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