Next thing we will here about is the thousands of job losses, the increase in health insurance premiums the increase in taxes and increased lawsuits caused by this anti consumer mess of a bill.
So we may save $50 a year on auto insurance but within 2 years we will all find we are paying more in health insurance premiums and taxes.
Good job Governor Evil Scott we would expect nothing less from someone who’s company committed 200 million in medicare fraudulent billing
There you guys go again, Governor Scott is doing his job as Governor, but because you disagree he is “Evil” and because he’s trying to combat fraud and successfully does his job as Governor you throw his alleged medicare fraud. What a piece of work. PIP is loaded with fraud and not just confined to Florida. Look at the ring just busted in NY – attorney’s, doctor’s and patients. Florida is no different. And because Gov. Scott had the intestinal fortitude to attack this “controversial” issue, he’s evil and you throw the medicare crap at him. But hey, Gov. Scott is tough and he’s clearly showing he has the backbone to lead! Great job Governor!! There was a 4 year hiatus in Gubenatorial leadership, at least the state can now put Charlie Crist behind us.
When the good Governor figures out how to educate the consumer on the PIP law before they are adversely affected by it, then maybe some can say he really is only trying to defray fraud. When the average consumer who has never made a claim over most, if not all, of their lifetime pays little to nothing for auto insurance, then maybe he did a good job. When the insurance companies are not making billions in profits, and their executives getting tens of millions in bonuses, maybe then he or any other good politician has done a fair job on behalf of the citizens. When law mandates required insurance for drivers, and starts capping what the industry execs make, then I will believe that politician is looking our for citizens, rather than the insurance companies. I am not holding my breath, though…
Fraud is really bad but this seems to be elliminating the good guys to, and totally screwing the public… doesn’t seem like those to things are worth the bottom line. Yes to all those out of work and that can’t get treatment for their injuries please send the thank you letters to the Governor who seems very concered about the bottom line for who… the insurance companies.
You obviously don’t work in the healthcare business. As a massage therapist that this is going to affect, I can personally say this is a BAD idea. We are a Legitimate business, and a real service to the medical community. Having worked with the insurance companies, I can tell you first hand you will NOT save any money on this. The insurance companies will find another way to get that $50 from you.
Amazing to see how its legal for big insurance to buy our politicians. The days of the government looking out for its citizens are long gone. Insurance profits rise every year, yet the Florida government screws the people so they can get more campaign constributions. The people need to rise up. Enough is enough. Good luck if you are injured in a car accident. If you receive a painful soft tissue injury that requires a few months of treatment, you are limited to only about 10-12 visits now. About one third of what you used to receive. Lets see if any media outlet has the balls to point out the fact that insurance companies are causing the Florida government to abandon the wellfare of its constituents.
Wah, wah, wah. The big bad insurance companies… I’ve been driving for 40 years and never had 10-12 visits to a pain clinic, let alone the 30+ you’re whining about. I’m sorry the pain clinics submitting fraudulent claims are going to have to close. What a shame.
YOUR NOT GETTING IT. THEY WONT BE CLOSING. THERE ARE SO MANY CROOKED MD’S AND HOSPITALS OUT THERE, THIS DECISION JUST MADE THE FRAUD WORSE. HERE A BETTER IDEA. WHY NOT GO AFTER THE PIP FRAUD WITH THE SAME FORCE FLORIDA USED ON THE PILL MILLS?
WHY NOT ARREST THOSE THAT DRIVE WITHOUT INSURANCE?
Holiday needs to google or search most profitable industries and see what comes up. I can assure you it is not the insurance industry. If they make such huge profits, I guess you must have a ton of their stock in your investment portfolio. Also, you must know of Florida’s excess profits laws that apply to many lines of coverage, go look them up while you are making your statements. I would love to see the same “excess profits” statutes apply to lawyers, health care providers etc, etc and see where that takes you. It is the same worn out response that you see everytime it comes to our industry, I don’t work for a company, but as an agent, I would love to get some of these companies that are making these huge profits come and plant with our agency to write all the profitable homeowners and auto business in our area.
Well said Kevin L! If unemployment rises in Florida due to fraudulent Chiropracters, acupunturists, and attorneys – so be it. Why would healthcare rise? Oh yeah, Obamacare for the ones who refuse to purchase health insurance with it paid for on my dime.
Holiday and Bryan, you guys are absolutely clueless as to the reality of the PIP industry. (Yes, PIP has become an industry of it’s own)Sit at a claims desk for 1 day, and resd the BS* reports being received by the hundreds. Be one of the thousands of employess within the “Insurance” industry seeing their future more and more uncertain because of rampant, undeterred fraud.
Maybe one or both of you have benefited from the disgrace that has become PIP, but ask any consumer, not associated with the fraudsters and they will appreciate those measly $50 -$100 savings.Still without a cap on Attorneys fees, ambulance chasers will continue to harp and try to find loop holes in the Statute to clog the county and circuit dockets, but any kind of reform at this point accounts for something.
