The Supreme Court Committee on Standard Jury Instructions in Civil Cases is proposing an instruction and verdict form for claims for personal injury protection (PIP) medical benefits, which are reproduced in full below as well as online at www.floridabar.org. Interested persons may provide comments on the proposals by December 15, but are encouraged to submit them by November 1 for consideration at the committee’s meeting on November 3-4. All comments should be sent to the committee chair, Scott D. Makar, Office of General Counsel, 117 West Duval St., Suite 480, Jacksonville 32202-5721 or via e-mail at [email protected] MI 13 CLAIM FOR PERSONAL INJURY PROTECTION BENEFITS (PIP) (Medical Benefits Only) a. Issues: (Plaintiff) seeks personal injury benefits from (Defendant) for [a medical service] [medical services]. (Plaintiff) is entitled to recover benefits if the service[s] is [are] related to the accident, the service[s] is [are] medically necessary, and the charge[s] for the service[s] is [are] reasonable. [Give this preemptive instruction only where rulings or stipulations have altered the number of issues to be proven.] In this case, there is no dispute that (the service[s] is [are] related to the accident) [and] (that the service[s] is [are] medically necessary) [and] (that the charge[s] is [are] reasonable), but there is dispute over (whether the service[s] is [are] related to the accident) [and] (whether the service[s] is [are] medically necessary) [and] (whether the charge[s] for the service[s] is [are] reasonable). [To be given in all cases. Alter numbering where required due to rulings or stipulations.] Therefore, on this claim for personal injury benefits, you must decide the following: The first issue is whether the service is related to the automobile accident of (date). If you decide that a service is not related to the accident, you should not award damages for that service. If you decide that one or more services are related to the accident, you must then decide a second issue. The second issue is whether the service is medically necessary. If you decide that a service was not medically necessary, you should not award damages for that service. If you decide that one or more services are medically necessary, you must then decide a third issue. The third issue is whether the charge is reasonable. If you find the charge for a service or services reasonable, you should award that amount as damages. If you find the charge for a service is not reasonable, you should determine what is a reasonable amount and award that amount. In determining these issues, you should apply the following definitions: [Give applicable definitions below] a. Services: The term “services” includes, but is not limited to, treatment, diagnostic studies, and supplies provided by the medical provider to the insured. b. Medically Necessary: “Medically necessary” refers to a medical service or supply that a prudent physician would provide for the purpose of preventing, diagnosing, or treating an illness, injury, disease, or symptom in a manner that is: (a) In accordance with generally accepted standards of medical practice; (b) Clinically appropriate in terms of type, frequency, extent, site, and duration; and, (c) Not primarily for the convenience of the patient, physician, or other health care provider. c. Reasonable Charge: 1 In deciding whether the amount of a charge is reasonable, you may consider evidence of: · usual and customary amounts charged and payments accepted by the provider; · reimbursement levels in the community; · various federal and state medical fee schedules applicable to automobile coverages; and · any other evidence relevant to the reasonableness of the charges. You may not, however, award an amount that exceeds the amount the provider customarily charges for like services or supplies. [Burden – To be given in all cases.] If the greater weight of the evidence does not support the claim of (Plaintiff), then your verdict should be for (Defendant). However if the greater weight of the evidence does support the claim of (Plaintiff), then your verdict should be for (Plaintiff) and against (Defendant). [Give when defenses to the claim have been raised.] If, however, the greater weight of the evidence does support the claim of (Plaintiff), then you shall consider the defense[s] raised by (Defendant). [Give in all cases.] “Greater weight of the evidence” means the more persuasive and convincing force and effect of the entire evidence in the case. NOTES ON USE This instruction assumes that the jury will be asked to decide the total amount of medical charges. It is anticipated that the judge will adjust this award in entering judgment to account for any payments previously made by the insurer, as well as for the effect of the 80% limitation in section 627.736(1)(a) and any deductible. COMMENT 1. The definition of “medically necessary” is based on section 736.732(2), Florida Statutes (2003). The committee has added the option of a “prudent health care provider” to this definition in anticipation that the phrase, “prudent physician,” as described in the statute could sometimes be inadequate. This statutory definition is somewhat complex. It is possible that the parties could agree upon a plainer and simpler definition. 