Florida Wellness & Rehabilitation Center v. Allstate Fire & Casualty Insurance Co., 201 So. 3d 169

Five consolidated appeals where medical providers, as assignees of Allstate insureds, sued Allstate for PIP medical-bill reimbursement.
Allstate reimbursed at 80% of 200% of Medicare Part B under Fla. Stat. § 627.736(5)(a)(2)(f) (2008).
Under GEICO v. Virtual Imaging Servs., Inc., 141 So. 3d 147 (Fla. 2013), an insurer must clearly and unambiguously notify insureds in the policy if it elects to limit reimbursements via the statutory Medicare-based fee schedules.
The contested Allstate policy clause stated: any amounts payable “shall be subject to any and all limitations, authorized by section 627.736 . . . including but not limited to, all fee schedules.”
County courts granted summary judgment for Allstate; the certified question asked whether that policy language satisfies Virtual Imaging’s election/notice requirement.
The district courts were split; the First and Second Districts upheld similar language, the Fourth District found it ambiguous—this Court affirms Allstate and certifies conflict with the Fourth District.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether a policy provision stating coverage is “subject to any and all limitations… including but not limited to, all fee schedules” clearly and unambiguously elects the §627.736(5)(a)2 Medicare-fee-schedule reimbursement method required by Virtual Imaging	Providers: language is not a clear, unambiguous election as required by Virtual Imaging; cannot limit reimbursement absent express election	Allstate: the phrase “subject to… including… all fee schedules” plainly notifies insureds that reimbursements are limited by the statute’s fee schedules	The court held the policy language is clear and unambiguous and satisfies Virtual Imaging; Allstate may limit reimbursement per §627.736(5)(a)2; affirmed and conflict with the Fourth District certified.

GEICO v. Virtual Imaging Servs., Inc., 141 So. 3d 147 (Fla. 2013) (insurer must elect fee-schedule limitation in policy to use Medicare-based limits)
Allstate Fire & Casualty Ins. v. Stand-Up MRI of Tallahassee, P.A., 188 So. 3d 1 (Fla. 1st DCA 2015) (identical Allstate language satisfies Virtual Imaging)
Orthopedic Specialists v. Allstate Ins. Co., 177 So. 3d 19 (Fla. 4th DCA 2015) (found identical language ambiguous; court below certifies conflict)
St. Augustine Pools, Inc. v. James M. Barker, Inc., 687 So. 2d 957 (Fla. 5th DCA 1997) (use of “subject to” signals subordination/limitation)