Florida Makes Changes to Personal Injury Protection (PIP) Coverage Law

By Orlando Personal Injury Attorney on January 31, 2017

Many times when somebody is involved in a Florida car accident they will require medical attention – which can be costly. If the injured victim doesn’t have the cash on hand, as many people don’t, this could quickly become a financial nightmare for them.

To help alleviate this burden and make sure that injured parties have the means to obtain necessary medical treatment, Florida law requires auto insurers to provide up to $10,000 of Personal Injury Protection (PIP) coverage for medical expenses. According to the law, this money is available to anyone involved in a Florida motor vehicle accident, regardless of whether or not one is at fault. It requires that the insurers pay all medical bills within 30 days.

But like most things, there’s a downside to PIP. For example, if a medical provider charges unreasonably high fees, then the injured party’s PIP benefits will be depleted before their treatment is finished – leaving them back at square one. Luckily, the Florida legislature caught on and amended the law so that insurance companies only have to pay a reasonable amount for the car provided. If a doctor charges too much, they won’t get paid.

Yet even this legislative solution has created new problems, namely, who decides what is ‘reasonable’. The most common answer is a jury. But this may be about to change. After decades of lawsuits between insurance companies and medical treatment providers, JDSupra Business Advisor is reporting that the Florida legislature has amended the PIP statute to include a schedule of maximum charges. According to the amendment, an insurer may limit reimbursement to 80% of the maximum charges of a specific list of treatments – from emergency transport to inpatient and outpatient services and medical supplies, among others.

Like most legislation, even this amendment is open to interpretation. For example, the insurance industry has interpreted the ‘may limit reimbursement’ wording to mean they can automatically reduce bills to the scheduled rates. Medical providers, however, care to differ. They argue that in order to apply the statutory schedule of maximum charges, the insurance company must clearly state within their policies that the amount paid for PIP benefits will be limited to the fee schedule.

The verdict on this issue is still out, so watch this space for more information.

James O. Cunningham

Since 1977, personal injury lawyer James Cunningham has provided effective legal advocacy to people who are injured through the negligent actions of another person or entity throughout the Central Florida area. He fights to obtain recoveries for his clients’ physical and emotional pain and suffering and pursues his clients’ personal injury cases with a commitment to excellence and impeccable preparation.