Caps interfere with free enterprise. Frankly, if insurers would admit liability and just pay or at least offer to pay, from the start instead of delaying, stalling and a great deal of money could be saved. The person who was hit head-on and suffered a traumatic brain injury should not require any attorney to be treated. It becomes adversary only when there is opposition.
Admit fault, make an offer that is realistic, and walk way.
I do agree with you Mr.Johnson in making a reasonable and expedient offer, however, you and I both know that this amendment was not geared towards an injured party with a legitimate brain injury. Let’s not try to create a distraction and agree that this is all about the 5mph fender bender orchestrated or legitimate, with $167.00 damage to a bumper where you need a magnifying glass to determine damages and 5 occupants inside this vehicle tear through $100,000.00 worth of “treatment” due to injuries! Then the reasonable and necessary question is raised, in comes Mr. Atty demanding payment on the $100,000.00 without regard to the facts surrounding the damages to the car and likelihood of injury! He/she then appears in front of a “judge” who awards $500/hr in Fees on a completely unmerited case. Even worse litigation over $300 difference between a bill and a payment (fee schedule) turns into a $50,000.00 in Attys fees with the multiplier. So, do I agree caps limit free enterprise, yes. Do I agree that caps would deter ridiculous litigation, absolutely.
“Me thinks thou doest protest too much”, Shakespere
Bill Montfort said “It’s not perfect, but…” [it’s a good start]
Try being a Florida PIP adjuster for a while and then tell me how they are wrong!
WHY can’t they just make PIP an option. If you have health insurance you don’t have to buy PIP, if you don’t have health insurance, buy it. Why does it have PIP have to be mandatory? Never made sense to me.
Only 1 out of 4 Florida drivers carries enough insurance now. I routinely treat patients who are hit bu uninsured or under insured drivers. You could eliminate PIP but you’d have to make BI mandatory. people are just not responsible
The lawyers can not split $2,500 with the injured party? No way. So, the injured party now gets nothing as the lawyers need their cash.
Making someone actually PROVE they are injured before handing them $10,000 is unreasonable?
Idiots….
Susan / AZ: PIP is mandatory in Fl because it is part of the No-Fault tort law. There’s plenty of room for reform of abuses there also; but it’s done one step at a time. The money for the mill-lawyers comes from the bad faith scenarios they eternally construct. Hopefully, they will now have to rely on the timely evaluations of licensed physicians to establish their grievous and life altering pain & suffering.
You referenced something very important Bad Faith. Florida is miasma when it comes to bad faith law. First thing it ought to do is get rid of Third Party Bad Faith which would take a lot of pressure off of insurers. Then it should get rid of the “subjective bad” faith standard that it employs. As a claims adjuster (although not auto and not PIP) I can tell you that bad faith law in florida is like a spider’s web if you get caught in the trap (oftentimes by doing your job correctly) the more you struggle the tighter it ensnares you. Its a mess.
here’s the problem with the no-fault! if you have gone and used my PIP for 10k and my med is 30k — who’s going to pay the other 20?! that person who was at-fault for the accident! that is the key… we need to remove the PIP and have BI and UM cvgs mandatory! this will help the insurance 1) decide who’s at-fault, 2) challenge the fraud medical…
You mistakenly believe that the insured actually receives PIP money. PIP money is only allotted for medical bills when someone gets medical treatment following an automobile accident. PIP is paid at the rate of 80% of an adjusted medical bill with the 20% balance being the responsibility of the injured insured person. The insured person NEVER gets PIP money unless they are out of work, have a doctor’s note, and do not get paid by their employer. In that case, whatever amount of time they lost from work at their pay rate, they are paid at the rate of 60% of their wages. The total amount of benefits paid out is the amount purchased (as you can purchase higher limits) but is the usually the state-required amount of $10,000.00. In fact, Florida law only requires that its drivers purchase PIP known as “No Fault” insurance and Property Damage Liability (for damage you may cause to another’s property). As to the PIP, that means regardless of who is at fault in the accident, YOU are required to carry the state required “PIP” a/k/a “No Fault” insurance to pay for YOUR OWN medical bills. Any other insurance you purchase is optional, which includes Bodily Injury – “BI” – liability (which will pay the other person for an accident YOU cause, and uninsured/ underinsured motorist (“UM”) coverage – which covers YOU if the other person is at fault and has NO “BI” insurance or has low limits and YOUR injuries far exceed the coverage they purchased. What I find ironic, is that a Florida driver is not allowed to purchase UM insurance (to protect themselves first against the many uninsured drivers in Florida) without first choosing to buy BI insurance. And, the BI insurance limits must be equal to or greater than the insurance you carry to protect yourself – the UM. Frankly, I think that set up just promotes lawsuits because if the BI is not available, the injured driver cannot pursue a claim because there is nothing