It’s 2022. 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. 

Florida Personal Injury Protection (PIP) and You

Florida law makers have passed legislation that requires every driver that has a registered vehicle in the state to carry a minimum amount of insurance coverage. The No Fault Statute in Florida requires each driver to maintain PIP and property damage liability. The minimum PIP coverage that each drive must have under the Statute is $10,000.00.

PIP in Florida also extends to provide coverage to the driver’s other individuals that are lawfully operating their vehicle, relatives and some other passengers that do not have their own PIP coverage and do not own a vehicle. Under the Statute, PIP coverage includes medical benefits, death benefits and disability benefits.

The coverage from PIP only covers bills up to the limits in the insurance policy. Any injuries that an individual sustains that end up requiring treatment that exceeds the policies coverage will result in the remainder of the expenses being paid out of pocket. It is also important to know that an individual will likely be required to pay a deductible before a insurance provider pays any benefits under the policy.

Florida Litigators Will Get Results For You

The Team at Florida Litigators has handled tens of thousands of insurance claims and litigated thousands of lawsuits on behalf of our clients resulting in millions of recovered revenue. Our success comes, in part, because we do not cherry pick through your patients and files and instead do a complete and comprehensive review each claim.  Our audit and demand processes always result in high success rates with volume and quality bringing often the best results for our clients.

We take cases on a contingent basis: We do not get paid unless you do. Insurance companies can underpay, delay, deny, and simply not pay, all at the expense of you, the client. While under paying 1-5% per CPT code does not look like much one code at a time, but it adds up and you have a right to the benefits you have billed. Get a lawyer on your side with a proven track record by scheduling a Free Consultation. We are here to help you recover your benefits. Contact us today.

More About Personal Injury Protection (PIP)

Personal Injury Protection, also known as PIP.

Personal Injury Protection, also known as “PIP”, is a term of reference for “Florida No Fault Insurance”. PIP insurance provides coverage to drivers and some other individuals that are covered under an auto insurance policy for personal injuries that arise from car accidents. The coverage extends benefits up to the limits of the auto policy whether or not an individual is at fault for their auto accident or not.

Anyone who has had their claim for these benefits denied unlawfully or in bad faith stands to gain from hiring an experienced and knowledgeable auto insurance attorney.

Florida PIP

Florida law makers have passed legislation that requires every driver that has a registered vehicle in the state to carry a minimum amount of insurance coverage. The No Fault Statute in Florida requires each driver to maintain PIP and property damage liability. The minimum PIP coverage that each driver must have under the Statute is $10,000.00.

PIP in Florida also extends to provide coverage to the driver’s other individuals that are lawfully operating their vehicle, relatives and some other passengers that do not have their own PIP coverage and do not own a vehicle. Under the Statute, PIP coverage includes medical benefits, death benefits and disability benefits.

The coverage from PIP only covers bills up to the limits in the insurance policy. Any injuries that an individual sustains that end up requiring treatment that exceeds the policies coverage will result in the remainder of the expenses being paid out of pocket. 

Procedure for Filing a PIP Claim

According to Florida Statutes, and most auto insurance policies, written notice of an auto accident is required as soon as reasonably possible after the accident occurs. The insurance provider is required to pay your benefits for any injuries sustained within 30 days after they were given written notice of a claim that is covered under the policy.

Some claims may still be excluded from PIP coverage, including conduct by the injured person that contributed to the injuries, injuries to a person driving without permission from the vehicle owner and injuries in an accident while committing a felony.

Handling of Denied Claims

Insurance companies regularly find reasons to deny claims by persons covered under PIP. Some of the more common reasons for denial include untimely payment of insurance premiums, suspicion that the injury was preexisting, claim that the injury was due to fraud, or that the injury is excluded from coverage because of a specific provision in the insurance policy.

If your claim has been denied by an insurance company, it is important to hire an attorney that is experienced in insurance law. If your claim was unlawfully denied or your car insurance carrier acted in bad faith, hiring the right attorney can be crucial to ensuring that the proper legal action is taken. Consulting with a Florida Litigators attorney is a great first step receiving the benefits that you deserve.

Liability Coverage

There are two types of liability coverage bodily injury and property damage.  These coverages protect you or cover you from legal liability up to the limit selected for damages caused in a covered accident.  This means if it’s your fault and you would be legally obligated to pay for another person’s injuries and damages as the result of a cover auto accident, the bodily injury liability would pay for the damages up to the selected limit.  Property damage liability insurance covers you for damages to property.  The insurance company will hire a lawyer and defend you if you are sued.

If you have been in an automobile accident that was not your fault and injured, the at fault driver’s liability insurance coverage would be available to pay your damages and perhaps other drivers in the accident.  If you have been hurt in an accident and would like help to determine the available liability coverage of the at fault driver give us a call and we can request this information from the insurance company on your behalf.

Personal Injury Protection Coverage

Personal Injury Protection coverage is commonly referred to as PIP and “no-fault insurance”.  In Florida, the state requires each person who owns a motor vehicle to carry PIP coverage.  PIP covers the insured as well as omnibus insureds which could include family members, passengers, and pedestrians that don’t own cars regardless of fault.  PIP offers up to $10,000.00 in coverage for medical bills, lost wages, millage, and loss of house hold services.  PIP may be subject to up to a $1,000.00 deductible.

Uninsured and Underinsured Motorist Coverage

Uninsured and Underinsured Motorist Coverage pays for damages that you may legally be entitled to when an accident is not your fault for bodily injury when the at fault driver has no or inadequate insurance coverage.  When you’re in an accident that is no fault of your own, you have no control over how much insurance coverage the other driver has.  Uninsured and Underinsured Motorist Coverage also provides coverage for hit and run accidents.

How our PIP Claim Process Works

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.

Send a 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.

WAIT 30 Days for Responses

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.

FILE LAWSUIT on your Behalf

If the insurance company continues to wrongfully deny or underpay 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.

PIP Frequently Asked Questions F.A.Q.

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 $2,500.00?

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 result. 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 cross-examined in court.

If the Insurance Company says benefits have been exhausted, have they paid $2,500.00 or $10,000.00?

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 sufferes 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.

 

Who is Florida Litigators and What do we do?

Florida Litigators is a local, independent, experienced Team of professionals serving our Florida communities since 2013. With our extended experience, across multiple disciplines and fields of expertise, we fight for our clients to recover benefits and build satisfaction and peace of mind out of legal and claim disputes.

We work with you starting with a free consulation and represent our clients on a Contingency Fee basis. This simply means that we only make money when we make money for you. No hidden fees or recurring costs come out of your pocket. Period.

Comprehensive and Dedicated Legal Representation

Free Consultation with No Strings Attached

Contingency Fee Structure. We don't get paid if you don't get paid. As Simple as that.

Results Driven, Client Satisfaction, before all else.

Experienced and Diverse Team of Professionals