How The New PIP / Auto Accident Legislation Will Affect Florida Consumers.

On the last day of the Florida legislative session, the Florida House & Senate agreed upon and passed a PIP Reform Bill which will change auto accident insurance coverage for Florida consumers. Some of the new legislation will go into effect on July 1, 2012 (other portions go into effect on January 1, 2013). This new legislation will have dire consequences for consumers in the State of Florida. To help inform the public, I have summarized the important changes to the PIP system so that consumers will have the information available in the event that they are in an auto accident. Please feel free to share this information with your friends, family, and neighbors.
• Time Limit To Report To Your Doctor’s Office Or ER:
o How It Affects You – The new legislation dictates that a person injured in an auto accident must present to a physician’s office or emergency room within 14 days of the auto accident. If the patient doesn’t seek care within 14 days, they will be ineligible for any PIP benefits for their injuries.
• Reduction Of Coverage to $2,500 from $10,000:
o How It Affects You – The new legislation differentiates between an ‘emergency medical condition’ (EMC) and a ‘non-emergency medical condition’ (non-EMC). An EMC can only be diagnosed by an MD, DO, nurse practitioner, or physician assistant, not a chiropractor (discriminatory against DC’s). If the patient is diagnosed with a non-EMC, they will only be able to use $2,500 of the $10,000 that the patient is paying for as part of his/her PIP insurance. The full $10,000 will only be accessible if the patient is diagnosed with an EMC. Unfortunately, the Florida legislature did not delineate what constitutes an EMC.
• Examinations Under Oath (EUO):
o How It Affects You – The new law permits the insurer to subject the injured person to an ‘examination under oath’ to determine if there are verifiable injuries that are not fraudulent. The law also allows the auto insurer to suspend payments to doctors until the patient goes through the examination under oath. You must attend the EUO or your insurer can ‘cut off’ your coverage.
• Rate Roll Backs For Insurance Premiums:
o How It Affects You – This new legislation was passed in the name of ‘anti-fraud’ and to reduce costs to Florida consumers. Unfortunately, the law makers did not include concrete rules to require insurance companies to roll back or reduce insurance premiums for consumers.
In conclusion, insurance companies will continue to charge Florida drivers higher rates for PIP coverage, but consumers will receive reduced benefits ($2,500 vs $10,000) and more ‘hoops to jump through’ to get care for their injuries. This law restricts consumer choice for healthcare and is a payoff to the insurance industry.
So, what should you do in the event that you are in an auto accident? Be sure to contact our office within 14 days of your accident (the sooner the better in the event that a referral is needed to an MD or DO). If a referral is necessary, we will be sure to get you examined by an MD or DO within 14 days to ensure that you receive the benefits for an EMC if it is deemed medically necessary.
For more information, contact our office at:
Dr. Jeremy Gordon – Chiropractic Physician – 905 N. Stone Street – DeLand. (386)734-9995