to pursue from. People should be able to purchase UM only if they so choose – because it is well known that their are extremely high amounts of either uninsured drivers on the roadways. Again, PIP only pays medical bills, and unless the injured driver has UM, there is no money to collect. Just way too many misconceptions in the industry, unfortunately. I have driven for 40 years and never made a claim for medical treatment. But I have always paid quite a bit of money for insurance – even though it may be considered on the low end – insurance premiums are high, whether it be automobile insurance, health insurance, homeowner’s insurance. While there are scams out there, no doubt, the average person pays for it, NOT the insurance companies. Some of them made record profits in the beginning of the recession (especially here in Florida after all the hurricanes when they were raising our “hurricane” protection insurance from under a $1,000 to over several thousand). This PIP law no doubt has been done to protect the insurance companies. I don’t foresee our auto ins rates going down despite this law, yet it is always cast as the reason why premiums are so high as its due to all the fraud out there – and yet they never seem to pass the savings on to the average consumer. Insurance companies rule the country, the government, and the average (unwillingly) person. Once you have bought their insurance, by the way, the first thing PIP claims does after you initiate any medical treatment, is set you for an appointment to see ‘their’ doctor who always writes the same report: you DON’T need any further medical care. WHY? Because the insurance company never wants to pay a claim, EVER. This is routine practice, and the average person is not aware of this UNTIL they are hurt. They cut off your benefits – the very thing you have been paying premiums for. They employ whole departments for this purpose. Nothing is ever done for the consumer where insurance is concerned…
RICK SCOTT IS SO FULL OF HIMSELF. HOW DARE HE TAKE AWAY MY FAMILIES RIGHT TO CHOOSE. IF I AM INJURED IN A MOTOR VEHICLE ACCIDENT I CHOOSE CHIROPRACTIC EVERY TIME. TAKING AWAY MASSAGE IS WRONG. PRO CHOICE!!!!!!! I HAVE RIGHTS!!!! IM A PPO PERSON NOT A HMO PERSON!
Do you have any idea how many massage therapists and acupuncturists will be unemployed due to this bill? We are not fraudulent: we are licensed professionals who work to bring our patient’s relief. Our company used 13 independent contractors who were highly trained, licensed Massage Therapists. We worked on over 80 people with Developmental Disabilities. The incredible benefits they received from our massage is documented. In 2007 it was written out of the state and federal budget. Now, our therapists have once again been written out. Never were our patients asked about the benefits received…
I, too, am a licensed massage therapist, who works part time for a doctor who treats both MVA victims and private-pay endocrine patients. He hired me to work on the MVA victims, because massage has proven to be useful in relieving pain and shortening the time needed for recovery. Some of our patients were referred to us because they were not seeing any improvement in their condition at other facilities, where massage was not part of the treatment protocol. Most of our patients have remarked on how quickly we get them out of pain and on the road to full recovery. The majority of these accident victims would not have been able to afford massage therapy on their own. I feel very sorry for anyone in FL who becomes involved in a MVA and suffers soft-tissue injuries (like whiplash, for instance) after December 1st. I WILL lose my job, as will any other massage therapist who works for those who treat MVA victims. It is my understanding that most health insurance companies will not pay massage therapists, either. If that were the case for physical therapists, and PIP was reformed to exclude payment for physical therapy, how many of them would become jobless?
I’m a P&C agent, but my girlfriend is a DPT (doctor of physical therapy) and she loves theraputic massage for the medical benefits it provides. She works with kids who have birth defects and it’s very helpful. I can also tell you that I’ve got soft tissue damage in my shoulder area (do not *EVER* drive with your arm behind the passenger seat – if you get rear ended, everything goes bad) and theraputic massage has helped me in ways I cannot describe.
Neither of us are in FL and it may be heavily abused there; I cannot speak to that. I can say that dismissing theraputic massage (if any are in fact doing so) is a mistake. It can be very helpful in reducing pain.
I don’t think my shoulder will ever get better, but it’s over and I pay for a massage once in a while to help.
The Chiropractors and Attorneys Tag team the insurance companies. Take the Chiropractors out of the picture. The MD’s are not AS bad as the Chiro’s. THen make the auto insurance companies accept electronic claims like everyone else, reducing the man power and expense needed at the doctors office, then reduce the amount of money that is paid per procedure. Right now the pip laws state that the DR gets TWICE as much money for the same procedure performed on an auto injury patient vs a medicare or commercial health insurnce patient. And that is only if the doctor has not figured out the loop hole yet. That actually allows them to collect what ever they bill. ( Except with Windhaven or Direct General)This should reduce the funds paid out by the ins. Co. and allow them to pass the savings on to the consumer.
