What does it mean to injured drivers?
This past December, Valerie Marshal, a licensed massage therapist and the owner of Indian Rehabilitation Center, Inc., along with 18 others, was arrested after an investigation uncovered a series of staged accidents and fraudulent insurance claims through Marshal’s clinic. If convicted, Marshal may spend up to 35 years in prison. The others face minimum 15 year jail terms.
According to the National Insurance Crime Bureau, Florida leads the nation in medical insurance fraud. Unfortunately, many people take advantage of the no-fault Personal Injury Protection (PIP) benefit by filing fraudulent claims with their insurance carriers. Florida residents pay higher auto insurance premiums as a result — roughly $250 more annually than many other states.
The most recent changes to the state’s Florida's no-fault law, which took effect on January 1, 2013, were designed to combat PIP fraud by making it much more difficult for Florida accident victims to collect PIP benefits.
- Long form traffic report required. Law enforcement is now required to complete a long form report if anyone experiences pain or discomfort at the scene of an accident. If you are not listed in the report, you are presumed not to have been injured in the accident and are not entitled to benefits.
- 14-day limit for seeking initial services or care. An accident victim must seek out initial medical treatment from a hospital, urgent care facility, medical doctor, osteopathic physician, chiropractor or dentist within 14 days of the accident.
- Treatment for medical emergencies. To receive the maximum $10,000 under PIP, you must have a diagnosis of an emergency medical condition by a physician, osteopath, dentist, advanced registered nurse practitioner or supervised physician’s assistant.
- Non-emergency treatment. Absent an emergency medical condition diagnosis, the maximum benefit available is $2,500. Furthermore, to receive medical services, you must have a referral from an MD, DO, chiropractor or dentist. You may seek treatment with any medical care provider you choose. However, massage therapists and acupuncturists are no longer included for PIP benefits.
- Time period for receipt of benefits. Insurance carriers typically have 30 days to provide benefits. Under the new amendments, as long as your provider notifies you within 30 days that your claim is being investigated for fraud, the company may take another 60 days to conduct its investigation. Payment or notification of denial may therefore take up to 90 days.
- Independent medical examination. Your insurance company may demand that you submit to an independent medical examination as a precondition to receiving PIP funds. Failure to comply could result in a loss of benefits.
If you have been in an accident and/or have been denied insurance benefits that you are legally entitled to, contact Viles & Beckman, LLC. Our car accident lawyers have significant experience in this area and are at your service.