On May 04, 2012, Florida Governor Rick Scott signed legislation that was designed to reduce auto accident fraud, lower the cost of auto insurance premiums, and reduce the litigation costs associated with the current Personal Injury Protection ("PIP") insurance statute. The purpose of this article is to help Florida motorists understand the changes made in the revised statute and to discuss how the changes will impact auto accident insurance claims when the revised statute takes effect. A portion of the revised statute goes into effect on July 01, 2012, with the remainder going into effect on January 01, 2013. Keep in mind that, in most cases, your insurance company may not be required to amend your policy or notify you about these changes before this revised law applies to your situation.
· In most cases, the revised PIP statute will apply to accidents occurring after July 01, 2012.
· Despite the fact that you are required to have $10,000 in PIP insurance coverage, your claim for PIP benefits, if you are injured in an auto accident, will be limited to $2,500 unless a medical doctor, osteopathic physician, dentist, physician assistant, or an advanced registered nurse practitioner determines that you have an "emergency medical condition", as that term is defined in the revised statute.
· You MUST receive initial services and care within 14 days after your auto accident or you will NOT be eligible to recover PIP benefits.
· If you receive initial services and care within the 14 days, you can then seek follow-up treatment, consistent with the underlying medical diagnosis, as long as you get a referral from one of the medical providers listed in the statute
· Neither massage therapy nor acupuncture is covered under the revised PIP statute. If your treatment plan includes either, make sure you check to see if your health insurance will pay for those services or you may have to pay out of your own pocket.
· If you receive a bill from a medical provider for services that were provided to you, be sure to inquire as to why the bill was not paid by your PIP carrier. If the bill was not paid because the medical provider did not timely submit the bill to the PIP carrier, then the medical provider most likely will not be able to bill you for the charges that were not paid because of the untimely submission.
· If your insurance carrier requests that you submit to an examination under oath ("EUO"), be sure that you comply because if you don't your claim under PIP may be denied and you may have to pay for medical expenses that you have already incurred out of your own pocket.
· If your insurance carrier requests that you submit to a medical examination, be sure to give that request your immediate attention since an unreasonable refusal or failure to appear at the examination may result in your claim for subsequent PIP benefits being denied. Also, if you fail to appear at two (2) examinations, your refusal and/or failure to appear will be deemed unreasonable unless you can prove otherwise.
· Although one of the purposes behind the revised PIP statute was to lower insurance premiums, the Florida Legislature and Governor Scott gave the insurance companies an "out", so we will all have to wait to see what happens. I wouldn't hold your breath! Your safest bet would probably be to plan on your insurance premiums NOT decreasing, but we can always hope for the best.
Disclaimer: All information and documents contained herein have been prepared for informational and educational purposes only and should neither be construed as legal advice nor a legal opinion. The information and documents herein are general in nature and since the law changes frequently and may be interpreted or applied differently depending on your location and the specific facts and circumstances of your situation, this information is not a substitute for the advice of a competent lawyer. Lastly, the distribution or review of this information in no way creates an attorney/client relationship. For case-specific advice, please do not hesitate to contact the Weinstein Law Firm at (954) 757-7500.
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