Why is to doctor being paid 200% more just because the patient was in an accident? The doctor shold get paid the same amount of money regardless of the patients insurance. What is this loophole that allows them to recover “whatever they bill”? PIP could save millions just by paying out the same as everone else.
OK, I’ve stopped laughing. I can catch my breath now. Pass the savings on to the consumer? In what parallel universe? Any savings will get passed along to the insurance coffers. As far as requiring the insurance company to justify rate reduction refusal – I can only imagine the creative writing that will go into that one. Bottom line – the consumer will never see any benefit from this, but the insurers certainly will.
Under previous administrations I’d agree with you. But my memory of CFOs/Treasurer-Ins.Comm.s goes back to Tom O’Malley; and I’ve met them all. I’ll tell anyone that our current CFO is by far the best of the lot and will do what he says, and more.
I agree that we will not see the savings. It’s a nice thought. And I just told them how to save money. Probably no one will listen. I guess if they want to throw away money they can,as long as we HAVE to give it to them, they will have it to throw away. They should quit complaining or do something logical about it.
It is sad that the fraud has been able to eliminate the benefits of such coverage to the consumers. If you ask me the insurance companies are the biggest frauders of all. They basically give you a benefits that are practically worthless with a claim that you the consumer will get some sort of break. No, they are getting the break bascially and we will all be paying for less coverage. Also what effects will this have on health insurance cost? It is sure to increase the cost of medical treatment for these injuries. Another really unfortunate side effect of this mess. I see patients all the time in our clinic that have to go through such trouble to have there claims paid for and do in fact have real injury. I think it is very sad that the insurance companies win again over the individual. I read a blog that accidents over all were down its interesting fact if fraud is so prevelent wouldn’t there be an increase in the number of accidents? Why not create penalties to those physicians found involved in fraud by taking their licenses? It seems to me that elliminating the benefits to the consumer to reduce fraud also puts the consumer on the sort end of the stick. But I think the true motive for all of this is to elliminate the cost of chiropratic treatment across the board. Therefore not only eliminating the fraud but also all of the benefit to the consumer, the real victim. It is easy to say from a desk a million miles away that someone doesn’t have real injury. But much more diffcult when they can’t form the functions of daily life the same anymore and are there asking for your help. This is another example of who runs our country and our lives…. Those that have the deepest pocketbook. Think of all those in the state that aid in this type of treatment
Lawyers being paid through PIP? When does that happen? When the consumer has to file suit against their PIP carrier to get the benefits for which they paid insurance premiums, that’s when. If a consumer is FORCED to file a PIP suit against their auto insurer and that consumer wins that PIP suit, then the insurer can be responsible for the attorney’s fees for filing that PIP suit only. The PIP benefits are paid directly to the medical provider or the consumer for reimbursement of medical bills and/or wages. I think YOU need to do your homework before making comments.
THE NEW PIP REFORM 2012 LAW, THE BIGGEST FRAUD OF ALL ON THE FLORIDA CITIZEN BY THE INSURANCE LOBBY MACHINE
WOW – the newly passed PIP reform HB 119 is the biggest fraud of all on the Florida citizen. Instead of going after the fraudsters (as they promised), they passed “PIP REFORM” decreasing citizen medical benefits, access and choice…and the poor citizen gets to pay the same high premiums.
Here’s what happened (read it yourself at HB 119):
• The insurance companies can continue to charge the same high premiums, BUT the citizen only gets $2,500 in medical benefits instead of the previous $10,000 – unless they’re severely injured, good luck with only $10,000 on that one.
• Instead of going after the true fraudsters (as they promised and should have done), the insurance lobby went after the Florida citizen.
• The insurance companies will make record, record profits (as they always make…year in, year out) off this law. Same high premiums, 75% less benefits ($2,500 versus previous $10,000), you figure it out!
• The insurance companies have already started donating (paying back for their vote) money to the political cronies that voted for this travesty on the citizen – in the sum of millions of dollars.
This is “great for the Florida consumer,” says Gov. Scotty and his cronies…really???? WOW! Talk about crony corruption/capitalism, WOW!
WAKE UP Florida citizens/voters…these cronies didn’t go after PIP corruption (as they said they would and should have done – they just used that excuse to short-change the Florida citizen); they passed “PIP Reform” so that their insurance buddies can continue to make record profits.
Instead of passing true PIP reform by going after the real crooks (as they promised), they defrauded the Florida citizens by once again stealing their money in the biggest fraud of all – throw the crooks out!!!!!
Luis, your facts are a bit skewed. As L said previously get your facts straight before mouthing off.
(The legislation requires an accident victim to obtain treatment within 14 days in an ambulance or hospital, or from a physician, osteopathic physician, chiropractic physician, or dentist. The full $10,000 PIP medical benefit is available only if a physician, osteopathic physician, dentist, or a supervised physician’s assistant or advanced registered nurse practitioner determines that the insured has an “emergency medical condition.” Otherwise, the PIP medical benefit is limited to $2,500.)
