New PIP Law To Go Into Effect January 1, 2012

Panter, Panter & Sampredo, P.A., are dedicated to providing expert representation and support to our clients who have suffered personal injury due to motor vehicle accidents. We work hard to obtain a full, fair personal injury settlement for those who are injured and their families. Therefore, we feel it is our duty to inform you that on January 1, 2013, a controversial new Personal Injury Protection (PIP) law will go into effect that will affect your medical coverage and ability to obtain care.

How does the new PIP law affect you?

Under the new PIP (or No Fault) law, individuals seeking PIP medical benefits must have their initial treatment and medical care rendered within fourteen (14) days of the accident; if the injured individual fails to do this, they will not be eligible for their PIP benefits. These services will only be reimbursed if they are lawfully provided, supervised, ordered, or prescribed by a licensed physician (M.D.), licensed osteopathic physician (D.O.), licensed chiropractic physician (D.C.) or licensed dentist (D.D.S.). Alternatively, these services may be provided by a hospital, a facility that owns or is owned by a hospital, or a licensed emergency transportation and treatment provider.

Highly supervised follow up treatment

Any follow up treatment must be supervised, ordered, or prescribed by an M.D., a D.O., dentist, physician’s assistant, or advanced registered nurse practitioner in order to be covered by PIP. The follow up visits must also be consistent with the original underlying medical diagnosis determined on the initial visit.

A change in medical benefit limits

The new bill applies two coverage limits for PIP medical benefits based on the severity of the medical condition. A maximum of $10,000 will be available to individuals who have an emergency medical condition as determined by sanctioned medical professionals. An emergency medical condition is “a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to patient health, serious impairment to bodily functions, or serious dysfunction of a body organ or part.”

If no finding of an emergency medical condition is made during the fourteen days after the collision, the PIP medical benefits allow up to $2,500. Again, if no treatment is received within fourteen days, then no personal injury benefits will be paid.

This law was passed to appease the insurance industry, which insists on alleging the existence of rampant insurance fraud. Considering there are very few actual fraud convictions, it is clear that this law makes it much more difficult for people injured in automobile accidents to access the help they require, while creating extensive additional litigation between insurance companies and medical care providers in potential wrongful denial of personal injury benefits by insurance companies. Rest assured, our law firm is ready to fight for your well-earned rights to appropriate medical care.

Sources:

County Line Chiropractic Medical and Rehab Centers, “New PIP Law in Effect January 1, 2013,” 22 October 2012.

The Florida Senate, “CS/CS/HB 119 – Motor Vehicle Personal Injury Protection Insurance.”