New Florida PIP Law Limits Time and Medical Options for Those Injured In a Car Accident

Four children and one adult driver had to be taken to the hospital near Miami, Florida after a driver crossed the center-line and hit their shuttle van head-on. Two children were ejected from the vehicle, but were in stable condition, one child’s condition was unknown, and the fourth child and driver remained uninjured. The driver claimed he was having a heart attack, but that was subsequently shown to be untrue.

While the victims in this recent accident quickly sought needed medical attention, other insured Florida car accident victims may not think they need, or can afford, medical services. The latest version of the Florida Motor Vehicle No-Fault statute, recently made effective at the beginning of 2013, substantially changed the laws regulating Personal Injury Protection (PIP). Foremost among the changes, is the mandate for those injured to receive initial services and care within 14 days of the accident.

Follow-up care is allowed, but must qualify under the statute. The new version of the PIP guidelines delineates the medical care providers that can perform the initial evaluation and treatment. Massage therapists and acupuncturists were explicitly excluded. Once that treatment is administered, then follow-up care related to the underlying condition is permitted.

The amount of coverage you receive under Florida’s new PIP laws will depend on whether the condition is considered an “emergency medical condition”. If it is, then you can receive up to $10,000. If not, then the maximum coverage is $2500. An “emergency medical condition” must be so serious that without immediate care, serious jeopardy to the patient’s health, serious impairment to bodily functions, or serious dysfunction of a body part or organ will occur. The previous statutory coverage also went up to $10,000, but allowed up to 80% of all reasonable expenses for medically necessary services, 60% of disability for any loss of gross income and earning capacity per individual from inability to work that was proximately caused by the accident, and 100% of replacement services like lawn care or childcare.

The Florida legislature was very concerned with the effectiveness of the state’s No-Fault statutes, and the amount of fraudulent claims. This is reflected in the new PIP law which allows an insurer to request an examination under oath (EUO) of the insured in their investigation of the claim. If the insured does not submit to the insurer’s independent medical examination (IME), then they are denied coverage. Two missed IME appointments create a rebuttable presumption that the refusal or failure to make the appointment is unreasonable.

An accident victim must also keep up with related paperwork. Those involved must rely on law enforcement to fill out the required long-form crash report if there is any indication of pain or discomfort from anyone in the crash. If the crash did not require law enforcement, then the insured must submit a report to Florida’s Department of Highway Safety and Motor Vehicles within 10 days of the crash.

Timely care and quickly submitted full reports are now essential to receiving the coverage you are owed. An experienced, assertive voice is needed to ensure the correct procedures have been followed and that the condition is properly diagnosed so that the maximum amount of coverage is received. The skilled South Florida injury attorneys at Friedman, Rodman & Frank are available to act quickly and offer a free consultation at multiple South Florida locations.