Insurance Fraud Guaranteed by New PIP Law

The Florida legislature in the last hours of this year's session drastically changed the PIP law that since 1972 has guaranteed citizens 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 guarantees fraud in a way you don't expect.

PIP stands for personal injury protection. Until the new law, which is called Emergency Care Coverage Law, replaces PIP later this year, we can get medical care up to $10,000 by any healthcare provider we choose. And after an accident, we can get it as needed until the coverage runs out. But when PIP is phased out and ECC moves in, we must 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.

Over fourteen days after the wreck? That's almost never going to happen, and when it does, the new law gives the 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, will 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. Big deal. It will generate hundreds of pages of explanation, and no doubt it will be honest, right? That's why I said earlier, the new law guarantees fraud in a way you don't expect. Directly from the insurance companies.

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