By Catherine Powell
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| Image courtesy of wikimedia |
For the uninitiated, PIP stands for
personal injury protection. In Florida
PIP pays for 80% of your medical bills and 60% of your lost wages caused by an
auto accident, up to a maximum of $10,000.
As such, it’s one of the few provisions of your auto insurance policy
that’s paid regardless of who is at fault or whether you are on foot or riding
a bicycle. This means if you carry auto
insurance in Florida and are involved in an auto accident in any way, shape or
form, you could be eligible to receive benefits. That’s the good news.
The bad news is $10,000 doesn’t amount to
a heck of a lot when it comes to medical expenses. Even worse is the fact that if your injury
isn’t considered an emergency, the maximum amount of benefits you can claim is
$2,500. Still, it’s better than nothing,
right? There is also a death benefit
that kicks in if you are killed in an auto accident. That pays your next of kin $5,000 to help
defray the cost of funeral expenses.
How
do you file a PIP claim?
If you hope to receive any reimbursement
by filing a PIP claim in Florida, you’re required to file within two weeks of
the auto accident. If you wait and file late, your claim will be automatically
rejected. I know this seems kind of
callous when you consider the fact that depending upon the severity of the
injuries sustained in a car crash, you could be incapacitated for more than two
weeks. Still, the law is inflexible when
it comes to the amount of time you have to file a PIP claim.
In addition to submitting receipts for
medical treatment from a physician, osteopath, chiropractor, dentist,
physician’s assistant, or registered nurse, you also need to have your employer
submit a wage and salary verification if you wish to be reimbursed for lost
wages. This record needs to document your wages for the 13-weeks prior to your
accident. Last but not least, you’re
required to get a note from your physician detailing why you were unable to
work after your accident.
How
long can the insurance company keep me waiting for a reimbursement?
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The good news is that your insurer has
only 30-days to pay up, provided you have provided the proper documentation in
a timely manner. The bad news is that
the insurer has up to 60-days to investigate any PIP claim.
The reason the insurance companies are
given such latitude when it comes to dealing with PIP claims comes down to one
word: Fraud. During the period of
2010-2012, the Florida Office of Insurance Regulation claimed that fraudulent
claims cost insurers in Florida more than $1 billion. We’re not talking about nickel and dime
claims either. Some of the criminals
involved fleeced the insurance companies out of millions of dollars, as you
will see below in an October 6, 2017 article from the South Florida Business
Journal.
Six South Floridians charged in
multimillion-dollar insurance fraud
Two South Florida residents have been
charged in a scheme that allegedly paid tow truck drivers to solicit accident
victims for chiropractic treatments they did not need, prosecutors said.
According to an indictment unsealed by the U.S.
Attorney's Office in Miami on Wednesday, Felix Filenger, 41, of Sunny Isles,
and Andrew Rubinstein, 48, of Miami, headed a
criminal enterprise that used a dozen chiropractic clinics to engage in
automobile insurance fraud.
According to federal prosecutors, the pair allegedly used
licensed chiropractors as nominee owners to obtain licensing for clinics, then
paid kickbacks ranging from $500 to $2,100 a person to tow truck employees to
refer accident victims. The clinics would "treat patients based solely on
a profit motive and without regard to patient health,'' acting U.S. Attorney
Benjamin G. Greenberg said in a release.
Altogether, prosecutors charged six people in the case. In addition
to Filenger and Rubinstein, Olga Spivak, 59, of Hollywood, and Linda Varisco, 55, of Coral
Springs were charged for allegedly filing false statements with insurance
companies claiming they were 100 percent owners of clinics that were, in fact,
owned by Filenger and Rubinstein.
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| Image courtesy of Picpedia |
The worst part is that fraud like this
cost all Florida motorists. Since 2017,
PIP rates in Florida have increased by more than 50%. The reason? Florida PIP
claims the same year rose by nearly 50% to more than 60,000.
Another reason for the surge in PIP claims
is third-parties suing for compensation.
It’s what’s known in the industry as Assignment of Benefits (AOB). The
Florida Justice Reform Institute reported that more than half the state’s
insurance litigation is not being brought by individuals but by auto repair
centers, chiropractors, image centers and other medical providers.
The Palm
Beach Post reported in May 2018, It happens when third parties like a
repair contractor or medical clinic tell consumers we’ll handle the claim for
you if you sign this form assigning us the insurance benefit. It’s not uncommon
in health care and other fields. Insurers say the trouble is, Florida’s laws
provide too many incentives for some of the third parties take the insurers to
court. The net effect: drivers keep paying rising premiums to insurers. A state-commissioned actuarial report said drivers could save up to $81 per car if
Florida repealed PIP and required bodily-injury liability coverage.
An even
more prevalent form of fraud occurs by people who are paid to stage accidents
and fake injuries to fraudulently collect PIP benefits. If you’re involved in any auto accident, no
matter how minor, make sure you file a police report, as well as getting the
names and addresses of the driver and all passengers in the other vehicle. This action could save you and the rest of
the driving public in Florida from getting popped by PIP fraud.
Catherine Powell is the owner of A Plus
All Florida, Insurance in Orange Park, Florida.
To find out more ways to save on liability insurance, check out her website at
Insurance fraud affects every driver in Florida. It's practically a cottage industry in South Florida.
ReplyDeleteI did not know all of these things about PIP. Now I do. Thanks.
ReplyDelete