Okay, looking back through this late-night final draft of my monthly column, I’m wondering now whether maybe I should have titled this piece: “What Not to Expect from Florida’s New P.I.P. Insurance Law” – since here we are in January 2013, the starting date for much of Governor Scotts’ sweeping P.I.P. insurance reform package, and the most-important change promised by our executive leadership – namely, lower insurance premiums for Florida drivers – is nowhere to be found.
“Wait, be patient,” insurers say, “We just need a little more time to figure out these changes.” In the meantime, as of this week, most insurers have actually requested rate increases in response to the new law or simply requested less of an increase than they had previously sought. How, you ask? Under the new P.I.P. law, insurers are authorized to dramatically scale back coverage and slow down payments but no one ever actually required them to reduce rates. There’s just a suggestion that insurers rollback prices or send an “excuse” note to the Insurance Commissioner explaining why rates aren’t dropping. That’s it. As you can guess, most car insurers chose Option B.
So what did we consumers get from this reform designed to put money back in our pockets? In short, we got less coverage for more money. Here’s an overview of what will apply for policies issued or renewed as of January 1, 2013:
1) P.I.P. coverage is reduced by 75% (down from $10,000 to $2,500) if it’s determined that there is no “Emergency Medical Condition.” Bruises, fractures, disc injuries and even trips to the ER can be deemed nonemergency.
2) Insurers can delay a claim an additional 60 days to investigate for fraud, bringing the total to as much as 120 days to pay a claim.
3) Massage and acupuncture are no longer covered.
4) Patients must see a qualified physician within 14 days or they’re not covered.
5) Injuries not mentioned in the initial medical records may also be denied.
6) Treating doctors and hospitals can also expect lower reimbursements based on new fee schedules reducing payments by 25% - 35% in most cases.
7) Finally, if you thought your P.I.P. claim was going to be quick and painless – think again. Your P.I.P. insurer may now force you to visit their lawyers for an examination under oath (essentially a deposition) before deciding whether to pay your claim and make you file a lawsuit if you want documentation verifying why your claim isn’t being paid.
So 2013 is here and we’ve seen our policies stripped down to bare-bone yet again. As for those savings we were promised in exchange, “Well,” insurers say, “we’ll maybe take a look at that next year.” Maybe.
Russel Lazega is an attorney and author of several of Florida’s most widely distributed legal textbooks on Florida Insurance Law: West’s Florida Practice Series Volume 7 and West’s Florida Insurance Law & Practice. Mr. Lazega represents accident victims, insurance policyholders and condominium associations and is based in Dania Beach, Tallahassee, North Miami, Orlando and Tampa, Florida. Contact: www.Lazegalaw.com.
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