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UNITED AUTOMOBILE INSURANCE COMPANY v. PROGRESSIVE REHABILITATION AND ORTHOPEDIC SERVICES, LLC A/A/O YASEL ALONSO
21-0108
| Fla. Dist. Ct. App. | Jul 21, 2021
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Background

  • Clinic (assignee of Yasel Alonso) sued United for PIP benefits, asserting medical charges were reasonable and seeking payment.
  • Clinic moved for summary judgment on reasonableness, submitting an affidavit from Dr. Jason Levine attesting charges were reasonable.
  • United filed an earlier affidavit from Monica Johnson, a claims adjuster/records custodian, opining the charges were unreasonable and stating she would oppose the Clinic’s motion.
  • The trial court granted summary judgment for the Clinic, finding Johnson’s affidavit speculative and legally insufficient, and entered final judgment for $1,275.26.
  • The district court reversed, holding Johnson’s affidavit was based on personal knowledge, experience, review of the file, statutory evidentiary factors, and fee schedules, and thus was not purely speculative; case remanded for further proceedings.

Issues

Issue Plaintiff's Argument Defendant's Argument Held
Whether Monica Johnson’s affidavit was legally sufficient to oppose summary judgment Johnson’s opinions are speculative, conclusory, and lack supporting facts, so insufficient to create a triable issue Johnson has 20+ years’ experience, reviewed the claims file, applied statutory evidentiary factors and fee schedules, so her affidavit is admissible and raises a factual dispute Affidavit was legally sufficient; not purely speculative; reversal and remand ordered
Whether experience-based expert opinion is barred or must meet Daubert reliability Clinic suggested experience-only opinions (per Marsh concerns) are insufficient without stricter admissibility screening Experience-based expert testimony is permitted under §90.702 and Daubert; reliability inquiry applies but does not bar experience alone Court explained Daubert permits experience-based opinions subject to reliability review; lower court may evaluate Johnson under Daubert on remand

Key Cases Cited

  • Gonzalez v. Citizens Prop. Ins. Corp., 273 So. 3d 1031 (affidavit insufficient where opinion lacked a fact-based chain of reasoning)
  • Morgan v. Cont'l Cas. Co., 382 So. 2d 351 (affidavits based on speculation or surmise cannot create material fact issues)
  • Panzera v. O'Neal, 198 So. 3d 663 (lay speculation not a substitute for expert or fact-based testimony)
  • Kumho Tire Co. v. Carmichael, 526 U.S. 137 (Daubert reliability inquiry applies to experience-based expert testimony)
  • Marsh v. Valyou, 977 So. 2d 543 (addressed the treatment of pure opinion testimony under Frye; discussed in legislative response)
  • Daubert v. Merrell Dow Pharm., Inc., 509 U.S. 579 (established the federal reliability framework for expert admissibility)
  • In re Amendments to Florida Evidence Code, 278 So. 3d 551 (Florida Supreme Court adoption of Daubert standard for expert testimony)
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Case Details

Case Name: UNITED AUTOMOBILE INSURANCE COMPANY v. PROGRESSIVE REHABILITATION AND ORTHOPEDIC SERVICES, LLC A/A/O YASEL ALONSO
Court Name: District Court of Appeal of Florida
Date Published: Jul 21, 2021
Docket Number: 21-0108
Court Abbreviation: Fla. Dist. Ct. App.