUNTY FILING FEE 1 $300.00 $300.00 TENDER TYPE:E-FILING ACH TENDER
AMT:$300.00 RECEIPT
12/19/2017
Docket Event
Number Date Book/Page Entry Type Comments
7 08/30/2017 Answer and Event
Affirmative
Defense
6 07/19/2017 Receipt: Event
5 06/19/2017 Receipt: Event
4 06/16/2017 Request for Event
Production
3 06/16/2017 Request for Event
Admissions
2 06/16/2017 Notice of Event
Interrogatory
1 06/16/2017 Complaint Event $6,550.00
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2/212/19/2017 UNITED AUTOMOBILE INSURANCE COMPANY, a Florida corporation, Appellant, vs. WEST HOLLYWOOD PAIN & REHABILITATION CENT...
20 Fla. L. Weekly Supp. 889a
Online Reference: FLWSUPP 2009KJEA
Insurance -- Personal injury protection -- Admissions -- No abuse
of discretion in denying insurer's motion for relief from
admissions where affidavit contradicting admissions was not
filed until after motion for relief from admissions was denied,
and medical provider argued that it would have suffered unfair
prejudice from withdrawal of technical admissions -- Trial court
did not err in striking affidavit offered solely to defeat provider's
motion for summary judgment where affidavit contradicted
insurer's technical admissions -- Final summary judgment in
favor of provider is affirmed
UNITED AUTOMOBILE INSURANCE COMPANY, a Florida
corporation, Appellant, vs. WEST HOLLYWOOD PAIN &
REHABILITATION CENTER, a/a/o Kathleen Jean, Appellee.
Circuit Court, 17th Judicial Circuit (Appellate) in and for Broward
County. Case No. 10-010958 CACE (26), consolidated with 10-
030431 (21). L.T. Case No. 07-004511 COCE (50). May 23, 2013.
OPINION
(HENNING, Judge.) THIS CAUSE came before the Court, sitting in
its appellate capacity, upon appeal by Appellant United Automobile
Insurance Company (“UAIC”), of the trial court's February 24, 2010
final summary judgment in favor of West Hollywood Pain and
Rehabilitation Center, Inc., (a/a/o Kathleen Jean) (“West
Hollywood”) and upon appeal of the trial court's July 21, 2010 final
judgment of attorney's fees and costs.! The court, having considered
the brief filed by the appellant? and being otherwise duly advised in
http://www. floridalawweekly.com/flwonline/?page=showfile&fromsearch=1 &file=../supfiles/issues/vol20/889a .htm&query=FLWSUPP+2009KJEA&altdoc... 1/612/19/2017 UNITED AUTOMOBILE INSURANCE COMPANY, a Florida corporation, Appellant, vs. WEST HOLLYWOOD PAIN & REHABILITATION CENT...
the premises, dispenses with oral argument and finds and decides as
follows:
On November 7, 2006, Kathleen Jean sustained injuries as a result of
an automobile accident and sought medical treatment for those
injuries. On March 15, 2007, Appellee West Hollywood filed suit
against UAIC seeking payment of personal injury protection (“PIP”)
benefits as assignee of UAIC's insured, Kathleen Jean. On April 11,
2007, West Hollywood serv ni jth
request for admissions. The record reveals that UAIC failed to timely
respond to the request for admissions. On June 20, 2007, UAIC
requested leave to file its responses to West Hollywood's request for
admissions. Subsequently, on April 3, 2008, UAIC filed an amended
verified motion for leave to file its responses to West Hollywood's
request for admissions. On May 12, 2008, Plaintiff moved for final
summary judgment, relying on UAIC's technical admissions of
liability and amount of damages. On June 17, 2008, the trial court
denied UAIC's motion for relief from admissions. On December 3,
2009, West Hollywood filed a Supplemental Motion for Final
Summary Judgment. On February 17, 2010, Plaintiff filed a
Renewed Motion for Summary Judgment. On February 24, 2010, the
trial court held a hearing and granted final summary judgment in
favor of West Hollywood in the amount of $2,600. West Hollywood
then moved for and was awarded $25,296 in attorney's fees and
costs. On March 5, 2010, UAIC timely filed its notice of appeal of
the trial court's February 24, 2010 Final Judgment for medical
benefits. On July 27, 2010, UAIC timely filed its notice of appeal of
the trial court's July 21, 2010 Final Judgment for attorney's fees and
costs.
The standard of review for a lower court's order granting summary
judgment is de novo. Major League Baseball v. Morsani, 790 So. 2d
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1071, 1074 (Fla. 2001) [26 Fla. L. Weekly S465a]. Summary
judgment is appropriate only where there is no genuine issue of
material fact and the movant is entitled to judgment as a matter of
law. See Volusia County vy. Aberdeen at Ormond Beach, L.P., 760 So.
2d 126, 130 (Fla. 2000) [25 Fla. L. Weekly S390a] (citation omitted).
The record clearly establishes that UAIC failed to timely respond to
West Hollywood's Request for Admissions. Further, the record
reveals that the trial court granted West Hollywood's motion for
summary judgment, relying on UAIC's technical admissions to
requests for admission numbers eight3 (8) and ten4 (10).
Florida Rule of Civil Procedure 1.370(a) provides that the failure to
timely respond to a party's request for admissions automatically
deems those unanswered requests as admitted. See Fla. R. Civ. P.
