On Friday March 9, 2012, at about 9:00 pm, the Florida Senate,by one vote, passed a bill comprehensively reforming Florida’s mandated No-Fault PIP insurance laws. Under heavy lobbying pressure from Governor Ric Scott, CFO Jeff Atwater, and the insurance industry, the House and Senate reached a compromise on a number of provisions. I must unfortunately report that my initial reviews and analysis of this bill show the changes to be very anti-consumer and very anti-doctor.
One of the biggest changes is that the new law requires all accident victims to present for medical treatment within 14 days of the accident. The initial treatment can be done by a hospital, medical doctor, a nurse practitioner, a dentist, or chiropractic physician. If you don’t present within 14 days of the accident, you never can get any PIP benefits. This may not seem like a big deal to most, because if you’re hurt, you go to a doctor, but a lot of accident injuries go undiscovered for well over 14 days post accident.
The new law also requires that a doctor, nurse practitioner, or dentist find that you have an “Emergent Medical Condition,” in order for your to receive up to the full $10,000.00 in benefits. What constitutes an “Emergent Medical Condition” is defined in the statute 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.” What the heck does that mean? The answer, for now, appears to be “who knows.” My preliminary research indicates that the drafters of this bill modeled this language straight out of the Florida and Federal Emergency Room anti-dumping statutes. See EMTALA (http://www.emtala.com/faq.htm) and Section 395.002, Fla. Statutes. However, the bill does not mention these laws, and the same where never brought up two years of Legislative hearings on this matter.
This is important, because if a diagnosis of an Emergent Medical Condition is not made, then you are capped at only $2,500.00 in PIP treatment benefits. So, all an insurance company has to say is that there was no Emergent Medical Condition, and you could lose up to $7,500.00 in benefits that you pay premiums for. What do you think the Insurance Companies will do?
The changes don’t take effect until January 1, 2013. However, be prepared to get only 25% of what you paid for.
Knowledge Equals Power in Orlando Auto Accident Cases
By the way, I am getting ready to release a book and a report on What You Must Do Following An Accident – following the same will help you comply and be ready for this New Law.