[JourneyOfLife]

After reading a little bit about PIP, I am not sure I would want to be a resident of Florida.


That looks like legislation gone wrong.


I will also add... Florida in general, looks like an insurance nightmare when it comes to P&C related insurance...

Add to the P&C insurance mess the new FEMA changes for flood insurance.... it looks pretty bad.

[784caroline]

It would be good if you cited some provisions, bills or proposals that you think are wrong. Without additional information its hard to respond to you one way or another.

[Indydealmaker]

Originally Posted by JourneyOfLife

After reading a little bit about PIP, I am not sure I would want to be a resident of Florida.


That looks like legislation gone wrong.


I will also add... Florida in general, looks like an insurance nightmare when it comes to P&C related insurance...

Add to the P&C insurance mess the new FEMA changes for flood insurance.... it looks pretty bad.

The FEMA changes relative to flood insurance are not unique to Florida. With regard to Florida PIP, other than being extremely difficult to read, what parts of the statute concern you?

[JourneyOfLife]

You read the post in the Medical Forum.


When one has insurance x2 (PIP and medical insurance) and cannot get medical treatment for injuries that is a pretty major issue, and more than an inconvenience.

IOW, one is forced to buy PIP to own a vehicle and register it. Then the outcome is the benefits are negated because medical providers don't want to deal with it.



refusal of treatment


I did some internet searches and this person is not experiencing an isolated incident. Look for yourself, it appears to be fairly common!

Who wants to have to fight the system to get medical attention... when they have paid x2 for insurance!


I you look at the law there are some obvious problems in it. There will probably be more to emerge. That 80% clause is a big rip too. You get injured through no fault of your own... It turns into your liability! No fault in Florida appears to mean the injured is liable for the first $10k.

What will be the next development.... something absurd like making the injured post a $10k bond before treatment begins?

Statutes & Constitution :View Statutes : Online Sunshine

Medical benefits.—Eighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices and medically necessary ambulance, hospital, and nursing services if the individual receives initial services and care pursuant to subparagraph 1. within 14 days after the motor vehicle accident. The medical benefits provide reimbursement only for:...

If you can't find a provider to begin treatment in 14 days, do you lose your benefit???.... that you had to buy per statute!

P&C Insurance (including flood) has been such a moving target in Florida in terms of what it means to residents and property owners. PIP is not looking like an improvement for consumers.

[rubicon]

As a youngster in the insurance industry I wrote a thesis in support of New York's proposal for No Fault (PIP). After its implementation and moving to a number of PIP states and actually dealing with ever PIP state in the union I reversed my opinion. Many states revamped their original policy, some states dropped it altogether I don't have a dog in this fight and hence not interested in debating it any longer. I will suggest that people read their insurance policies carefully and slowly to understand their rights. By law insurers are required to explain all of your rights under any policy of insurance

Personal Best Regards

[GatorFan]

No Fault's purpose was to make sure everyone would be treated if injured by an auto in Florida. Prior to the no fault law one who was injured by someone else would still be liable for medical bills and courts were their only choice to recoup from an at fault party. Sometimes that took years with no guarantee they would ever be reimbursed. Many injured would have a huge financial burden trying to pay medical and rehab bills. Many filed bankruptcy.

No fault will pay up to $10,000 medical, loss wages and household expenses. The new law states that one must see a Doctor within 14 days to determine injury. This law was passed to try and prevent fraud which has totally gotten out of hand in Florida. Medical payment coverage pays in additional to no fault.

If the other party who is at fault and does not have sufficient Bodily Injury limits to pay over and above your no fault limits then you collect under your uninsured/ underinsured motorist limits.

It is true that many doctors do not treat patients who are filing under their no fault which is required by law. However, if your insurance company and agent can not help you find a Doctor then you should look for another company.

Last thing to pay after all auto limits have been exhausted is your health insurance.

[JourneyOfLife]

Originally Posted by GatorFan

No Fault's purpose was to make sure everyone would be treated if injured by an auto in Florida. Prior to the no fault law one who was injured by someone else would still be liable for medical bills and courts were their only choice to recoup from an at fault party. Sometimes that took years with no guarantee they would ever be reimbursed. Many injured would have a huge financial burden trying to pay medical and rehab bills. Many filed bankruptcy.