2. No definition of “related” is provided in this instruction. Causation can be a complex issue in a PIP case. Generally, to invoke this insurance coverage a bodily injury must “arise out of the ownership, maintenance, or use of a motor vehicle.” See § 768.736(1), Fla. Stat. (2003); Lumbermen’s Mutual Casualty Co. v. Castagna, 368 So. 2d 348 (Fla. 1979). The medical treatment covered by the insurance policy is the treatment that is related to the bodily injury arising out of the ownership, maintenance, or use of the motor vehicle. The committee has been advised that most practitioners prefer to use the term, “related,” as a simple method to explain causation to the jury. The committee does not intend for S.J.I. 5.1 to be given in a PIP case as an explanation of causation. (Footnotes) 1 T his statutory description of reasonable amount may require a supplemental instruction for fee capped diagnostic testing services as described in Section 627.736(5)(b), Florida Statutes (2003). IN THE COUNTY COURT IN AND FOR _________________COUNTY, FLORIDA Case No. Judge Plaintiff, v. Defendant. ________________________________/ VERDICT FORM MI 13 PIP – Medical Services 1. Are any of the services related to the accident of (date). ______ Yes ______ No If your answer is no, your verdict is for the Defendant and you should go no further but to sign and date the verdict form. If your answer is yes, you should answer question 2. 2. Are any of the services medically necessary? ______ Yes ______ No If your answer is no, your verdict is for the Defendant and you should go no further but to sign and date the verdict form. If your answer is yes, you should answer question 3. 3. Are [is] the charge[s] for the service[s] reasonable? If you find the charge or charges reasonable, you should proceed to number 4. However, if you find the charge or charges unreasonable, you must determine a reasonable amount for the charge or charges, then proceed to question 4. 4. What is the total amount do you find reasonable? $____________________ SO SAY WE ALL, this _____ day of ________________________, _______. ___________________________ FOREPERSON October 15, 2005 Regular News Proposed ‘PIP’ jury instructions Proposed ‘PIP’ jury instructions
All five presidential candidates have been all over New York City and they’ve made an effort to criss-cross the entire state.“Normally New York is just the ATM on the political circuit,” said Siena College pollster Steven Greenberg.The political climate is different this time around, however.“New Yorkers get to feel a little bit like how voters in Iowa and New Hampshire feel,” he added. “We actually get to see and feel the candidates.”Greenberg told the story of his 18-year-old daughter attending a Sanders rally at the Washington Avenue Armory in Albany on the same day she saw Trump speak at the Times Union Center arena in the state capital. The week before that she turned out for a Clinton event.“I think that’s really cool for New Yorkers,” Greenberg said. “For my daughter and for many others, it was a civics lesson. It was a chance to see history and to see the process in action. I think anytime we have that, that’s great.”Some have pointed to the 1976 presidential primary, which came on the heels of President Richard Nixon’s resignation before he could get impeached in 1974, as the last time the New York primary mattered this much for both parties. Forty-years later, New York is back in play.Leslie D. Feldman, a professor of political science at Hofstra University, considers the competitive primaries as a win for New York in general.“This is the best thing that ever happened to New York because if we have the choice of Hillary Clinton or Trump, we get a president from New York, which is something that we haven’t had in decades,” Feldman said, noting that three of the five candidates have played up their New York roots.“Doesn’t everyone in New York want a New York president?” she added.Political observers have also speculated that primary fever could drive people to the polls, with Feldman predicting lines down the block.In 2008, the last time both parties held presidential primaries, 36 percent of Democrats and 34 percent of Republicans turned out to vote in Nassau County. Turnout was significantly less in Suffolk, with roughly 19 percent of voters coming out for both parties.Despite the political frenzy, Greenberg suspects turnout could fall short of 40 percent statewide, but he’s hoping for record turnouts.No matter what happens, for two weeks New York was front and center in the political world, giving the rest of the nation a unique opportunity to see what it means for candidates to come face-to-face with voters here.Just ask Kasich what’s it’s like to stump on LI. When the audience got a chance to challenge the Ohio governor directly at the MSNBC town hall, one skeptical voter was not buying the Ohio governor’s claims that he’s appealing to New York voters and questioned where the candidate was getting his information.“Who told you that you’re all that popular?” the man said.Only in New York. Sign up for our COVID-19 newsletter to stay up-to-date on the latest coronavirus news throughout New York To appreciate just how bizarre it is that New York votes could prove crucial to deciding each party’s nominee in the presidential primary, consider what happened at an MSNBC-hosted town hall for John Kasich last week in Jericho.Seated a stone’s throw from the network’s cozy set inside historic Milleridge Inn was Jane Baum of Huntington, a proud “liberal Democrat” and Hillary Clinton supporter who would never consider voting for the Republican Ohio governor, even if New York’s closed primary voting rules allowed it.Yet she decided to come out for the event anyway for the rare opportunity to see a presidential candidate stump for votes—an experience that New Englanders know well in the Granite State.“I feel like I’m in living in New Hampshire right now,” Baum smiled.She wasn’t the only Long Islander enjoying the presidential election-year frenzy. Some voters observing the primary fight from afar even sounded like seasoned operatives, offering armchair analyses.“I think it’s a total crapshoot,” said Baum’s partner, Todd Kupferman, referring to the GOP’s national nominating convention to be held July in Cleveland.Several rows behind them was retiree Audrey Schorr of Woodmere, who admitted to tuning into Fox News to stay on top of the primary season.