In 2013, Florida enacted a personal injury protection law known as PIP. Now the applicability of that law is being challenged in the Florida Supreme Court. The law itself is a regulatory scheme that provides minimum requirements and reimbursement rates for hospitals who take care of those injured in accidents.
Part of the law is the requirements it puts on car drivers in Florida. Under the law, found in Florida Statutes Section 627.736, establishes minimum coverage requirements for car insurance in Florida. For example, there is a minimum coverage requirement of $10,000 for medical bills that result from car accidents. In return for these coverage minimums, insurance companies are required to pay up to 80% of claimed hospital bills that are submitted for payment.
What Happened in This Case
Soon after this law was passed, insurance companies looked for ways to get around the language of the statute, and put themselves in a better bargaining position. To that end, some insurance companies put language in their insurance contracts that are unclear as to how much they will pay for insurance claims made under their policies.
According to some insurance companies, they are limited to the 80% language of the statute. But within their insurance contracts, there is a guarantee to pay the reasonable expenses under the then current Medicare fee schedule. Of course this would make the insurance companies liable for more than 80% of expenses in most case because the Medicare fee schedule is the standard for for hospital bills and costs. This is not the first time that insurance companies have been accused of putting ambiguous language in their contracts. In fact, there is well-known legal doctrine that requires ambiguities in insurance contracts to be interpreted in favor of providing benefits against the insurance companies.
Now the insurance companies are asking the Supreme Court to review the ruling from a lower court and side in their favor. The lower court ruled that the language of these insurance contracts are ambiguous as written, and leave health care providers seeking to collect for work done in an untenable position. Now it is up to the Florida Supreme Court to decide how much these insurance companies will be required to pay under the contracts. If they side for the hospitals, it may result in a windfall for them, but if the insurance companies win, then hospitals will be faced with finding other ways to fund the bills injured people amass.
Panama City Accident and Injury Attorney
If you or someone you care about has been injured in an accident in the Panama City area, contact us. Our practice is dedicated to ensuring that those injured in a car accident are able to recover the fair and just amount they were damaged by. At The Pittman Firm, we investigate each case we are entrusted with. We help our clients understand their legal position, what they can expect going forward, and provide the best predictions we can. When it comes to protecting victims of accidents and injuries, our team takes every measure we can under the law.