The Silent Killer: Florida’s PIP Amendments Could Cost Floridians Millions

BY MICHAEL LEWENZ — Florida’s Personal Injury Protection (PIP) statute, which governs auto insurance coverage, was recently amended. And one new provision, in particular, will have potentially a catastrophic impact on thousands of Floridians. The PIP amendment, which took effect January 1, 2013, affects the medical expenses Floridians may have to pay if they find themselves in an automobile accident. The amendment—known as the “14-day provision”—is, to date, largely unknown to the public.

Under Florida’s PIP statute all Florida motorists who carry PIP insurance are entitled to 80 percent of their reasonable medical expenses, with up to ten thousand dollars paid for by their PIP carrier.  Before the enactment of the 14-day provision, there was no stated time period or designated list of physicians a Floridian had to seek treatment from to be entitled to his or medical benefits under the PIP statute. The statute now, however, states that a motorist has 14 days after an automobile accident to seek medical treatment from a hospital facility, emergency transport, medical doctor, doctor of osteopathy, chiropractor or a dentist.

Failure to seek medical treatment after 14 days will result in forfeiture of the motorist’s PIP coverage. Moreover, Florida insurers will no longer be required by law to cover the medical expenses of those who wait to get treated, or whose symptoms do not manifest until more than two weeks after the accident. This provision has essentially given Florida’s auto insurance companies a get-out-of-jail free card for the expenses of Floridians who do not seek medical treatment within the 14-day period.  Failure to satisfy the new provision will leave an innocent Floridian paying out of pocket if he or she does not have health insurance.

The purpose behind legislations amendment to Florida’s PIP statute is to decrease PIP fraud—a $600 million problem in the state of Florida. The Florida legislature obviously hoped that a decrease in PIP fraud will result in lower premiums across the board by curtailing fraudulent claims. But that remains to be seen. In the meantime, Floridians could lose out in thousands of dollars in medical coverage.