In the Summer of 2012 the automobile insurance industry convinced the Florida Legislature and Governor Rick Scott to make substantial changes to the medical insurance that has been mandatory for automobile owners in Florida since 1973. This coverage is called Personal Injury Protection, or more commonly, PIP. The changes to PIP that were passed in the last hours of the 2012 Legislative are potentially devastating for Florida automobile accident victims. Valuable insurance benefits that consumers have enjoyed for decades have essentially disappeared “ and most Floridians don’t even realize it has happened.
On January 1, 2013 a highly debated new PIP Statute went into effect. After close examination of the new law it becomes obvious the new rules are a boon to Florida insurance companies. The new PIP rules make it more difficult for people who have been injured on Florida’s roadways to receive their claims benefits in good faith, and allow insurance companies a loophole for keeping rates high. The new rules have the unintended effect of increasing both litigation and administrative burden on law enforcement. Whether or not any of the new changes will actually reduce insurance fraud remains to be seen. Below I have outlined the ways the new PIP laws will affect the injured…
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New PIP Law
1. The initial medical treatment must be obtained within fourteen (14) days from the accident. So, if you don’t see a medical provider within 2 weeks of the accident, no PIP benefits.
2. The initial medical treatment must be lawfully provided, supervised, ordered, or prescribed by a licensed physician (M.D.), D.O. (Doctor of Osteopath), Dentist or Chiropractic Physician, or provided in a hospital or in a facility that owns or is wholly owned by a hospital.
3. Follow up treatment: PIP will only pay for follow up services if there was initial medical treatment within fourteen (14) days and the following occurs:
- the follow up services are on the referral from an M.D., D.O., D.C and;
- the follow up services are consistent with the underlying medical diagnosis rendered on the initial visit.
4. This follow up treatment must be supervised, ordered, or prescribed by a medical doctor, chiropractor physician, doctor of osteopath, a dentist, physician assistant or ARNP (advanced registered nurse practitioner).
5. If the above referenced criteria are met, there are two (2) levels of PIP medical benefits:
- $10,000 for an emergency medical condition and
- $2,500.00 for treatment that is not for any initially diagnosed emergency medical condition.
6. The Statute defines œemergency medical condition as: medical conditions manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention would be reasonably expected to result in any of the following:
- Serious jeopardy to the patient health.
- Serious impairment to bodily functions.
- Serious dysfunction of any bodily organ or part.
To read the legislation see: 627.736ƒRequired personal injury protection benefits; exclusions; priority; claims or for a summary of the changes, CS/CS/HB 119- Motor Vehicle Personal Injury Protection Insurance
Read: Sun Sentinal: PIP reform law finally takes effect
Car and truck accidents are the most frequent cause of personal injury claims. Insurance companies immediately assign an adjuster or attorney to the negligent driver. Whether you retain a lawyer or not, you should at least consult with an attorney before talking to the insurance company, and/or giving a recorded statement. You can contact us at (800)366-1609 or at www.edwardsragatz.com