Talk of The Villages Florida

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-   Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)
-   -   refusal of treatment (https://www.talkofthevillages.com/forums/medical-health-discussion-94/refusal-treatment-107021/)

ilovetv 03-15-2014 10:03 AM

The State of Florida Insurance Regulation Department is in place for this and other consumer problems. I would contact them immediately.

Here is a brief explanation of why there are consumer/victim problems with PIP cases. The rest of the page has excellent background on why PIP has been needed. As always, it's because of lawsuits by people who prefer to game the system and vote for a living or sue for a living instead of work for it. Then those who cannot work because they've been truly injured get the runaround that the o.p. has.

"....In recent years, the number of drivers and auto accidents has remained relatively constant, but the amount of PIP claims, and PIP payments has skyrocketed. The National Insurance Crime Bureau lists Florida as having several cities reporting the highest amount of “questionable claims” nationally. While PIP premium represents roughly two percent of Florida’s collected insurance premium, this issue accounts for nearly 50 percent of fraud referrals....."

http://www.floir.com/Sections/PandC/...w/PIPInfo.aspx

JourneyOfLife 03-15-2014 10:40 AM

IMO, the legislation is flawed.

If the injured is frustrated into not seeking treatment, who benefits?

For that matter... wonder who wrote the piece of legislation? Probably insurance company lobbyist!

DaleMN 03-15-2014 10:20 PM

I'm skeptical. :doh:

JourneyOfLife 03-16-2014 09:13 AM

Some probably will not even know about it unless they experience if first hand.


I am sure that Niezsche quote you sport on your signature line looks a lot more palatable philosophically than in reality.

rubicon 03-16-2014 09:38 AM

Quote:

Originally Posted by ilovetv (Post 845766)
The State of Florida Insurance Regulation Department is in place for this and other consumer problems. I would contact them immediately.

Here is a brief explanation of why there are consumer/victim problems with PIP cases. The rest of the page has excellent background on why PIP has been needed. As always, it's because of lawsuits by people who prefer to game the system and vote for a living or sue for a living instead of work for it. Then those who cannot work because they've been truly injured get the runaround that the o.p. has.

"....In recent years, the number of drivers and auto accidents has remained relatively constant, but the amount of PIP claims, and PIP payments has skyrocketed. The National Insurance Crime Bureau lists Florida as having several cities reporting the highest amount of “questionable claims” nationally. While PIP premium represents roughly two percent of Florida’s collected insurance premium, this issue accounts for nearly 50 percent of fraud referrals....."

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NICB is a good organization and has uncovered many insurance fraud schemes. You are spot on.

Plaintiff attorneys utilize PIP to grease their liability claims. If you visit a plaintiff attorney about your claim and its value, the first thing the attorney is going to say is "tell the insurance company there is not enough money to compensate you for the pain and suffering you have undergone. This little bity rear end accident wrecked my life caused my divorce because the pain caused me to cheat on my wife, led to my taking drugs and losing my job and all my friends. In fact everything of a negative value that has occurred to me can be laid at the feet of this accident. since your insured was responsible I deserve to be compensated so well that I should never have to want for anything the rest of my life. Pardon, the damages to my car, cost me $300 to have it repaired boy the guy must have been going a zillion miles an hour...but sir, the car was parked, where you still in it?:D

Tweety Bird 03-16-2014 11:45 AM

Would going to the Mayo Clinic help?

JP 03-16-2014 01:46 PM

Quote:

Originally Posted by DaleMN (Post 846106)
I'm skeptical. :doh:

Me too

rubicon 03-16-2014 02:38 PM

Knowing the position of all parties involved would be beneficial because a medical facility does not just refuse treatment for no reason. something is going on here and without a full explanation of the facts involved we can only guess. This is a position I took on another PIP thread that referenced this thread

ahayward65 03-16-2014 02:53 PM

I think it is the ER's responsiblity to set up an appointment with an ortho doctor. I just don't understand why this was not done. The longer you wait the more problems may develop with your knee.

cromlich 03-17-2014 09:29 AM

Quote:

Originally Posted by ahayward65 (Post 846469)
I think it is the ER's responsiblity to set up an appointment with an ortho doctor. I just don't understand why this was not done. The longer you wait the more problems may develop with your knee.

you are so right. The ER , however, is aware of the problems we will have after leaving their care. It's terrible how we are treated during a very stressful time. It's made me feel less than a stray animal that got hit by a car. I think vets are more caring then our medical field out there.

cromlich 03-17-2014 09:32 AM

Quote:

Originally Posted by rubicon (Post 846454)
Knowing the position of all parties involved would be beneficial because a medical facility does not just refuse treatment for no reason. something is going on here and without a full explanation of the facts involved we can only guess. This is a position I took on another PIP thread that referenced this thread

It looks like the Ortho docs have organized for the refusal of treatment. I don't understand at all why. I get mixed answers when I ? it. It is just down right sad and according to my PC doc it's going to get worse. They will be "cherry picking" their patients and if you have too many problems they won't keep you as a patient......these were words from a PC's mouth.

