Why No-Fault Insurance is Bad for Floridians
Ever since Florida’s No-Fault Insurance scheme, with its Personal Injury Protection (PIP) requirement, was initially imposed on motorists in this State, repeated claims regarding cost-saving and litigation-reducing benefits continuously went unrealized. In fact, the opposite is true, as automobile insurance rates in Florida are among the highest in the nation, and there has been no discernible effect on the reduction of litigation involving automobile accidents. To make matters worse, politicians have been unable to repeal this immensely unpopular law. Retaining the services of an experienced personal injury attorney with expertise in automobile accidents may be the only way in which a victim can be truly made whole from the costs incurred as a result of an automobile accident. Recently, another issue increasingly associated with PIP coverage are allegations of fraud. A lawsuit out of the Southern District of Florida Federal Court, in which State Farm accuses three clinics of cheating it out of nearly $5 million based upon claims of unnecessary medical treatment and billing for services never provided to car accident victims, illustrates the hardships caused by this law on Florida motorists, for if State Farm is unsuccessful in its lawsuit, it will no doubt pass the costs on to its insureds. A discussion of the PIP requirement, and the hardships brought on by its implementation, will follow below.
The PIP requirement is at the core of Florida’s No-Fault Insurance scheme. Generally, PIP pays for a motorist’s medical bills when he/she is in an accident, whether or not he/she contributed to the cause of the accident. Generally, PIP pays a motorist’s medical bills up to his/her policy limit, minus any deductible. The following services must be covered by the PIP policy:
- Medical, surgical, X-ray, dental, and rehabilitative services;
- Hospital, ambulance, and nursing services; and
- Follow-up care.
However, the PIP plan is limited in providing payment, according to the following schedule:
- 80% of all medical-related expenses;
- 60% of lost wages;
- $5,000 worth of death benefits; and
- Mileage reimbursement to/from the physician.
Additionally, if the injury is not considered an emergency medical condition, the PIP is limited to $2,500 in benefits. Thus, a serious injury which is not considered an emergency may not be fully covered by PIP benefits.
Further, Florida motorists are only required to maintain a minimum of $10,000 of PIP for their own medical expenses and lost wages, and $10,000 for damage to another’s automobile. Unfortunately, since a trip to the Emergency Room can use most of that figure, if a motorist is in an accident and not at fault, there is a strong likelihood that no insurance payout will be able to reimburse all of his/her expenses, and he/she may be responsible for costs above the $10,000 figure. In some cases, a motorist may have elected to purchase an optional supplemental coverage that pays for medical bills that PIP does not. However, this increases the overall insurance cost. And, further, this optional coverage has limits as well. Thus, a motorist may then have to turn to his/her health insurance provider. And, if this provider does not cover the remainder of the costs, the motorist may be required to pay for that amount out of his/her own pocket. In many cases, recouping such costs through a personal injury lawsuit may be the best option available, and an experienced attorney can help formulate a strategy in this regard.
Seek Legal Advice
If you or a loved one suffered an injury in an automobile accident, contact the attorneys at Pita Weber & Del Prado as soon as possible. The attorneys at Pita Weber & Del Prado have the experience necessary to deal with the various provisions of Florida’s no-fault insurance scheme, including the deadlines. We will work with you to develop the best strategy to ensure you get the compensation you deserve. Contact our Miami office today for an initial consultation.