The Florida legislature in the last hours of the 2012 legislative drastically
PIP law that since 1972 had guaranteed people in an auto accident quick repayment
for medical bills and lost wages. Touted as a measure to avoid insurance
fraud that drives up our policy premiums, it instead invites fraud in
a way you probably don’t expect.
PIP stands for personal injury protection. Until the new law, which is
called Emergency Care Coverage Law (ECC), took effect in 2012, a person
injured in an auto accident, regardless of who was at fault, was entitled
under the PIP coverage to medical care up to $10,000 by any healthcare
provider. But after the old PIP law was replaced by the ECC, we have to
get the care within fourteen days of the wreck and by medical care providers
the state dictates to us. If we don’t, we lose $7,500 of our coverage
unless the doctor certifies that the care is for an emergency issue related
to the accident.
The new law also gives insurance companies the privilege to challenge the
doctor’s statement that it was an emergency. They will do exactly
that, and the injured person, maybe you or me, could have to pay for the
treatment out of our pockets. Even worse, the law doesn’t require
the insurance companies to lower our premiums in proportion to the drastically
reduced coverage. We will still pay for $10,000 of coverage but in most
cases get only $2,500 of it even if the full amount is needed.
The new law simply says that if an insurance company doesn’t reduce
its rate for this insurance by ten percent, it has to explain why to the
insurance regulators. Not a problem for insurance companies. They are
used to generating hundreds of pages of explanations whether they have
merit or not. That’s why I said earlier, the new law invites fraud
in a way you don’t expect. Directly from the insurance companies.
To protect yourself if you’re in a wreck, get medical care within
14 days, and let the doctor know you consider it an emergency.