Maybe Luis you should have read the article Insurance Journal posted. The operative word in the article is “OTHERWISE”. All an injured party has to do is follow the rules and their PIP does not change. I understand following rules these days is difficult for this generation. It’s not “FAIR”. But the law states you can get treated from a “Physician” within 14 days. If you want the freedom of choice, use your “Physician”. Why shouldn’t insurance companies selling PIP dictate where to seek treatment, they are the payors? The legislature should have taken it a bit further and had payments based on the Medicare allowable, just like what happens with our individual health insurance, as a means of controlling costs.
Luis you are obviously in the pocket of an insurance company. I have worked for a physician for over thirty years and have seen more and more crazy rules that help insurance companys and hurt the medical community. A small percentage of medical providers commit 90% of the fraud. I personally know many friends who work in the insurance industry: pip, health, workers comp and none are or have been out of work. However, I personally know two orthopaedics, one neurologist, one podiatrist and several PCPs who retired from practice to enter another field due to inability to pay existing staff because of insurance cutbacks. I have also been severely injured in two mva’s (not my fault) and have been kept functioning without recommended surgery by a neurologist and a chiropractor @ 1/10 the cost of surgery that the IME DOCTOR recommended. You need to open your eyes and not get caught up in politics.
I have been a paralegal in personal injury law for 23 years. Wow, some of these posts are rediculous. I feel very sorry for ignorant people. I hope you people dont find yourself in a serious car accident and in need of medical care one day. We do our absolute best for our injured clients. We dont permote fraud in our practice. We deal with real people in need of real help. Oh, and please note, PIP does not pay 100% of the meical. They pay 80%. Some PIP carrieres also make adjustments and pay 80% of their allowable amount. You are paying premiums for these benefits, and in a time of need you may find that they will not be available to you. Hello!! Wake up people!
I’ve been an insurance agent for 35 years, and you are not entirely correct in your post. While basic PIP pays 80% of medical expenses up to $10,000 in FL, you can add Extended PIP that increases reimbursement to 100% up to $10,000. Some companies, though very few, offer Additional PIP that increases the limit up to $100,000. In my 35 years I have had very few insureds that have needed the services of an attorney to receive PIP benefits, including my 30 years in NY, where the top PIP limit is $175,000 per person.
While I am happy to hear you handle your clients affairs in a non-fraudulent manner, if a claim is presented in a straight-forward, non-suspicious way, insurance companies pay the benefits an insured purchased. In almost all cases, it’s unnecessary for a claimant to pay for an attorney’s services in order to receive their purchased benefits. I find it borderline unethical that some attorneys and pain clinics advertise that injured parties should call the police first and their attorney second. As an insurance professional, I am quite capable of guiding an insured through the claims process, without charging them a fee or contigency.
Absolutely a flat out lie. Attorneys file 1,000’s of PIP suits every week to collect benefits for doctors because auto insurance companies systematically refuse to pay benefits out to doctors.
Kokoemo
Its clear to me that you are unaware of a few facts. First, Florida is ranked #1 in staged accidents. Secondly we are second to New York in PIP claims. Something had to be done and while i would have loved to see PIP sunset, we all know how that did not happen in the past. Clearly no one goes in business not to make a profit, would it make you happier if like homeowners insurance auto carriers left the state therefore limiting your choices- ensuring higher premiums? These are the facts: fraud is rampant. Most of your cost for insurance is in the PIP coverage, clinics are making a killing on your PIP. Many only see auto accident customers. The clinics won a major battle against insurance companies which has caused you to pay more. There was a District court decision that allowed them to bill for and get more than the 80% of Medicare part B allowed by Florida statue. If u are looking to blame, look deeper. Change happens and while this bill offers less than i had hoped, its a pebble ripple on a large mountain of snow.
Only the players are changed, but the fraud remains the same. Not a day went by before I was getting advertised to on how to create a “multi-disciplinary” practice (hire a medical doctor) to beat the new changes.
Our politicians are idiots. There is a way to eliminate fraud without cutting out any benefits. I submitted it to our politicians, but because they are too thick to understand healthcare, they do what the lobbyists with the most money tell them to do.
I wrote the real solutions here: http://drhaley.com/obama-did-get-healthcare-reform-suggestions/
I’m concerned if this is going to affect my job position. I am a Licensed Massage Therapist at a Chiropractic Office.. One thing I’ll never understand is the politics and the fraud behind all of this PIP situation.. But if it’s one thing I do know is that Massage Therapy has been a very effective treatment for patients. We manipulate the muscle tissue and help reduce tension. How can massage not be considered as something beneficial to the injured person? Am I wrong to worry if this could put thousands of therapists and acupuncturists out out of a job? Or am I just being paranoid?