cromlich 03-29-2014 07:04 AM

thumbs up for TV Healthcare
 
Did some detailed checking on TV Healthcare and was pleasantly surprised. Asked a million questions because of the problems I have had with the providers who refuse to treat because of PIP insurance. The gal we spoke with actually brough out a billing person who verified that they do accept PIP and were happy to help those of us unfortunate enough to end up in an accident. What a relief! Needless to say, we will be signing up with TV Healthcare. I had to go to Ocoee to get an Ortho doc to treat my hand, knee, ankle and shoulder (all injured in the wreck) I am so very please with Dr. Shuler in Ocoee and highly recommend him to anyone needing Ortho treatment. Such a kind demeanor! Knows what he is talking about and sincerely cares. Meanwhile for PCP it's back to TV Healthcare. Just wanted to update everyone and let you know that if you should ever be unfortunate enough to be in an accident it might be wise to be in TV Healthcare system. God bless them! :a040::a040: For those of you unfamiliar with my story I had to get an attorney to find me an Ortho doc in Central Florida. I use Ramsey Smathers and you could not ask for a more compassionate, caring legal office. Bless Dr. Shuler and Ramsey! You are a gift to those of us needing assistance. It took me 6 weeks after my injury to be seen by an Ortho doc and after being told by a PCP they are "cherry picking" patients and if we have too many issues and cause them to much time they won't be seeing us. Time for us to start our own "cherry picking".

Parker 03-29-2014 07:56 AM

Cromlich, that is wonderful news! What a stressful time you've had, but it looks like help is on the way. Hope better days are ahead.

GatorFan 03-29-2014 10:20 AM

I am so sorry you are going through this. After reading all the post it sounds like the insurance company accepted liability and has agreed to pay your medical bills. The problem is the medical field. Is the attorney you hired going after them or the insurance company who did nothing wrong? I hope everyone understands after reading your post that the bad guy here is not the insurance company but the medical field. Try calling Shands in Gainesville for help

ilovetv 03-29-2014 10:52 AM

I don't think this problem is anywhere close to being all the fault of insurers or all the fault of the doctors who get dragged into court numerous times to sit there and wait for hours to testify about the medical record (unpaid for that time in which they could be seeing patients, doing surgery, treatments and evaluations), while their current patients and new ones are waiting weeks and months to get an office evaluation or surgical appointment.

Ambulance-chasing lawyers who milk the personal-injury lawsuit cow, and legislators who are lobbied by the three groups plus the public, have a lot to do with this mess, too:
"Florida PIP Laws Change…For The Worse
— April 1, 2013

Fifteen states in the U.S., including the District of Columbia, require Personal Injury Insurance (PIP), commonly called ‘no-fault insurance,’ for their licensed drivers. PIP was invented to help vehicle accident victims obtain medical care if injured in an accident and the “at fault” party had no bodily injury liability coverage and/or might fight over the issue of who was to blame for the accident.

Although Florida’s car insurance laws have been in place some thirty years now, Florida has unfortunately gained a reputation, especially in the past decade, for rampant vehicle insurance fraud. Attempting to stem this tide, or so it was claimed by the state’s legislatures, as of January 2013 Florida’s PIP regulations were changed in some very significant ways, and in the opinion of many, quite restrictive ways.

“It has never been a more dangerous time to drive in Florida,” David B. Pittman, Esq. of the Pittman Law Firm, P.L. of Bonita Springs, Florida warns over the new changes in the PIP statutes.

“As of January 1, 2013 PIP insurance is not bound to pay eighty percent of an injured victim medical bills and sixty percent of lost wages up to $10,000 as the insurance carriers were responsible to prior to the reform. Plus, now victims only have 14 days to receive initial medical care and only from certain physicians outlined in the new PIP statute or they can lose all $10,000 of PIP coverage.”

Also the brand new policy changes sees victims of accidents being restricted in what kind of care they might eventually be able to be covered for. In the case of physical therapy of chiropractic care-certainly two of the many areas where vehicle accident victims often seek relief, the patient must have a diagnosis of an emergency medical condition from “certain specified medical providers in order to receive benefits for physical therapy and a multitude of other rehabilitative medical specialists” Pittman says or PIP can refuse to pay over $2,500 for that medical care.

In fact as Pittman goes on to opine: “The restrictions and reform is so stringent and difficult to comply with that this insurance policy is completely contrary to its original purpose of insuring medical care coverage for those in an accident.”

So what is the common variety everyday driver in Florida to do to make sure they are covered sufficiently in light of these new statutes?

“The best possible thing is to purchase a sufficient amount of PIP coverage along with uninsured motorist’s coverage so that you can have some assurance of recovering medically after an accident.” Pittman advises.

Or Floridians might be able to count on astute judges fighting back......"

Florida PIP Laws Change


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