The Florida legislature recently passed a bill with numerous changes to the current Personal Injury Protection (PIP) law. With ever-increasing insurance rates and a seemingly never-ending wave of PIP cases being litigated, the bill has an ultimate goal of reducing both the number of PIP cases in litigation and insurance rates for consumers. Rate reductions are even written into the bill… well, sort of.
The problem is that these reductions are quasi-mandatory. The bill attempts to require two major rate reductions from insurers: one by October 1, 2012 that is to provide at least a 10 percent reduction to the insurer’s current rate, and another by January 1, 2014 that is to provide at least a 25-percent reduction. This sounds great for consumers except for one major flaw: the bill leaves insurer’s with a loophole to avoid these reductions. The bill states that if an insurer fails to achieve these reductions, it must explain in detail its reasons for failing to do so. This would be tantamount to legislation that gives citizens the option to submit to the IRS a detailed explanation of why they were unable to pay their taxes this year instead of actually paying them. It seems absurd that the legislature doesn’t think that the insurance companies aren’t going to utilize this exception instead of actually reducing their rates. It’s not hard for one to envision the devious, Grinch-like grin on the face of insurance executives while they were reading the provisions in the new law allowing them to explain there reason for not reducing there rates.
In an attempt to make these reductions possible, the bill has numerous provisions aiming to reduce fraud and frivolous litigation. Whether or not these changes will be effective is yet to be seen. Here are some of the major changes the new legislation will have on Florida’s current PIP law:
- An insured is only entitled to reimbursement for services and care provided up to $10,000
if a licensed physician, physician’s assistant, dentist, or an advanced registered nurse
practitioner has determined that the injured person had an “emergency medical
The statute defines an emergency medical condition, as “a medical condition
manifesting itself by acute symptoms of sufficient severity, which may include severe pain,
such that the absence of immediate medical attention could reasonably be expected to
result in serious jeopardy to patient health, serious impairment to bodily functions, or
serious dysfunction of any bodily organ or part.”
- If any of the above mentioned medical providers determine that the injured person did not
have an “emergency medical condition,” reimbursement for services and care provided is
limited to $2,500.
- An insured seeking PIP medical benefits now must have received there initial medical
services within 14 days of the motor vehicle accident.
- Medical benefits will no longer cover massage and/or acupuncture therapy regardless of
the person, entity, or licensee providing the massage or acupuncture, and a licensed
massage therapist or licensed acupuncturist may not be reimbursed.
- PIP will now offer $5,000 in death benefits in addition to $10,000 in medical and disability
benefits, rather than the $5,000 being included in the available $10,000.
PIP litigation can be very complex. Insurance companies often refuse to pay their insureds the benefits they are rightfully owed. Don’t let this happen to you. Visit www.LaBovick.com for more information. Our attorneys can help you receive the benefits you are legally entitled to.