About Personal Injury Protection
What you NEED to know about the new PIP laws
and what the government and insurance companies DON’T want you to know.
What is Personal Injury Protection (P.I.P.)?
P.I.P. stands for Personal Injury Protection. It is also known as “no-fault” coverage. All Florida motor-vehicle owners are required to maintain P.I.P. by law. It pays medical expenses related to a motor-vehicle collision up to the first $10,000 regardless of fault.
January 1, 2013: PIP laws changed
1. Patients now only have 14 days to seek treatment from an approved medical doctor or you will lose full PIP benefits.
2. Patients are required to see an approved doctor for an EMC (Emergency Medical Consultation) to help the insurance decide whether you need your entire PIP.
This forces patients to rely on their health insurance to pay for medical bills that are related to their auto accident. Previously, these bills and expenses were covered under the PIP coverage that is required by the state of Florida.
3. Only approved doctors can consult for the EMC required to obtain full PIP benefits. The following doctors are able to diagnose and declare an EMC: Medical Doctors (MD), Osteopathic Doctors (DO), Physician Assistants (PA), Dentists (DMD), and Registered Nurses (RN). Chiropractors (DC) are no longer given authority to diagnose for EMC.
Most people treated by a chiropractor after an accident report the greatest relief from motor vehicle accident injuries and experience an easier path to recovery from soft tissue injuries.
4. Massage Therapy and Acupuncture treatment are no longer covered under the new PIP laws.
There are 8 primary benefits of massage therapy after an accident. Massage therapy stimulates tissue healing, reduces muscle spasms, improves scar tissue, increases joint flexibility, lowers blood pressure, reduces stress/anxiety, retrain soft tissue to function properly, and releases endorphins (the “happy” hormones).
March 18, 2013: Temporary Injunction against New PIP laws
A ruling in Myers vs. McCarty was declared that no longer required EMC for the patient to seek treatment, and the injunction gave the patient full PIP benefits. Massage therapy and Acupuncture was once again payable for patients involved in auto accidents.
April 19, 2013: Appeal was filed to stop Temporary Injunction
Gov. Rick Scott and insurance commissioner, Kevin McCarty, filed an appeal to stop the temporary injunction granted on March 18, 2013.
April 22, 2013: Ruling in favor of Injunction
On April 22, 2013, a ruling was made in the favor of the injunction. Circuit Court Judge Terry Lewis issued an order granting the Plaintiff’s request to remove the appeal on the PIP laws and keeps the injunction in place.
Florida Court Lifts Ban on PIP Law But Challenge Continues
October 25, 2013
Florida’s no-fault automobile insurance law is fully in force for now after a district court lifted an injunction that blocked part of law on a legal technicality leaving open the possibility for further challenges in the future. The Florida First …
Florida Judge Upholds Injunction Against Portions of State’s PIP Law
April 24, 2013
A Florida judge has upheld his temporary injunction partially blocking portions of the state’s automobile no-fault insurance law on the basis it infringes on drivers’ access to the courts. As a result, regulators are appealing to a higher court. Second …
Florida Gov. Scott, Insurers Vow Fight to Save PIP Law After Injunction
March 22, 2013
A Florida circuit court judge has issued a temporary injunction against certain provisions of the state’s no-fault personal injury protection (PIP) law, ruling that it is no longer a “reasonable alternative” to a tort system because of recent changes to …
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.”
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.