JC! You are not even close. This is a big scam, The Gov. RS got a big payoff for this deal. He also violated civil rights. There are 50 to 60 thousand LMT’s in Florida, African American, Hispanic and Caucasion. All affected by deleting massage from the practice, also I have not seen our professional association , NAACP, ALCU step in to help, It goes on and on frome here.
Florida should look to Colorado. Colorado allowed PIP to sunset and returned to a tort system in 2003-04. The result? Auto insurance premiums dropped by 20%, essentially overnight.
Correct me if I’m wrong, but this applies to PIP only correct? Wouldn’t all of this (massage, accupuncture, etc.) still be covered under Bodily Injury Liability or Uninsured Motorists coverage?
The no fault law was written to be self executing to promptly pay legitimate claims. That is, it was written so there would not be delays in payment. Currently, it works about 50% of the time. The other 50% is due to a cut off of some type, that is not what the legislature intended. I am not pointing fingers just saying it is broken.
I think we all agree there is a minority of medical providers in system who game the system that is to bill out the entire benefit as they have learned to extract every last penny from the policy.
The money extracted from the policy does not match the risk we consumers pay for because the injury although real should of clinically resolved sooner, unfortunately it is few medical providers who can walk away from an 80% reimbursement of medical bills.
As a result the insurers are almost guarantied a $10,000.00 risk on every motor vehicle accident case. That is the problem at hand the legislature was trying to fix albeit in-artfully.
The real tragedy is when someone is in the low speed accident category and is actually injured and then gets put through the inquisition of EUO, IME and then denial. Basically treated like a thug or fraudster when they are not. Truthfully, medical science cannot weed out with precision the fraudsters from the truly injured. When you through in the patient advocate medical provider and the IME who has inherent bias (If you do not think so read the Boecher decision in Florida)the system has turned into a Free For All (FFA you gamers will appreciate that reference.
The insurance industry now reacts the same way to almost every low speed case ( I will give some of you the benefit of the doubt I have seen fair results “some times”, and like an abused junkyard dog has become vicious callous “zealously” guarding the benefits, which is a problem also. Generally, adjusters are supposed to be neutral sound crazy in this system but that is a fact. Guys five hour EUO’s? really? If you want to see what happens when an EUO abuse is brought to the attention of the 3rd DCA read read Jose Deleon vs. Great American Insurance Company No. 3D09-646 (3rd DCA, it will be an eye opener for most adjusters on what is actually reasonable and also look at https://www.flrules.org/gateway/ruleno.asp?id=69B-220.051, the rules of ethics relating to adjusting then consider what the junk yard dog in your office has been up to for the last six months and whether that zealous conduct is actually permitted. A backlash is to be expected with so many medical abusers out there. However, when you squeeze the doctors by lowering reimbursements across the board expect them to seek to keep their standard of living, in that respect PIP is subsidizing Medicare, by subsidizing medical providers. Reduce PIP and we may lose doctors.
I am sure you all realize that EUO’s and IME’s are a thing of the past now right? if you do not lament the physical therapist, then you will not lament that your next career may be coming sooner rather than later. Because the Florida Legislature just made a lot of adjusting capacity needed obsolete with this law.
Ironically, this bill actually benefits the lawyers (guess what I do for a living) to the exclusion of consumers and that should be easy enough to figure out. If you cap PIP but do not cap medical damages the risk of payment of medical bills is shifted to the tortfeasor insurance.
The at fault party better hope the Health Care Act care is not overturned by the Supreme Court (in Florida anyway) and they have Health insurance because they are now capped at $2,500.00. This risk will also be shifted to some extent to health care insurers, or Medicare and medicaid to the taxpayers.
In the end the taxpayer foots the bill for the “serious injury” that is not an emergency within the meaning of the law.
Lastly, if you thought there was PIP litigation before get ready because the emergency issue as written is vague and will open the flood gates of entitlement law suits. Whenever the law is vague and subject to multiple interpretations litigation will ensue.
Lastly, I agree with the bill but the cap should be $5,000.00 not $2,500.00 Does it make any sense to any here it is reasonable in “every” soft tissue case to to bill $15,000.00 for palliative medical care?
When I started in this profession and had not a clue about same the first time I saw a bill like that I thought it was a mistake now a decade later I know it is the norm. Orthopedic medicine and chiropractic medicine treatises recommend about six weeks of physical therapy to resolve a soft tissue injury, you can double that as reasonable, but 18 months ? That is not treatment that is an annuity.
This law solves some problems and makes some new ones it hard to call that a success more like status quo. It is the at fault party who takes it on the chin here maybe that is as it should be in a society where we value responsibility.
