Florida Emergency Medical Condition PIP No-Fault

Florida Emergency Medical Condition PIP No-Fault

Alan Himmel, DC.  
December 29, 2012

The changes to Florida's new PIP No-Fault law did not actually include any requirement that the insurance companies must advise policy holders of the changes.  This means that after Jan 1, 2013, if a Florida consumer gets into a car accident, they are going to expect to have their full $10,000 in coverage, but they will not, unless the injuries are considered a medical emergency.  Because car insurance companies are not required to tell, and the details of this new law are not explained in the language of the insurance policies, this is obviously an unfair tactic, and would expose insurance companies to the possibility of a law suit, which would be rightly justified.  When you buy insurance, its a contract that both the policy holder and insurance company agree and sign.  Nowhere in the current policy does it state that you are only entitled to $2500 for non emergency care.  It states that you are entitled to $10,000.





Imagine having an accident, going to the hospital to get checked, which could be thousands of dollars if any diagnostic test or injections for pain are given, and then you go for follow up care, to be left with unpaid medical bills.  This is exactly what is going to happen under the revised PIP law beginning 01-01-13.

So, in regard to this dilemma, the Florida Cabinet and Insurance Commissioner have adopted and approved an emergency form that will be either included in your new policy or mailed out to you separately advising you of this change.  Here is an article that explains what is going to happen:

  http://www.claimsjournal.com/news/southeast/2012/12/18/219368.htm


By the way, I hate claimsjournal.com.  This is a  "journal" or newsletter if you will, which is totally and completely biased toward insurance companies.  It is not meant for policy holders to read, it is meant for insurance adjusters, agents, representatives, etc.  You can tell this by the sponsors on the page and what they write in their articles...  but I digress.  This is really a topic for another blog post.

The main thing is that you should be made aware of the emergency provision on your auto policy starting Jan 1, 2013.  It looks like you can read it, as long as you take the time to look in the letter sent by your auto carrier.

If you don't use it, you lose it. (after 14 days)--Your Florida PIP Benefit

Your Florida PIP No-Fault benefits:  If you don't use it, you lose it.  (after 14 days)

That's exactly what happens.  If you have an accident, and you don't use your insurance, you lose it.

Imagine having insurance coverage that you paid for, but because you did not use it within a certain window, your insurance coverage expires and you get nothing.  Well, if you have an accident after Jan 1, 2013, and you decide to wait more than 14 days to go get checked out, your insurance will expire, and your insurance company which you pay good money, will deny your claim.  That's not much time is it, just 14 days?  Well according to the insurance companies, if you have an injury from a car accident in Florida, if there is truly an injury, you should have enough time, within those 2 weeks, to be looked at by a doctor.  Their rational is that pain, headaches, and impairments never arise after 14 days have passed.

Yes.  Its downright silly, yet it is exactly the way the law reads.

Anyway, I was talking to a friend of mine tonight, who lives in Colorado, and in regard to the recent changes to the Florida PIP law, he pointed something out to me that I had not even thought of.  First and foremost, we know that people NEED TO BE MADE AWARE OF THE CHANGES TO PIP, because their insurance company is not required to advise them of this change, and the new insurance policies don't even include this language in the paperwork.  It's a fact that they plan on keeping this detail hidden, because "the less an injured person knows about the procedure, the better."  Its obvious that your insurance company is banking on the fact that you will wait 14 days and one second, so they will be off the hook for any medical claims.

So, this brings up something very interesting and this is what he said:  If a person were to know that they would have no insurance if they waited too long to file a claim for injuries, why wouldn't you expect an increase the PIP claims that the insurance companies will get?  In other words, this may bring more claims to the insurance company, because  people are not going to want to lose their benefit.  

Could this 14 day thing backfire on the insurance companies?

Its very possibly could backfire.  I expect to start seeing radio and TV advertisements talking about the 14 days, which would prompt people to go get checked out who normally would have just dealt with the pain.  Some people may go to a doctor once, just for the purpose of securing their insurance benefit, which means some people may go get checked out, even if they have absolutely no pain.  Most intelligent people are cognizant of the fact that problems often show up later, due to injuries they suffer today.  I hope it doesn't cause people to bring in completely fake claims, just so future claims are not denied, but this is exactly what might happen when people become aware of the 14 day cut-off.  This may be a completely unintended consequence of the PIP change.  But, it was his opinion that even the most honest person would go get checked out by a doctor, if he knew that he would lose his insurance if he didn't go.

...just something to think of, right?

Have a Happy Holiday!

Dr. A. Himmel

954-659-8600 

Car Accident Victims: 14 Days Left to Begin Treatment

Attention Car Accident Victims in Florida

Beginning January 1, 2013, you will have UP TO 14 DAYS to initiate treatment of painful injuries if you have been involved in a Car Accident.  If you wait one extra minute, you will have NO COVERAGE for these injuries under the new State Law.



This is what our Doctors Do:

1.  We are licensed Doctors who will Personally See you at a moments notice at your home, your work, or our office BEFORE the 14 days have passed.

2.  We have 18 years experience treating and documenting painful car accident injuries.

3.  We handle ALL the paperwork on our end.  You don't have to worry.  We file the claim for you.  Don't go to any doctor for this type of injury care.  Most doctors are not familiar with the New No-Fault Law.  You will likely get stuck with a large out of pocket expense if you do not use the right doctors.

4.  If you wait one extra second you LOSE YOUR BENEFIT.

5.  Call if you Have Had a Car Accident.

954-659-8600:  Dr. Himmel

Professionally yours,

Doctors Mobile Rehab
http://www.MiramarChiropractor.com