Meet the New PIP

 

While most Florida media ignores the recent changes to Personal Injury Protection (PIP), the insurance for Floridians injured in auto accidents, one local newspaper is willing to talk about what most wont.  Discovery West Newspaper, a new local paper focused on St. Lucie West recently published my article about PIP.  We think that as more Floridians feel the impact of this new law you’ll see more about it in the news.  

Meet the New PIP

If you drive or ride in a car in Florida, odds are you are not aware that “The New PIP – House Bill 119” can have a dramatic impact on your future well-being should you become involved in an accident. In fact, millions of Floridians, including thousands on the Treasure Coast, are unaware of PIP’s new twists and turns.

Historically, almost every state in America requires drivers to have auto insurance coverage and Florida is no exception.  In Florida everyone is mandated to purchase $10,000 of Personal Injury Protection (PIP) coverage.  You have the option to choose to purchase other types of insurance that protect you from liability, protect your and other’s property, and pay for certain other expenses in case another driver does not have the proper insurance. But every driver is required to purchase PIP, “No Fault” as it is sometimes called, coverage as a protection against damages from uninsured motorists who opt out of those many other types of insurance.

Up until January 1st of this year your own insurance company was required to pay for treatment, up to $10,000, for injuries you sustained in an auto accident whether the accident was your fault or someone else’s fault.  This is because Florida is a “No Fault” state.  Your insurance pays for your treatment and the other person’s insurance pays for theirs.    It is possible, of course, to sue another driver if they were negligent and caused an accident that permanently injures you or caused damages to your property, but that is separate from the PIP insurance policy coverage.

So what has changed in the “New PIP”?  A lot.

First, every vehicle owner is still required to purchase $10,000 of coverage. However, effective January 1, your insurance company, by State Law, may only allow you to use $2,500 if they determine that your accident related injury is not an “Emergency Medical Condition” (EMC).   What is an EMC?  Good question!  The new law defines Emergency Medical Condition to mean a medical condition manifesting itself by acute symptoms of sufficient severity which may include sever pain, such that the absence of immediate medical attention could reasonably be expected to results in serious jeopardy to the patient’s health; serious impairment to bodily function; or, serious dysfunction of any bodily organ or part.  Although the new law does provide us a definition it is rather vague and will have to be worked out over the next year.

Unintended Consequences

627.732(16) (2012) defines “Emergency Medical Condition” as:  “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 reasonably 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

It appears that this vaguely worded EMC provision will be one of the first aspects of the New PIP to affect Floridians in what could be a very negative way. Consider that when, after an auto accident someone receives a large bill from the hospital for services provided simply because the Insurance Company determines that the injuries were not a medical emergency.

Further complicating the coverage questions, the New PIP requires that an individual involved in an accident (whether a driver or passenger) must initiate treatment for their injuries within 14 days of the accident or they forfeit ALL benefits.  Up until this year there was no such time limit.

So if an injured person decides to wait-and-see how they feel before seeking treatment (which is exceptionally common), they better not wait too long or they could suffer more than just physical hardship.  According to New PIP, the injured person must seek initial treatment for their injuries by a Medical Doctor (MD), Doctor of Osteopathy (DO), Chiropractic Physician (DC), and a few other provider types within 14 days in order to qualify for their PIP benefits.  If the injuries are considered to be an Emergency Medical Condition (by the MD, DO, Nurse Practitioner or even a Dentist) and the insurance company agrees, only then may they qualify for $10,000 in coverage they are required to purchase. If the injuries are not determined to be an Emergency Medical Condition (for whatever reason) not only do you qualify for $2,500 in benefits, you are still paying for $10,000 worth of coverage regardless!

What’s Next?

A key component in enacting the New PIP was the premise that changing the law for accidents in Florida would result in fewer claims for injuries that were not deemed serious. It was envisioned as a way of cutting down on insurance fraud that many State Legislators claimed was rampant and running up Florida’s insurance rates.

A provision of the New PIP required insurance carriers in Florida to reduce their rates to reflect their savings in paying fewer fraudulent claims. That is, unless the insurance carrier simply claimed they saw no reduction in claims. So how many insurance carriers have rolled back rates? Very, very few.

That fact has infuriated various watchdog groups, some legislators, and the public prompting them to demand the New PIP be reviewed again in the upcoming Florida legislative session that starts March 5. Whether changes in the New PIP are forthcoming or not will remain to be seen. What is certain that Florida residents who drive or ride in an automobile need to be aware of the perceived pitfalls of the current Personal Injury Protection insurance law to take full advantage of the coverage that is mandated by the State of Florida.

Vital Chiropractic Wellness Center benchmarks success through patient satisfaction, extraordinary care, and wellness.   Vital Chiropractic Wellness Center has locations in Stuart and Ft. Pierce and provides convenient hours of operation Monday through Friday from 9 am to 7pm, and Saturday from 10 am to 2pm.  For additional information call (772) 232-4091 in Stuart or (772) 882-9788 in Ft. Pierce or visit their website at http://www.vitalwellnesscenter.com.

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