PIP INFORMATION FROM OUR PERSONAL INJURY CHIROPRACTIC TEAM
Our personal injury chiropractor will tell you what you need to know about the new Personal Injury Chiropractic laws and what the government and insurance companies don’t want you to find out.
What is Personal Injury Protection (P.I.P.)?
P.I.P. stands for Personal Injury Protection, also known as “no-fault” coverage. Florida law requires all motor-vehicle owners to maintain P.I.P. insurance. This coverage pays for medical expenses related to a motor-vehicle collision up to the first $10,000 regardless of who caused the accident.
January 1, 2013: PIP Laws Changed
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Patients now have only 14 days to seek treatment from an approved medical doctor. If you miss this window, you lose access to full PIP benefits.
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Patients must visit an approved doctor for an EMC (Emergency Medical Consultation), which helps the insurance company decide whether you need your entire PIP benefits.
This change forces patients to rely on their health insurance to pay for medical bills related to auto accidents. Previously, PIP coverage required by the state of Florida covered these expenses directly.
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Only approved doctors can perform EMC consultations required to obtain full PIP benefits. The following professionals have the authority to diagnose and declare an EMC: Medical Doctors (MD), Osteopathic Doctors (DO), Physician Assistants (PA), Dentists (DMD), and Registered Nurses (RN). Chiropractors (DC), however, no longer hold the authority to diagnose for EMC.
Most people who receive personal injury chiropractic treatment after an accident report the greatest relief from motor vehicle accident injuries and follow an easier path to recovery from soft tissue injuries.
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The new PIP laws exclude Massage Therapy and Acupuncture treatment from coverage.
Massage therapy offers eight primary benefits after an accident. It stimulates tissue healing, reduces muscle spasms, improves scar tissue, increases joint flexibility, lowers blood pressure, reduces stress and anxiety, retrains soft tissue to function properly, and releases endorphins the body’s natural “happy” hormones.
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COURT RULINGS
March 18, 2013: Temporary Injunction Against New Personal Injury Protection Laws
In the Myers vs. McCarty case, the court ruled that patients no longer needed an EMC (Emergency Medical Condition) to seek treatment. This injunction restored full PIP benefits for patients and allowed massage therapy and acupuncture to be payable again for those involved in auto accidents.
April 19, 2013: Appeal to Stop the Temporary Injunction
Governor Rick Scott and Insurance Commissioner Kevin McCarty filed an appeal to overturn the temporary injunction that the court had granted on March 18, 2013.
April 22, 2013: Ruling in Favor of the Injunction
On April 22, 2013, Circuit Court Judge Terry Lewis issued an order supporting the plaintiff’s request. He removed the appeal on the PIP laws and kept the injunction in place.
DEFINITION OF EMERGENCY MEDICAL CONDITION
Emergency Medical Condition is defined as “a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to patient health, and/or serious impairment to bodily functions, and/or serious dysfunction of any bodily organ or part.”
What is an Emergency Medical Condition?
Look at the definition of EMC. Look at the patient’s injuries. If you think the patient’s injuries are serious then the patient may have an EMC. The word “serious” is mentioned three times in the definition so the “seriousness” of the injury is important when diagnosing EMC.
Is there an Emergency Medical Condition Form for PIPNo. There is no form approved by the state. There is no form needed. The bare minimum requirement to comply with the law (assuming the patient has an EMC) is to say “patient had/has an emergency medical condition.”
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Can an IME doctor say there is no Emergency Medical Condition?
No. The PIP statute specifically says “a provider in subparagraph 1 and 2”. Those providers are all “treating” providers and an IME doctor is not a treating provider.
Attorney Abe Ovadia has filed thousands of lawsuits related to PIP and continues to file PIP suits on behalf of chiropractors, MRI centers, and other medical providers.
How do I know if a patient is covered through P.I.P.?
The patient should have an auto insurance card. Make a copy. If they reported the car collision then they should have been assigned a claim number from the P.I.P. insurance company. If the patient has treated with other medical providers before presenting to your office, you should ask the P.I.P. insurance company to provide a “P.I.P. payment log” so that you can determine how much, if any, coverage is remaining. Remember that once that $10,000 policy limit is reached then benefits have exhausted and, for the most part, no further payments will be made.
Who is covered by P.I.P.?
P.I.P. covers the owner of the motor-vehicle, resident-relatives, and passengers injured in the owner’s motor-vehicle.
Must I obtain prior approval from a P.I.P. insurance company before treating a P.I.P. patient?
State law does not require prior approval for P.I.P. insurance.
What if the patient caused the accident?
The patient is still covered through P.I.P. insurance.
NEWS UPDATES
Florida Court Lifts Ban on PIP Law But Challenge Continues
October 25, 2013
The Florida district court lifted the injunction that had blocked part of the no-fault automobile insurance law, citing a legal technicality. As a result, the law is fully in force for now. However, this action still leaves room for future legal challenges.
Florida Judge Upholds Injunction Against Portions of State’s PIP Law
April 24, 2013
A Florida judge upheld his temporary injunction that partially blocks portions of the state’s no-fault insurance law, arguing that the law infringes on drivers’ access to the courts. Consequently, regulators have decided to appeal the decision to a higher court.
Florida Gov. Scott, Insurers Vow Fight to Save PIP Law After Injunction
March 22, 2013
A Florida circuit court judge issued a temporary injunction against certain provisions of the state’s personal injury protection (PIP) law. The judge ruled that, due to recent changes, the PIP law no longer serves as a “reasonable alternative” to the tort system. Therefore, Florida Governor Rick Scott and insurance companies have vowed to fight and defend the law.