According to an article in the May 19, 2013 edition of the Palm Beach Post, major Florida auto insurers are denying benefits based on a contested state law disregarding an injunction entered by a judge According to documents obtained by the Post, certain insurers are limiting non-emergency benefits to $2,500, excluding massage therapy and other denying coverage under provisions of the revised PIP law that a judge found unconstitutional. The Post cited claims records made available by medical providers.
At least one big insurer, State Farm, is respecting the injunction. But Progressive Select Insurance Co., for example, seems to cite the new law explictly and its $2,500 cap for non-emergency care in a May claim letter that The Post checked with the insurer. Progressive said it doesn’t discuss claims processes with third parties but argues the order affects the state’s Office of Insurance Regulation, not insurers.
The main provisions of the law, one of Gov. Rick Scott’s top legislative priorities, took effect Jan. 1. They slash benefits for Personal Injury Protection insurance in the name of curbing fraud, though a targeted 10 percent PIP premium savings for drivers in 2013 has averaged closer to 1 percent, The Post found. For its part, State Farm supported HB 119 but concluded the injunction has created uncertainty about whether it will be validated in the courts. Claim records appear to show that the insurer USAA is applying the $2,500 limit.
Key provisions of PIP law (effective Jan. 1, 20130:
(1) To qualify for the full $10,000 benefit, treatment must be by ambulance or at a hospital, or from a physician, dentist, supervised physician’s assistant or advance registered nurse practitioner.
(2) Treatment must begin within 14 days.
(3) Non-emergency benefits limited to $2,500.
(4) No massage or acupuncture treatments will be covered.
If you, a friend or loved has been involved in an auto accident or is involved in an auto accident in the future, it is important to be aware of these changes in the No-Fault (PIP law). You MUST seek treatment within 14 days of the accident and you MUST be diagnosed with an “emergency medical condition” in order to recover the full benefits under the PIP portion of your policy, for which you have paid hefty premiums.
If you have any questions or concerns about the changes in the No-Fault law and how it affects your treatment and injuries from an accident, please contact our office immediately at (800) 443-4LAW or www.SmithVanture.com