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Filing # 118466920 E-Filed 12/18/2020 02:07:33 PM
10983972 IN THE SMALL CLAIMS COURT OF THE NINTH
JUDICIAL CIRCUIT IN AND FOR ORANGE
COUNTY, FLORIDA
STAND-UP MRI OF TALLAHASSEE, P.A. a/a/o CASE NO.:
JANET BOHANNON,
Plaintiff,
vs.
MGA INSURANCE COMPANY, INC.,
Defendant.
_________________________________________/
PLAINTIFF'S FIRST REQUEST TO PRODUCE TO DEFENDANT
Plaintiff, STAND-UP MRI OF TALLAHASSEE, P.A., as assignee of Janet Bohannon,
pursuant to Florida Rule 1.350 Florida Rules of Civil Procedure, hereby requests that the
Defendant MGA INSURANCE COMPANY, INC., to produce the items and matters hereinafter set
forth.
The items and matters to be produced are as follows:
1. Please produce a copy of allautomobile insurance policies that cover the Plaintiff’s claim
for personal injury protection benefits and medical payments coverage as referenced in
the complaint.
2. Please produce a declaration of coverage regarding all automobile insurance policies that
cover the Plaintiff’s claim for personal injury protection benefits and medical payments
coverage as referenced in the complaint, including a sworn statement of a corporate
officer or Defendant attesting to the coverage and authenticity of the policy as required by
Florida Statutes.
3. Please produce any and all documents executed by Janet Bohannon regarding all
automobile insurance policies that cover the Plaintiff’s claim for personal injury protection
benefits and medical payments coverage as referenced in the complaint.
4. Please produce all explanations of benefits, explanations of reviews, or similar documents
that listthe dates of service, the dates the medical billsor charges were received, CPT
codes billed, amounts billed, amounts paid, and basis of reduction or nonpayment for all
treatment, medical services, and diagnostic testing provided to Janet Bohannon.
5. Please produce a current PIP log, PIP payout sheet, or similar document that lists the
total amount of PIP benefits and medical payments coverage that have been paid by
Defendant for all claims by Janet Bohannon regarding the October 30, 2016 accident.
6. Please produce a copy of the “demand letter under Florida Statutes § 627.736(10)” that
you received from Plaintiff regarding the medical bills or charges at issue in this case, as
referenced in the complaint.
7. Please produce all requests for additional information pursuant to Florida Statutes §
627.736(6)(b) that you sent to Plaintiff regarding any of the medical bills or charges at
issue in this case, as reflected in the complaint.
8. Please produce the reasonable proof you relied upon to deny or withhold payment for the
medical bills or charges at issue in this case, as referenced in the complaint.
9. Please produce the reasonable proof you relied upon to reduce the amount paid for the
medical bills or charges at issue in this case, as referenced in the complaint.
10. Please produce the reasonable proof you relied upon to deny personal injury protection and
medical payments coverage to Janet Bohannon regarding the accident referenced in the
complaint.
11. If you denied payment to Plaintiff due to Janet Bohannon’s or the policyholder’s failure to
comply with conditions precedent, please produce the reasonable proof you relied upon to
establish that Janet Bohannon or the policyholder failed to comply with conditions
precedent.
12. Any and all correspondence between the insured and carrier regarding the PIP and/or
medical payment benefits available under the subject automobile insurance policy.
13. Any and all correspondence between the insured and carrier explaining benefits
available under the subject policy of insurance.
14. Please produce any and all compulsory medical examination/independent medical
examination/peer review/medical review/billing review reports obtained by Defendant, or
anyone on Defendant’s behalf, regarding the medical condition, treatment or charges of
the Insured.
15. Please produce a copy of every written response Defendant sent to Plaintiff for every
“demand letter under s. 627.736” that you received from or on behalf of Plaintiff regarding
the medical bills or charges by the medical provider for treatment of the Insured.
16. Please produce a copy of every invoice, bill, or claim form that you received from the
medical provider for treatment of the Insured.
17. If you challenge the reasonableness, relatedness or necessity of any of the treatment
referenced in the Complaint or Demand letter, please produce all medical records of the
Insured.
18. Please produce a copy of every “demand letter under s. 627.736” that you received from
or on behalf of Plaintiff regarding the medical bills or charges by the medical provider for
treatment of the Insured.
19. If Defendant made reductions to the medical provider’s bills or charges at issue based
upon evidence of usual and customary charges and payments accepted by the provider
involved in the dispute, reimbursement levels in the community and various federal and
state medical fee schedules applicable to motor vehicle and other insurance coverages,
and other information relevant to the reasonableness of the reimbursement for the
service, treatment, or supply, please produce all such evidence.
20. If you contend the medical provider or Insured failed to comply with conditions
precedent, please produce the reasonable proof you relied upon to establish that Patient
or the policyholder failed to comply with conditions precedent.
21. Please produce a signed copy of any “Deductible Election Form” if you contend the
Deductible is applicable to the Assignor.
It is hereby requested that the aforementioned production be made within forty-five (45)
days from the date of service to HANS KENNON, ESQUIRE, at the offices of Morgan & Morgan,
P.A., 20 North Orange Avenue, Suite 400, Orlando, Florida 32801. Inspection will be made by
visual observation, examination and/or copying.
I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished
to the Defendant along with the Summons and Complaint.
/s/ HANS KENNON
HANS KENNON, ESQUIRE
Florida Bar No. 0059323
MORGAN & MORGAN, P.A.