The problem was not the PIP, but the attorneys, doctors, and clerk of the courts selling accident information. The three combined is a form of underground illegal tort organization scheming to undermined the victim of an accident and the insurer paying. At the end of the day, the victim lose half of their settlement to the doctors and lawyers. Now by giving the same crooks the final say within 14 days, will make it worst.
A new Law is sitting on Gov. Rick Scott’s desk waiting to be sign or better yet to be VETO.
Floridian “PIP, Personal Insurance Protection” are about to be limited; ask Gov. Scott to VETO.
Please request the petition at petition@againsthb119.com copy and paste this petition not only from your email but to all social media outlets and email database to spread the word. Please help us reach as many Floridians as possible before May 5, 2012.
Thank you for your time
Dr. J. Michael Lemus
Governor Scott will and should sign the bill – TODAY. Its not a perfect bill, but its a great first step to reducing fraud. Its a little soft on the trial lawyers. It doesn’t cap attorneys fees, which is a must. Its also a little soft on the doctors, and lets them get away with billing murder still – but he, its the Florida Medical Association and with their boy running the Florida senate next year, we should hope that insurance companies dont have to back up brinks trucks to doctors offices and pay them in gold anytime they ask.
Its a good bill. And the perfect example of what happens when you get hoggish (ie pigs get fat, hogs get slaughtered). Look, I agree that massage therapists are a quality profession. Many times, they get better results than going to the ER and blowing $5k on test and BS. But in the end, they were scamming the system, so they were shut out.
PIP will be an evolving system of reforms. I’ll just say this, and I know enough about what goes on in Florida government to know this – thank God State Farm is pushing this stuff. I know many of you other companies resent them, but they are about the only insurance company in Florida that can take on the trial lawyers, get votes and beat them, while the other companies just stand around, have conferences and talk to themselves.
Yes! Its illegal to drive wioutht it. You will get a ticket if you’re pulled over.If you own a car(not financed) insurance is relatively inexpensive because you only need PIP. If you do finance, it is pricey because you need full coverage.You can get better prices by paying the insurance in sixth month increments, as oppose to paying it monthly. The insurance companies always give a better price when you pay it in full.Also, call around to all the major insurance companies and get a quote. Each company will give you a different price. You have to shop around to get a good price.
The fraud is advertised on the radio. 411-Pain. No need to look further. Massage is a cheaper and less destructive treatment for whiplash (real) than a chiro “manipulation”. I don’t see this bill doing much to eliminate the real fraud, but doing a lot to limit an injured person’s options.
Yuhmi,
Where are you living? Liability & PIP on a paid off car are NOT cheap for the young at least. Isn’t it funny we have the least money and are charged out the ass? As an unmarried female college student with 0 claims, 0 accidents, and 0 points I am expected to find $140 per month to put the bare minimum legal coverage on my 2005 Hyundai Accent (1.6L, less than 100hp, subcompact car). That was the cheapest rate I’ve been able to find. With my school schedule, I can maintain a part-time job that pays $9/hr for 15 hours a week. I am legally required to pay more than I make in a week every month for the privilege of being able to get to my classes and job – that insurance doesn’t do a damn thing for me. There’s nothing “cheap” about that.
Next thing we will here about is the thousands of job losses, the increase in health insurance premiums the increase in taxes and increased lawsuits caused by this anti consumer mess of a bill.
So we may save $50 a year on auto insurance but within 2 years we will all find we are paying more in health insurance premiums and taxes.
Good job Governor Evil Scott we would expect nothing less from someone who’s company committed 200 million in medicare fraudulent billing
There you guys go again, Governor Scott is doing his job as Governor, but because you disagree he is “Evil” and because he’s trying to combat fraud and successfully does his job as Governor you throw his alleged medicare fraud. What a piece of work. PIP is loaded with fraud and not just confined to Florida. Look at the ring just busted in NY – attorney’s, doctor’s and patients. Florida is no different. And because Gov. Scott had the intestinal fortitude to attack this “controversial” issue, he’s evil and you throw the medicare crap at him. But hey, Gov. Scott is tough and he’s clearly showing he has the backbone to lead! Great job Governor!! There was a 4 year hiatus in Gubenatorial leadership, at least the state can now put Charlie Crist behind us.
When the good Governor figures out how to educate the consumer on the PIP law before they are adversely affected by it, then maybe some can say he really is only trying to defray fraud. When the average consumer who has never made a claim over most, if not all, of their lifetime pays little to nothing for auto insurance, then maybe he did a good job. When the insurance companies are not making billions in profits, and their executives getting tens of millions in bonuses, maybe then he or any other good politician has done a fair job on behalf of the citizens. When law mandates required insurance for drivers, and starts capping what the industry execs make, then I will believe that politician is looking our for citizens, rather than the insurance companies. I am not holding my breath, though…
Fraud is really bad but this seems to be elliminating the good guys to, and totally screwing the public… doesn’t seem like those to things are worth the bottom line. Yes to all those out of work and that can’t get treatment for their injuries please send the thank you letters to the Governor who seems very concered about the bottom line for who… the insurance companies.
