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Perhaps the greatest insurance scam ever perpetrated against car and truck owners and those who get injured by them in Florida was the creation of no-fault statutory scheme known as Personal Injury Protection, or PIP insurance.  The stated idea behind PIP was to provide people who are involved in traffic accidents with “swift and virtually automatic payment.”   However, the questions of how swiftly and how automatically and precisely what payments remain among the most litigated issues clogging Florida’s courts in recent years.

Florida’s PIP statute is unique in that it destroyed the traditional common law rights of car accident victims in exchange for forcing anyone who owns a vehicle in Florida to purchase required PIP insurance.  Its name alone is misleading because PIP, or personal injury protection, which any Miami car accident lawyer could agree, does not pay for anyone’s personal injury; rather, it pays only for the insured’s first $10,000 of medical bills and/or lost wages, regardless of whether or not the injured is responsible for the accident.  PIP should really be called just called what it is–medical insurance to make sure that wealthy hospitals don’t get stuck with big unpaid emergency-room and x-ray bills by people who are treated for traffic accident injuries.

As a Floridian, know what PIP is.

As a Floridian, know what PIP insurance is.

Insurance companies go to enormous expense and effort to avoid paying PIP benefits, especially when those payments are for medical treatment from healthcare providers (other than hospitals) that insurance companies don’t like, such as chiropractors, acupuncturists, and physical therapists.

GOVERNOR RICK SCOTT CHANGES FLORIDA’S PIP STATUTE

On January 1, 2013, significant amendments to the PIP statute that were approved by Florida’s Governor Rick Scott became effective.   Amongst Governor Scott’s most ridiculous changes is the new requirement that anyone seeking benefits under PIP submit to an “examination under oath” or EUO. An EUO, which as a Miami accident attorney, is a nasty tool used by the insurance industry to investigate claims and intimidate claimants before having to pay out any benefits.  Actually, EUOs are contrary to the statutory intent of PIP of providing swift payment of benefits because they are actually used by insurance companies to delay and often deny payment.

 

Three Typical EUO Requirements:

  1. Victims are required to appear personally at the office of an insurance claims adjuster or insurance defense lawyer, usually in the middle of the day, causing a disruption of work, school, or family obligations.
  2.  Victims are subjected to a prolonged interrogation under oath and can be asked questions about their claims, medical treatments, doctors, and many other factors that may bear on coverage.
  3. EUOs are either tape recorded or transcribed by a court reporter. The transcription is available to be used in a court proceeding against the insured in the event of a lawsuit.

 

GEICO claims that EOUs are consistent with the intent of the PIP statute because they assist in the “prevention of fraud” and the “investigation and payment of claims.”  However, a claimant’s failure to appear for an EUO can be a basis to deny a victim coverage and often results in litigation commonly known as a PIP suit.

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FLORIDA SUPREME COURT RULING

For this reason, Miami accident attorneys who sue insurance companies in Florida eagerly awaited the Supreme Court’s decision in the case of Merly Nunez v. GEICO, which focused on this question: Can an insurance company require a person to attend an EUO as a condition of payment?  By the time the case—which evolved from a 2008 accident—had plowed its way through both the Florida state and appellate courts and Federal state and appellate courts and landed in front of Florida’s Supreme in 2013, Governor Scott’s mutilated PIP statute was in effect, requiring EUOs.

Fortunately for Ms. Nunez, the court ruled that her accident and the laws that governed at the time did not require EUOs, and therefore she was not obligated to submit to GEICO’s EUO as a condition of getting her bills paid.  Although the court did not rule on the legality of the new law that does require EUOs, it certainly hinted that it is looking forward to addressing it.

Until the courts address the legality of that bill, I as a Miami accident attorney recommend that anyone who drives or owns a vehicle in Florida–and who is in an accident and seeks PIP benefits–comply with the law concerning attending EUOs only after first consulting with an attorney who is experience with and knowledgeable about the current state of the law.

Our Florida PIP lawyers offer anyone involved in an accident a free initial legal consultation regarding your rights.  If you have been hurt in a car, truck, motorcycle, bicycle, or pedestrian traffic accident, Email me, Spencer Aronfeld, or call our personal injury lawyers in Miami at 305-441-0440 or Toll Free at: 1-866-597-4529. And . . . please don’t text and drive.