New Florida PIP law limits benefits, faces court challenge

Drivers in Florida are required to carry personal injury protection auto insurance, which is also known as PIP coverage. The purpose of this coverage is to pay for reasonable medical expenses and wage losses in car accidents, without regard to who was actually at fault for the accident.

The PIP system has long been a source of controversy. Advocates of the law say that it allows quick payment of medical costs and lost wages and avoids the uncertainties of a system where the recovery is based on personal injury lawsuits. However, opponents of the law assert that the costs of PIP have been inflated because of fraud and excessive medical treatment that was encouraged by the system. In order to address the system’s perceived shortcomings, reforms that limit an accident victim’s rights to recover medical expenses were recently passed.

New PIP law’s provisions

The new PIP law took effect in January 2013. Among the changes it made was to give victims of car accidents only 14 days to seek medical treatment after the accident. If the victim waits more than two weeks, he or she will likely not receive any benefits under the PIP policy. Before this change, there was no real time limit on filing a claim for benefits.

Additionally, medical expenses under the new law are only reimbursable if they are provided or ordered by a licensed physician, osteopath, dentist, hospital or paramedic. A change in the law excludes car accident victims from claiming benefits for certain types of treatments such acupuncture or massage therapy.

Finally, the most controversial part of the new PIP law is its limits on the total amount of medical benefits. Although all drivers must purchase at least $10,000 in PIP coverage, in order to recover the full amount of benefits, the injuries must be diagnosed as an “emergency medical condition.” An “emergency medical condition” is a serious injury where failing to get immediate medical attention is reasonably expected to seriously jeopardize the patient’s health or bodily functions. For car accident victims who have non-emergency injuries, the maximum amount of benefits is limited to $2,500.

In exchange for these limitations, the law encourages PIP insurance providers to cut insurance rates by 10 percent. However, the law does not guarantee this discount; insurers who do not cut their rates by 10 percent only have to submit a statement explaining why they did not do so.

Consult an attorney

Because of a recent lawsuit filed by a group of acupuncturists, massage therapists and chiropractors, a Florida judge recently issued a temporary injunction, blocking many of the benefit limitations in the new PIP law from being implemented. The injunction order is being appealed.

It is unclear whether the provisions of the new law will ultimately go into effect. However, if you are injured in a car accident, a personal injury attorney can work to ensure that you collect all the benefits that you are entitled to and can ensure that your insurance company treats you fairly throughout the process.