Florida Insurance Companies Establish New PIP Policy for 2013

Effective this January, Florida will implement a new Personal Injury Protection (PIP) law. Pushed by the insurance industry, this laws was passed to curb fraud—but as a result, may just increase profits for insurance companies throughout the state.

Personal Injury Protection (PIP) is required for every driver in Florida. Through PIP, drivers are covered for 80% of their medical bills (up to $10,000), 60% of loss wages, and can receive a death benefit for those who lose their lives suddenly in an accident. Starting January 1, 2013, anyone who is injured in a car accident will need to obtain treatment within 14 days, or they will be denied PIP coverage. This treatment can be provided by an M.D., a D.O., dentist, chiropractor, or can be provided in a hospital or in a facility that owns, or is completely owned, by a hospital. Furthermore, under this plan, any follow-up treatment will need to be supervised, ordered, or prescribed by an M.D., chiropractor, D.O., dentist, physician assistant or ARNP.

Furthermore, under this new policy, should you obtain treatment within the 14-day period, Floridians will have access to two levels of Personal Injury Protection:
• $10,000 for an emergency medical condition
• $2,500 for a non-emergency medical condition.

According to the law, “emergency medical condition” can be defined as “medical conditions manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention would be reasonable expected to result in any of the following:
1. Serious jeopardy to the patient health;
2. Serious impairment to bodily functions; or
3. Serious dysfunction of any bodily organ or part.”

What does this mean for you? This means that, although insurance companies are asking you to pay $10,000 in coverage, they will only let you use $2,500 of that money. Even worse, these insurance companies will have the opportunity to send you to a doctor of their choosing to challenge your original diagnosis. You can believe the doctor they send you to is one that they use on a regular basis. Secondly, under this law, massage therapy and acupuncture will not be covered—even if it is prescribed by an M.D., a chiropractor, D.O., dentist, physician assistant or ARNP. In short, as of January 2013, insurance companies will be able to decide the type of treatment you need.