WHAT IS FLORIDA LITIGATORS PLLC?
A private law firm that helps medical providers (including MRI centers, clinics, rehabilitation centers, and chiropractors) recover unpaid or underpaid Personal Injury Protection benefits from insurance companies for medical services rendered to automobile accident victims.
HOW MUCH DO FLORIDA LITIGATORS’ SERVICES COST?
Florida Litigators’ PIP services are 100% free to our clients. When we recover PIP benefits, our clients keep 100% of the benefits, and the insurance company pays Florida Litigators’ costs and fees. If we do not recover benefits, we do not charge our clients for fees or costs.
CAN FLORIDA LITIGATORS PURSUE MY OLD CLAIMS?
Yes! We can pursue PIP benefits for bills submitted as far back as five years ago. It is not uncommon for a medical provider to be unaware of the underpayments contained within its PIP files. At no cost to you, we will review your past and present PIP files and determine which claims have been incorrectly reimbursed. We will then demand that the insurance company pay 100% of the amount you are owed.
WHY DO I NEED A PIP ATTORNEY?
Insurance companies regularly DENY, DELAY & DON’T PAY. PIP attorneys challenge the insurance companies’ unjust denials or reductions of PIP benefits covered under Florida of PIP benefits covered under Florida Statute § 627.736. As PIP attorneys, we focus on recovering no-fault benefits on behalf of medical providers. Most personal injury attorneys do not handle PIP matters for their clients’ providers.
HOW OUR PIP CLAIM PROCESS WORKS
1. PIP Audit by a Florida Litigators Attorney
Clients can make an appointment for a Florida Litigators attorney to visit their office to review their files or documents can easily be submitted electronically.
2. DEMAND LETTER
After reviewing our client’s files and determining which claims have been wrongfully reduced or denied by the insurance companies, Florida Litigators prepares demands and sends a written notice of intent to initiate litigation.
3. WAIT 30 DAYS
If the insurance company tenders payment, our client receives the benefits and Florida Litigators receives the statutory penalty, interest, and postage as attorney’s fees and costs.
Florida Litigators does not keep a percentage of the PIP benefits.
4. FILE LAWSUIT
If the insurance company continues to wrongfully file a claim, we file a lawsuit. When benefits are recovered from a lawsuit, the client is entitled to the medical benefits and interest, and the attorney’s fees and costs are paid by the insurance company.
OUR GOAL IS QUICK AND EFFICIENT RECOVERY OF PIP BENEFITS FOR OUR CLIENTS
In the event that the PIP lawsuit is not successful, our clients never pay Florida Litigators fees and costs.
WHY PIP AUDIT?
Call Florida Litigators today to make an appointment with an attorney to help identify the all-too-common underpayments and non-payments that are buried within your files. PIP law is complex in that it is constantly changing; different versions of the Statute and different insurance policies govern each claim. Florida Litigators Attorneys are happy to help you sort through your files and identify underpayments that can quickly add up.
JONATHAN PHILLIPS, ESQ.
Jonathan focuses his practice on (PIP) Personal Injury Protection. He earned his Juris Doctorate, Cum Laude, from the University of Florida Levin College of Law. He also earned his master’s degree in finance at the University of Florida. Jonathan was admitted to the Florida Bar in May 2013. He is a member of the American Bar Association, the American Association for Justice, the Florida Justice Association, and the Palm Beach County Bar Association.
FREQUENTLY ASKED QUESTIONS
Does the patient need to seek treatment within 14 days of the motor vehicle accident to qualify for PIP coverage?
To qualify for PIP benefits, injured car accident victims must be treated within 14 days of the accident. If a patient does not qualify for PIP benefits because of the 14-day requirement, medical providers can certainly still provide treatment. Other possible sources of payment are health insurance, cash, and/or a letter of protection from the patient’s personal injury attorney.
What is an ||emergency medical condition|| and when can the insurance company properly limit benefits to $2,500?
The Current PIP law allows insurance companies to cap benefits at $2,500 (rather than $10,000) if a medical provider listed in the statute determines that the patient does not suffer from “Emergency Medical Condition” or EMC.
The statue defines an EMC 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 any of the following:
(1) Serious jeopardy to patient health;
(2) Serious impairment to bodily functions;
(3) Serious dysfunction of any bodily organ or part.
EMC is a hot issue in Florida PIP law, and Florida Litigators has been able to successfully recover medical benefits in excess of $2,500 in cases where insurance companies initially took the position that the patient did not suffer from an EMC and therefore denied reimbursement for medical services. Results may not be typical. You may not have as beneficial a result.
Does an ||Emergency Medical Condition|| need to be determined within 14 days?
No. The EMC requirement and the 14-day requirement should not be confused. An EMC determination can be made at any time.
If benefits are denied based on an independent medical examination or a peer review, can they be recovered?
Yes! Florida Litigators has successfully recovered benefits that were initially denied based on the results of an independent medical examination (IME) or Peer Review. results may not be typical. You may not have as beneficial of a results IME’s are conducted by doctors who regularly work for insurance companies. Insurance companies pay these doctors to conduct IME’s and Peer Reviews. After the insurance company pays the doctor to form an opinion, it may cut off benefits. The credibility of these doctors can be undetermined in court.
If the insurance company says benefits have been exhausted, have they paid $2,500 or $10,000?
Some insurance companies send correspondence which states that benefits have been exhausted, yet they unscrupulously do not state what amount has been paid. It is important that medical providers look out for this issue and have a PIP attorney review their files.
Can massage therapy, acupuncture, or manual therapy be reimbursed?
Under the current PIP law, medical benefits do not include massage or acupuncture, regardless of the person, entity, or licensee providing the services. Manual therapy is reimbursable. Some insurance companies are denying claims for manual therapy (CPT Code 97140) and claiming that it is actual massage therapy (CPT Code 97124). This is incorrect. If you have experienced denials for manual therapy, contact a PIP attorney.
Can a chiropractor determine that a patient suffers from an "Emergency Medical Condition"?
No; only a treating medical doctor, an osteopath, a dentist, a physician’s assistant, or an advanced registered nurse practitioner can make an EMC determination.