Florida’s Governor Rick Scott made changing Florida’s Personal Injury Protection insurance laws a top priority. He claimed that staged accidents and insurance fraud was costing Floridians “a billion dollars a year” by paying higher insurance premiums.
The Florida House and Senate narrowly passed major changes to the law that Governor Scott will happily sign. The sweeping changes to PIP will take affect on January 1, 2013.
PIP is the mandatory insurance that all Florida car auto owners have to carry. It was designed to ensure anyone injured in a Florida car crash receive medical care and reimbursement for lost wages. I have been representing people hurt in a South Florida car wreck for over twenty years. During my entire legal career Florida PIP insurance paid 80 percent of an injured person’s medical bills and 60 percent of lost wages up to $10,000 regardless of who or what caused the car accident.
Somehow, of all of the economic and social issues plaguing our state, limiting car insurance payments was one of Governor Scott’s top three priorities. The new law forces anyone injured in a Florida car accident to seek medical attention within fourteen days of the crash. In those fourteen days, if the injured seeks medical care anywhere but a hospital, the PIP benefits are reduced to $2,500. After the two week window closes, no bills will be paid by PIP.
In other words, for an injured individual to be eligible to receive to the full $10,000 of the PIP benefits he or she is obligated to purchase in order to own or operate a car in Florida, he or she has to be seen and receive medical care from a medical doctor, osteopathic physician, dentist, physician’s assistant or advanced registered nurse practitioner that diagnoses the patient with an “emergency medical condition”. The new PIP law defines an “emergency medical condition” as an injury that is so acute and serious that if the injured did not receive treatment it would put the person’s health, bodily functions, body organs or parts in “serious jeopardy”. For instance, if one is not so seriously hurt in a Miami Beach hit and run wreck, PIP insurance benefits are now limited to $2,500, excluding massage and acupuncture treatments.
In my opinion this will actually force people to seek medical care, primarily from hospitals, whether or not they are injured, for fear of risking having their medical bills go unpaid if their “pain” does not go away.
To further discourage any one from seeking treatment, the new law allows insurance companies to take Examinations Under Oath (EUO) of their own insureds BEFORE any benefits will be paid. An EUO is essentially a sworn deposition, by an insurance company fraud investigator, grilling the injured person about the accident, injuries and treatments. As a Miami back over car accident attorney, I suggest that if you are involved in an a car accident and your insurance company requests an EUO, IMMEDIATELY contact a lawyer and DO NOT attend the EUO without the benefit of counsel.
PIP insurance companies can now force you to undergo an Independent Medical Examination or IME. The problem is that there is nothing “independent” about the exam. Those seeking to obtain benefits might be subjected to having to undergo a physical examination of a doctor chosen for and paid by the insurance company before the benefits will be paid. The new law states that if the injured person fails to show up to two of the scheduled IME appointments, the carrier is no longer responsible for the benefits. Refusing or failing to appear at two IME’s will create a presumption that the refusal or failure to appear was unreasonable. This will make it more difficult for an injured person seeking reimbursement of PIP benefits. Our PIP insurance law firm recommends that if your insurance company requests that you undergo an IME, you attend or risk losing your PIP benefits and also immediately contact an attorney to protect your legal rights.
Governor Scott’s new PIP law does nothing but create a monumental hassle to those who are injured to simply get their medical bills paid after a car accident. Forcing people to go hospitals and doctors within a prescribed time limit, undergo sworn interrogations and physical examinations simply to get their bills paid seems to me like it is intended to discourage anyone from using their PIP benefits. I wonder what State Farm, All State and Progressive are going to do with all those untouched premiums? I guess if it were up to Governor Scott, they would pay nothing.