“I watch Greta, Bill, Megyn…” said Schorr, rattling off the conservative news channel’s weeknight lineup, as if they were her own children. She was attending the town hall with her son.Now pulling for Kasich, who was about to go toe-to-toe with MSNBC mainstay Chris Matthews, Schorr said she admired Ben Carson, the retired brain surgeon who finally dropped out of the primary race after failing to make a dent. She was also a fan of U.S. Sen. Marco Rubio (R-FL), whose delegate count remarkably has him still in third place despite his dropping out of the race more than a month ago after a humiliating home-state defeat. Schorr had nothing but kind words to say about Kasich.“He’s utterly charming,” she said.For Republican voters like Schorr, this presidential primary has been like a real-life Game of Thrones, with an abundance of Oval Office suitors careening toward the nomination.At one point last year, 18 Republicans were competing for the nomination. Now only three remain—as reality TV star and real estate mogul Donald Trump leads both U.S. Sen. Ted Cruz (R-TX) and Kasich in the delegate count. An impressive showing in New York on April 19 could swing Trump’s seemingly narrow path to securing the 1,237 delegates he needs for the nomination.Hillary Clinton surrounded by family members of victim’s of gun violence during an event in Port Washington. Photo credit: By Michael Davidson for Hillary for America/FlickrOn the Democratic side, former Secretary of State Clinton has a 244-delegate advantage over U.S. Sen. Bernie Sanders (I-VT) going into Tuesday, not counting 400-plus super delegates who are expected to support her at the convention, at least on the first ballot. A win in New York could give Clinton a stranglehold on the nomination and provide much-needed momentum going into similar voting states like Rhode Island and Connecticut. But a surprise Sanders victory would give the self-proclaimed Democratic socialist eight wins in the last nine primaries or caucuses and set the stage for a bitter battle all the way to the party’s July convention.“Normally New York is just the ATM on the political circuit.”For many New Yorkers, this is the political equivalent of a 100-year storm. Usually at this point in the primary season, both parties are on the verge of coalescing around one candidate if they haven’t done so already. But this time, New York’s vote could swing the pendulum irreversibly in favor of the two leading contenders.“In terms of presidential primaries, I don’t remember seeing this kind of activity and this kind of frenzied pace,” said Nassau County Democratic Chairman Jay Jacobs, a Clinton supporter.On Long Island alone, Clinton, former President Bill Clinton and their daughter, Chelsea, have all made public appearances since the primary calendar turned from Wisconsin to New York two weeks ago. Sanders has not held an event on LI, preferring large rallies in liberal New York City, but his wife, Jane, did attend a canvassing effort with supporters in Farmingdale last week.Jacobs said he couldn’t recall a presidential primary in which Democratic candidates actively campaigned on the Island.On the other side of the aisle, Trump has held two events on LI, one of which attracted 12,000 supporters at Grumman Studios in Bethpage. Kasich engaged in two cable-TV town halls in both Nassau and Suffolk counties, giving voters an opportunity to more closely scrutinize the candidates. Cruz, who has been dogged by his off-putting “New York values” comment, has not stepped foot on the Island, but his wife, Heidi, campaigned in Mineola, Melville and Bellmore—although Ted made a few appearances in New York City. For comparison, former Massachusetts Gov. Mitt Romney, the eventual Republican nominee in 2012, won all 95 delegates in New York without actually coming to the state because his main competitor at the time, ex-U.S. Sen. Rick Santorum (R-PA), had already ended his campaign.
RelatedPosts COVID-19: NCAA to revoke erring airlines licence over non-compliance FRSC to Schools: We’ll arrest, prosecute drivers who flout COVID-19 rules Sanwo-Olu: We’re committed to fulfilling promises to Lagosians The age limit for the Tokyo Olympics men’s football tournament could be raised, world football ruling body FIFA said on Friday. It said this was to ensure that players who were eligible in 2020 will not miss out following the postponement of the Games until the following year. Olympic football is usually restricted to under-23 teams for the men’s tournament, with three overage players allowed per team. “However, a working group set up by FIFA recommended on Friday that the competition should remain open to players born on or after January 1, 1997, as originally planned,” FIFA said in a statement. This will effectively raise the age limit by one year, as requested by both South Korea and Australia. There is no age limit for the women’s tournament. The working group also recommended the postponement of all international matches due to be played in June. This is a formality as Euro 2020, the Copa America and the month’s World Cup qualifiers have already been called off due to the COVID-19 pandemic. The recommendations still have to be approved by the FIFA Bureau, a reduced version of its decision-making Council. “FIFA also reiterates that health must always be the first priority and the main criteria in any decision-making process, especially in these challenging times,” the football ruling body said. The group proposed discussions with continental confederations to finalise a revised schedule for 2022 World Cup qualifiers, after matches this month and in June were postponed. It also recommended the postponement of the under-20 women’s World Cup, due to be co-hosted by Panama and Costa Rica in August and September. The group further advised on the postponement of the under-17 women’s World Cup in India, originally scheduled for November. A decision on the Futsal World Cup in Lithuania in September should be made by the end of this month, it said. Reuters/NAN.Tags: COVID-19FIFATokyo Olympics Football Tournament