Your Rights to Medical Benefits Can Be Lost if You Fail to Do These 3 Things
3 Things You MUST Know about Florida's New PIP Law
Under the guise of reform, the Florida Legislature radically changed how medical benefits are to be administered under the Personal Injury Protection(PIP) section of every policy of car insurance issued in Florida. A system that was originally designed to provide the broadest coverage and prompt recovery for accident victims will now restrict treatment options and encourage insurance company stonewalling and delay.
There are many changes to the PIP Law, but 3 of the most important are:
1) YOU MUST SEEK INITIAL TREATMENT WITHIN 14 DAYS OF THE ACCIDENT.
On its face this seems to be not unreasonable and most people, if experiencing pain, will seek medical attention within a short time after the accident.
However, we've all known people that, short of a broken bone or bleeding, will "buck up" and wait for a condition to get better. Some people ,because of dislike of doctors or money concerns, will wait until they are in unbearable pain to go to an ER or doctor. Those people will forever lose their right to the $10,000 in PIP benefits they paid for if they wait more than 14 days.
This requirement does not appear in any present Florida car insurance policy. Yet as of July 1, 2013, this 14 day cut-off will become the law of this state and insurance companies are not even required to notify their insureds of this significant change to their contractual rights. Unless an injured person consults with a Florida injury lawyer , he or she may not find out about this "trap" until it's too late.
2) YOU MUST HAVE AN " EMERGENCY MEDICAL CONDITION " OR ELSE YOU WILL ONLY HAVE $2500 IN COVERAGE.
The PIP law in effect for many years simply provided $10,000 in coverage to cover the cost of all medical care received as a result of injuries from a car accident. However, as of July 1, 2013, that $10,000 is only to cover an "Emergency Medical Condition".
The definition of this condition revolves around "serious jeopardy to patient health" and the determination can only be made by a medical doctor, osteopath, dentist, physician's assistant or nurse administrator. (Note: not a chiropractor)
Unless one of these providers use that magic phrase , instead of being entitled to the $10,000 you paid for, you will only be able to claim reimbursement for $2500. Even if your doctor finds an "EMC", there is nothing to stop an insurance company from disagreeing with him or her and denying the claim. Unless I am wrong, I see more, not less PIP litigation coming.
By the way, even if a doctor certifies you have an "EMC", no payments will be made for any massage therapy or acupunture.
3) AN INSURANCE COMPANY CAN MAKE YOU GIVE AN ORAL STATEMENT UNDER OATH WITH NO TIME RESTRICTIONS.
Under the new act , insurance companies can pick a time and place and demand that you appear and submit to an "Examination under Oath". Although any questioning is supposed to be "relevant", when one's health is involved, it doesn't take too much creativity to exhaustively explore a person's complete medical history. Recently, a Florida appellate court pointed out, in a simple property claim, the insurance company subjected their insured to a seven hour Examination under Oath.
If you didn't show up or walked out of such a "enhanced interrogation", the company could deny all benefits.
This is the first in a series of articles on how to protect yourself under Florida new PIP law. But the over-riding conclusion of even a brief reading of this act is that most injured people are going to need the services of a Florida injury lawyer as soon as possible after a car accident, simply to navigate the many traps the Legislature has created for the driving public.