PIP insurance, otherwise known as Personal Injury Protection, is a type of “no fault’ coverage that was adopted by the Florida Legislature in 1972. The law was passed to ensure that anyone who was involved in an automobile accident and sustained injuries as a result of the accident would receive money to cover their medical expenses in a timely manner. Under the law, insurance carriers are required to pay up to $10,000 to their own policyholder after an accident to cover medical bills and lost wages, regardless of who was labeled at fault. Persons involved in car accidents and who were injured could receive immediate medical treatment without having to wait for insurance carriers to accept or admit fault. Under Florida law, all drivers are required to carry "no fault" or PIP insurance.
In 2012, the Florida Legislature passed HB 119 which made drastic changes to Florida’s Personal Injury Protection (PIP) laws. On January 1st, 2013, the changes under this PIP reform bill became effective. The $10,000 in coverage is still mandatory, but the new law limits the amount actually available to $2,500.00, unless the injuries constitute an EMC or “Emergency Medical Condition”. An Emergency Medical Condition is defined 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 serious jeopardy to health, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.” In other words, being in severe pain as a result of injuries sustained in an auto accident is no longer enough to qualify for the $10,000 in mandatory PIP coverage that you are required to carry in Florida. So if you are not diagnosed with an EMC, your PIP benefits are reduced from $10,000 to $2,500. The only individuals authorized to make the Emergency Medical Condition diagnosis are a medical doctor, an osteopathic physician, an advanced registered nurse practitioner, or a dentist. Another provision under the new law is that if you are injured in an automobile accident, you have 14 days from the date of the accident to seek medical attention or no PIP benefits will be paid. In addition, you can no longer use the full $10,000 in coverage for chiropractic treatment, nor can you use PIP for a massage therapist or acupuncturist.
The provisions set forth under the new 2013 PIP laws are without question controversial, and have left many confused as to whether the statutory changes are legal. David M. Kerner, a Florida State Representative and Trial Attorney with Schuler, Halvorson, Weisser & Zoeller, P.A., expressed his concerns in a recent issue of The Palm Beach Post dated April 5th, 2013. “Recently, Governor Scott and the Legislature took drastic steps to reduce PIP injury benefits and protections. This was done under the guise of reducing “fraud.” However, many have argued that it was really an effort to boost insurance company profits.” Kerner points out that the new PIP laws do more than reduce and restrict benefits. “ Though the law did not mandate reduced premiums, it severely reduced your access to courts and limited the type of treatment you could seek. Just as brazen, it reduced from $10,000 to $2,500 of coverage available, unless an emergency condition existed.”
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