Florida trial lawyer and chiropractic physician discusses why No-Fault (“PIP”) fraud hurts all Floridians.
In the 1970s, Florida's government looked for a way to limit the number of lawsuits that would be filed over minor car accidents so it looked to some states in the Northeast and wrote Florida's PIP – No-Fault law. The law requires all people who have a motor vehicle registered in Florida to purchase PIP in the amount of $10,000. PIP is available to pay for medical charges and lost wages that result from a motor vehicle accident without regard to who caused the accident.
Since its inception, folks have claimed that PIP is a Bastian of fraud. Every few years the law was revamped and recently the legislature put in supposed anti-fraud provisions. In January 2013 the law is changing again. I believe everybody except the insurance companies will lose with the new PIP law. It is difficult for me to argue against the changes when we see reports of fraud in PIP.
The Claims Journal recently ran a report about two Manatee County men who were arrested for PIP fraud and patient brokering. Patient brokering is a term used when a person solicits accident victims to go to a certain PIP clinic and the clinic will pay the broker for bringing the patient to the clinic.
I do not see how the 2013 changes to PIP will stop fraud but here are some of them you should know:
- If you are injured in a motor vehicle accident, you have to see a healthcare provider within 14 days. If you wait longer than 14 days – you are not entitled to PIP.
- There will be two layers of coverage – $2,500 and $10,000.
- In order to get the full $10,000 PIP benefit – a person injured in a motor vehicle accident has to have qualifying medical condition. The law talks in terms of “emergency medical condition” but nobody knows what conditions will be considered an “emergency medical condition.” This will be sorted out in the courts.
- PIP will no longer pay for massage therapy.
- PIP will no longer pay for acupuncture.
There is no doubt that insurance fraud hurts us all because when confronted with fraud the legislature makes a law, like the 2013 PIP law, that will not curtail fraud but will lead to a lot of lawsuits between healthcare providers and their patients against the automobile insurance companies. You see, we all pay for $10,000 of PIP coverage and the concern is that the insurance companies will attempt to arbitrarily place a ceiling at the $2,500 level.
If you have any questions about a motor vehicle accident or Florida PIP, give me a call at (352) 267-9168 or fill out the Internet consultation form on the right.