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Wednesday, 06 February 2013 17:25

More Stringent PIP Laws in Effect in Florida

Florida has a new set of stringent personal injury protection laws, which offer less time to make auto insurance claims and make it more difficult to get full medical benefit pay-outs, the Sun Sentinel recently reported.

Claims for reimbursement must be filed in 14 days. Before, there was no set limit.

As of Jan. 1, drivers involved in injury-inducing crashes must follow stricter rules to take full advantage of their PIP insurance policy. Initial treatments must be provided in a hospital or licensed clinic or by a select group of professionals, including medical doctor, dentist, chiropractor and paramedic. There also are two benefit thresholds: To qualify for $10,000, injuries must be diagnosed as an emergency medical condition. For non-emergency treatment, the maximum benefit is $2,500.

Proponents hope these new laws will keep premiums down by curbing fraudulent claims, especially those which seek maximum insurance payoffs for non-emergency services. The other side says the need to fight fraud is just an excuse to limit consumer rights and options.

“The Legislature took away a consumer’s right to benefits they paid for,” said Craig Goldenfarb, who runs a personal injury law firm in West Palm Beach. “You paid for that coverage, and now if you don’t get treatment in time your benefits could be reduced to zero. Zippo,” said Goldenfarb.

Goldenfarb also took issue with the fact that massage therapy and acupuncture visits are no longer covered by PIP.

Robin Smith Westcott, Florida’s Insurance Consumer Advocate, counters that the new laws are more in line with proper public policy.

Westcott’s office released a report in December that revealed the average PIP insurance claim is $12,900, including about $4,400 in acupuncture, $3,700 for massage therapy, $3,200 to chiropractors and $1,600 for emergency room costs.

“Yes, massages and cold packs make you feel better,” Westcott said, “but if you ask Floridians whether they want to pay double their premiums to pay for that, most will say they do not. Legitimate claims need to be paid by insurance companies. These laws do not shield anyone from paying good claims. This was about good public policy.”

 

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