No fault will pay up to $10,000 medical, loss wages and household expenses. The new law states that one must see a Doctor within 14 days to determine injury. This law was passed to try and prevent fraud which has totally gotten out of hand in Florida. Medical payment coverage pays in additional to no fault.

If the other party who is at fault and does not have sufficient Bodily Injury limits to pay over and above your no fault limits then you collect under your uninsured/ underinsured motorist limits.

It is true that many doctors do not treat patients who are filing under their no fault which is required by law. However, if your insurance company and agent can not help you find a Doctor then you should look for another company.

Last thing to pay after all auto limits have been exhausted is your health insurance.

Guess what, it is not working out well!

Rationale aside. It is not ok!

Plus, what you described is not any sort of solution.

The fix will require the legislature to make changes. But that might take years as the lobbyist fight it out ... between the insurance companies and medical providers. Consumers are now stuck in the middle worse than ever!

[justjim]

I guess talk to Morgan & Morgan! According to their television advertisements they are trying to get to get the 14 day rule changed. Or perhaps "cash in" on the 14 day rule!

[graciegirl]

Originally Posted by justjim

I guess talk to Morgan & Morgan! According to their television advertisements they are trying to get to get the 14 day rule changed. Or perhaps "cash in" on the 14 day rule!

I noticed that too. And wondered what it referenced. Now I know thanks to GatorFan.

[JourneyOfLife]

The initiative was driven by the FL governor Rick Scott.

Unfortunately, it appears that the crack down on medical providers was more than some medical providers could/would tolerate.

Florida Gov. Rick Scott PIP abuse: Governor meets with top law enforcement officers to discuss PIP - Orlando Sentinel

[graciegirl]

Originally Posted by JourneyOfLife

The initiative was driven by the FL governor Rick Scott.

Unfortunately, it appears that the crack down on medical providers was more than some medical providers could/would tolerate.

Florida Gov. Rick Scott PIP abuse: Governor meets with top law enforcement officers to discuss PIP - Orlando Sentinel

I didn't read it that way. AND it was favorable to Governor Scott. Usually the Orlando Sentinel is biased toward the other side.

[JourneyOfLife]

Originally Posted by graciegirl

I didn't read it that way. AND it was favorable to Governor Scott. Usually the Orlando Sentinel is biased toward the other side.

Oh yes... its all a big conspiracy.

Do some reading.

[rubicon]

Originally Posted by JourneyOfLife

Guess what, it is not working out well!

Rationale aside. It is not ok!

Plus, what you described is not any sort of solution.

The fix will require the legislature to make changes. But that might take years as the lobbyist fight it out ... between the insurance companies and medical providers. Consumers are now stuck in the middle worse than ever!

PIP original was a social solution for accident victims and addressed the problems associated with the liability laws in various states. It was a good thing on paper but like any program making money available there is going always going to be people who abuse the system.

PIP is one of those populist topics and so those abusing it can spin it in their favor . I suspect many of the problems associated with refusal to pay benefits has to do with suspected fraud and abuse

[JourneyOfLife]

Originally Posted by rubicon

PIP original was a social solution for accident victims and addressed the problems associated with the liability laws in various states. It was a good thing on paper but like any program making money available there is going always going to be people who abuse the system.

PIP is one of those populist topics and so those abusing it can spin it in their favor . I suspect many of the problems associated with refusal to pay benefits has to do with suspected fraud and abuse

While claim denial might be a problem.

IMO, this is the big problem: refusal of treatment

[stroglass]

I worked as a nurse in the PIP world in NJ and a lot of what I see in this bill is the same .We did however require claimants to have treatment precerted for a list of DX for the neck and back .Max benefit in Nj was 250,000.00 and the 80% was on the first 5,000 in claims.When this first started in Nj no one like it but the cost and fraud were so bad something had to be done.I an sure the law will be revised many times as the problems are discovered and the people who commit fraud find a way to beat the system