1.370(a). However, “the court may permit withdrawal or amendment
[of a technical admission] when the presentation of the merits of the
action will be subserved by it and the party who obtained the
admission fails to satisfy the court that withdrawal or amendment
will prejudice that party in maintaining an action or defense on the
merits.” See Fla. R. Civ. P. 1.370(b). Florida courts have observed
that this “liberal standard favors amendment in most cases in order to
allow disposition on the merits.” Ramos v. Growing Together, Inc.,
672 So. 2d 103, 104 (Fla. 4th DCA 1996) [21 Fla. L. Weekly D991b]
(citations omitted). Further, “the use of admissions obtained through
a technicality should not for a basis to preclude adjudication of a
legitimate claim.” /d. (citations omitted).
Appellant argues that the trial court erred in denying UAIC's motion
for relief from admissions and in granting Plaintiff's motion for final
summary judgment where the record contained evidence
contradicting the admissions and Plaintiff failed to show that it
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would have suffered unfair prejudice resulting from the withdrawal
of the technical admissions. Under Florida law, it is an abuse of
discretion to deny a motion for relief from technical admissions
where there is an affidavit that clearly contradicts those technical
admissions, and where the opposing party “failed to show ‘prejudice'
within the meaning of the rule.” Thomas vy. Chase Manhattan Bank,
875 So. 2d 758, 760 (Fla. 4th DCA 2004) [29 Fla. L. Weekly
D1528a]. Despite Appellant's argument to the contrary, the record
reveals that at the time the trial court denied the motion for relief
from admissions, UAIC had not yet filed the affidavit of Dr. Bradley
Simon. Dr. Simon conducted a peer review of Kathleen Jean's
medical records and opined that some of the treatment was
unnecessary and that some of the charges were excessive. Dr.
Simon's affidavit was not filed until December 28, 2009. The trial
court's order denying UAIC's motion for relief from admissions was
entered on June 17, 2008. Furthermore, the record and transcript of
the proceedings reveals that the parties argued the issue of prejudice.
Thus, this Court determines that the trial court did not abuse its
discretion when it denied UAIC's motion for relief from its
admissions.
Next, Appellant argues that the trial court erred in granting summary
judgment where the record contained evidence contradicting the
technical admissions. At issue isthe affidavit of Dr. Bradley Simon,
which wassubmitted in opposition to the motion for summary
judgment. The February 24, 2010 transcript of the proceedings
reveals that the affidavit of Dr. Simon was the subject of a motion to
strike. West Hollywood, in its motion to strike, argued that a party
cannot submit an affidavit in opposition to a summary judgment that
controverts a prior admission. Although there is no written order, the
transcript of the proceedings reveals that the trial court agreed with
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Plaintiff, struck the affidavit of Dr. Simon, and entered summary
judgment in favor of West Hollywood.
This Court has reviewed the affidavit of Dr. Bradley Simon. The
affidavit clearly contradicts the technical admissions. Under Florida
law, a party cannot submit an affidavit which deviates from a party's
previous admission solely to defeat a summary judgment. See
McKean vy. Kloeppel Hotels, Inc., 171 So. 2d 552, 555 (Fla. Ist DCA
1965); See also, Jordan yv. State Farm Ins. Co., 515 So. 2d 1317,
1319 (Fla. 2d DCA 1987). Thus, this Court determines that the trial
court did not err when it struck the affidavit of Dr. Simon. Therefore,
upon a review of the record and in light of the summary judgment
evidence before the court, there is no genuine issue of material fact
that West Hollywood is entitled to judgment as a matter of law. West
Hollywood met its burden on summary judgment based on its own
affidavits and the technical admissions of UAIC. UAIC did not
submit any summary judgment evidence to demonstrate that a
genuine issue of material fact exists. Thus, West Hollywood was
entitled to summary judgment as a matter of law. Furthermore, since
the trial court did not err in entering Final Judgment for medical
benefits in favor of West Hollywood, the Final Judgment for
attorney's fees and costs judgment must also be affirmed.
Accordingly, it ishereby:
ORDERED AND ADJUDGED that the trial court's February 24,
2010 final summary judgment is AFFIRMED.
IT IS FURTHER ORDERED AND ADJUDGED that the trial court's
July 21, 2010 final judgment of attorney's fees and costs is
AFFIRMED.
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1On August 19, 2010, this Court ci ———__—eetems no
Appeal No. 10-030431 CACE (21) from Division 2 and
consolidating into Appeal No. 1010958 CACE (26).
2This court permitted extensions of time to file an answer brief on:
(1) 7/28/2011; (2) 8/30/2011; (3) 10/5/2011; (4) 11/22/2011; (5)
12/13/2011; (6) 1/19/2012; (7) 2/22/2012; (8) 4/17/2012; (9)
5/4/2012; (10) 6/12/2012; (11) 8/10/2012; and (12) /14/2013.
Appellee failed to file an answer brief.
3UAIC technically admitted that the “defendant refuses to pay to the
Plaintiff the contractual portion of the medical charges incurred by
[Kathleen Jean] with the Plaintiff since the date of the subject
accident, and the Defendant is liable for those sums under the
personal injury protection insurance provisions of the above
automobile policy.” (Req. for Admission #8).
4UAIC technically admitted that the “Defendant is fully liable to
Plaintiff for the medical service rendered on behalf of its insured.”
(Req. for Admission #10).
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