As a Miami Car Accident Attorney it infuriates me to see Governor Scott handout yet another gift to the insurance industry. The new PIP law which was passed in the closing moments of the legislative session was the center piece of Governor Scott’s agenda. I am the first to agree that the PIP system in its current format needed change. The change was simple, focus on cutting out fraud and the clinics that recruit patients with the promise of $10,000.00. Work on those unscrupilous medical providers and you can save consumers money. However, Governor Scott chose a different route. On the very day that Governor Scott received a check from United Automobile Insurance Company in the amount of $100,000.00 he pushed for legislation that limits the amount of payable insurance benefits.
Allow me to explain the new law in comparison to our current PIP law. Under the current system, if a person in injured in a car accident, the injured individual is entitled to $10,000.00 of medical benefits for reasonable and necessary medical expenses. Of course we all pay a premium for that insurance. The insurance includes but is not limited to treatment by medical doctors, chiropractors, massage therapists, and for diagnostic testing. Yes, this system was abused by fraudulent medical providers, lawyers, and individuals, and was in need of fraud reform.
The new law which goes into effect January 1, 2013, penalizes the 99% of Floridians that do right. The law essentially limits benefits to $2,500.00. Consumers will pay a premium for up to $10,000.00 of insurance, but will really only be getting $2,500.00 of coverage.
The new law requires an injured person seek service within 14 days following an accident. Not sure if you were hurt? If you think you were hurt, you better get to hospital or a doctor.
More importantly, in order to qualify for the $10,000.00 of coverage, a determination must be made that the injured person suffered an EMERGENCY MEDICAL CONDITION.
Specifically, the new law states:
Reimbursement for services and care provided in subparagraph 1. or subparagraph 2. is limited to $2,500 if any provider listed in subparagraph 1. or subparagraph 2. determines that the injured person did not have an emergency medical condition.
“Emergency Medical Condition” means a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonable be expected to result in any of the following:
(a) Serious jeopardy to patient health.
(b) Serious impairment to bodily functions.
(c) Serious dysfunction of any bodily organ or part.
This law was a pure gift to the insurance industry.