20 N. Orange Avenue, 4th Floor
Post Office Box 4979
Orlando, FL 32802-4979
(407) 420-6686 – Phone
(407) 245-3370 – Fax
Primary Email: Hkennon@forthepeople.com
Secondary Email:
MTurner@forthepeople.com
Attorneys for Plaintiff
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Filing # 118466920 E-Filed 12/18/2020 02:07:33 PM 10983972 IN THE SMALL CLAIMS COURT OF THE NINTH JUDICIAL CIRCUIT IN AND FOR ORANGE COUNTY, FLORIDA STAND-UP MRI OF TALLAHASSEE, P.A. a/a/o CASE NO.: JANET BOHANNON, Plaintiff, vs. MGA INSURANCE COMPANY, INC., Defendant. _________________________________________/ PLAINTIFF'S FIRST REQUEST TO PRODUCE TO DEFENDANT Plaintiff, STAND-UP MRI OF TALLAHASSEE, P.A., as assignee of Janet Bohannon, pursuant to Florida Rule 1.350 Florida Rules of Civil Procedure, hereby requests that the Defendant MGA INSURANCE COMPANY, INC., to produce the items and matters hereinafter set forth. The items and matters to be produced are as follows: 1. Please produce a copy of allautomobile insurance policies that cover the Plaintiff’s claim for personal injury protection benefits and medical payments coverage as referenced in the complaint. 2. Please produce a declaration of coverage regarding all automobile insurance policies that cover the Plaintiff’s claim for personal injury protection benefits and medical payments coverage as referenced in the complaint, including a sworn statement of a corporate officer or Defendant attesting to the coverage and authenticity of the policy as required by Florida Statutes. 3. Please produce any and all documents executed by Janet Bohannon regarding all automobile insurance policies that cover the Plaintiff’s claim for personal injury protection benefits and medical payments coverage as referenced in the complaint. 4. Please produce all explanations of benefits, explanations of reviews, or similar documents that listthe dates of service, the dates the medical billsor charges were received, CPT codes billed, amounts billed, amounts paid, and basis of reduction or nonpayment for all treatment, medical services, and diagnostic testing provided to Janet Bohannon. 5. Please produce a current PIP log, PIP payout sheet, or similar document that lists the total amount of PIP benefits and medical payments coverage that have been paid by Defendant for all claims by Janet Bohannon regarding the October 30, 2016 accident. 6. Please produce a copy of the “demand letter under Florida Statutes § 627.736(10)” that you received from Plaintiff regarding the medical bills or charges at issue in this case, as referenced in the complaint. 7. Please produce all requests for additional information pursuant to Florida Statutes § 627.736(6)(b) that you sent to Plaintiff regarding any of the medical bills or charges at issue in this case, as reflected in the complaint. 8. Please produce the reasonable proof you relied upon to deny or withhold payment for the medical bills or charges at issue in this case, as referenced in the complaint. 9. Please produce the reasonable proof you relied upon to reduce the amount paid for the medical bills or charges at issue in this case, as referenced in the complaint. 10. Please produce the reasonable proof you relied upon to deny personal injury protection and medical payments coverage to Janet Bohannon regarding the accident referenced in the complaint. 11. If you denied payment to Plaintiff due to Janet Bohannon’s or the policyholder’s failure to comply with conditions precedent, please produce the reasonable proof you relied upon to establish that Janet Bohannon or the policyholder failed to comply with conditions precedent. 12. Any and all correspondence between the insured and carrier regarding the PIP and/or medical payment benefits available under the subject automobile insurance policy. 13. Any and all correspondence between the insured and carrier explaining benefits available under the subject policy of insurance. 14. Please produce any and all compulsory medical examination/independent medical examination/peer review/medical review/billing review reports obtained by Defendant, or anyone on Defendant’s behalf, regarding the medical condition, treatment or charges of the Insured. 15. Please produce a copy of every written response Defendant sent to Plaintiff for every “demand letter under s. 627.736” that you received from or on behalf of Plaintiff regarding the medical bills or charges by the medical provider for treatment of the Insured. 16. Please produce a copy of every invoice, bill, or claim form that you received from the medical provider for treatment of the Insured. 17. If you challenge the reasonableness, relatedness or necessity of any of the treatment referenced in the Complaint or Demand letter, please produce all medical records of the Insured. 18. Please produce a copy of every “demand letter under s. 627.736” that you received from or on behalf of Plaintiff regarding the medical bills or charges by the medical provider for treatment of the Insured. 19. If Defendant made reductions to the medical provider’s bills or charges at issue based upon evidence of usual and customary charges and payments accepted by the provider involved in the dispute, reimbursement levels in the community and various federal and state medical fee schedules applicable to motor vehicle and other insurance coverages, and other information relevant to the reasonableness of the reimbursement for the service, treatment, or supply, please produce all such evidence. 20. If you contend the medical provider or Insured failed to comply with conditions precedent, please produce the reasonable proof you relied upon to establish that Patient or the policyholder failed to comply with conditions precedent. 21. Please produce a signed copy of any “Deductible Election Form” if you contend the Deductible is applicable to the Assignor. It is hereby requested that the aforementioned production be made within forty-five (45) days from the date of service to HANS KENNON, ESQUIRE, at the offices of Morgan & Morgan, P.A., 20 North Orange Avenue, Suite 400, Orlando, Florida 32801. Inspection will be made by visual observation, examination and/or copying. I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the Defendant along with the Summons and Complaint. /s/ HANS KENNON HANS KENNON, ESQUIRE Florida Bar No. 0059323 MORGAN & MORGAN, P.A. 20 N. Orange Avenue, 4th Floor Post Office Box 4979 Orlando, FL 32802-4979 (407) 420-6686 – Phone (407) 245-3370 – Fax Primary Email: Hkennon@forthepeople.com Secondary Email: MTurner@forthepeople.com Attorneys for Plaintiff