You obviously don’t work in the healthcare business. As a massage therapist that this is going to affect, I can personally say this is a BAD idea. We are a Legitimate business, and a real service to the medical community. Having worked with the insurance companies, I can tell you first hand you will NOT save any money on this. The insurance companies will find another way to get that $50 from you.
Increased lawsuits? What a joke. The Florida PIP system causes more litigation than any tort state has.
Amazing to see how its legal for big insurance to buy our politicians. The days of the government looking out for its citizens are long gone. Insurance profits rise every year, yet the Florida government screws the people so they can get more campaign constributions. The people need to rise up. Enough is enough. Good luck if you are injured in a car accident. If you receive a painful soft tissue injury that requires a few months of treatment, you are limited to only about 10-12 visits now. About one third of what you used to receive. Lets see if any media outlet has the balls to point out the fact that insurance companies are causing the Florida government to abandon the wellfare of its constituents.
Wah, wah, wah. The big bad insurance companies… I’ve been driving for 40 years and never had 10-12 visits to a pain clinic, let alone the 30+ you’re whining about. I’m sorry the pain clinics submitting fraudulent claims are going to have to close. What a shame.
YOUR NOT GETTING IT. THEY WONT BE CLOSING. THERE ARE SO MANY CROOKED MD’S AND HOSPITALS OUT THERE, THIS DECISION JUST MADE THE FRAUD WORSE. HERE A BETTER IDEA. WHY NOT GO AFTER THE PIP FRAUD WITH THE SAME FORCE FLORIDA USED ON THE PILL MILLS?
WHY NOT ARREST THOSE THAT DRIVE WITHOUT INSURANCE?
Great you paid some insurance company a bunch of money for nothing jokes on you.
Holiday needs to google or search most profitable industries and see what comes up. I can assure you it is not the insurance industry. If they make such huge profits, I guess you must have a ton of their stock in your investment portfolio. Also, you must know of Florida’s excess profits laws that apply to many lines of coverage, go look them up while you are making your statements. I would love to see the same “excess profits” statutes apply to lawyers, health care providers etc, etc and see where that takes you. It is the same worn out response that you see everytime it comes to our industry, I don’t work for a company, but as an agent, I would love to get some of these companies that are making these huge profits come and plant with our agency to write all the profitable homeowners and auto business in our area.
Holiday spelled contributions wrong.
Well said Kevin L! If unemployment rises in Florida due to fraudulent Chiropracters, acupunturists, and attorneys – so be it. Why would healthcare rise? Oh yeah, Obamacare for the ones who refuse to purchase health insurance with it paid for on my dime.
I don’t know where you are going with this but (GOOGLE – EXCEPTIONS TO OBAMACARE) and we will pay there bill. This really sucks
Holiday and Bryan, you guys are absolutely clueless as to the reality of the PIP industry. (Yes, PIP has become an industry of it’s own)Sit at a claims desk for 1 day, and resd the BS* reports being received by the hundreds. Be one of the thousands of employess within the “Insurance” industry seeing their future more and more uncertain because of rampant, undeterred fraud.
Maybe one or both of you have benefited from the disgrace that has become PIP, but ask any consumer, not associated with the fraudsters and they will appreciate those measly $50 -$100 savings.Still without a cap on Attorneys fees, ambulance chasers will continue to harp and try to find loop holes in the Statute to clog the county and circuit dockets, but any kind of reform at this point accounts for something.
Caps interfere with free enterprise. Frankly, if insurers would admit liability and just pay or at least offer to pay, from the start instead of delaying, stalling and a great deal of money could be saved. The person who was hit head-on and suffered a traumatic brain injury should not require any attorney to be treated. It becomes adversary only when there is opposition.
Admit fault, make an offer that is realistic, and walk way.
I do agree with you Mr.Johnson in making a reasonable and expedient offer, however, you and I both know that this amendment was not geared towards an injured party with a legitimate brain injury. Let’s not try to create a distraction and agree that this is all about the 5mph fender bender orchestrated or legitimate, with $167.00 damage to a bumper where you need a magnifying glass to determine damages and 5 occupants inside this vehicle tear through $100,000.00 worth of “treatment” due to injuries! Then the reasonable and necessary question is raised, in comes Mr. Atty demanding payment on the $100,000.00 without regard to the facts surrounding the damages to the car and likelihood of injury! He/she then appears in front of a “judge” who awards $500/hr in Fees on a completely unmerited case. Even worse litigation over $300 difference between a bill and a payment (fee schedule) turns into a $50,000.00 in Attys fees with the multiplier. So, do I agree caps limit free enterprise, yes. Do I agree that caps would deter ridiculous litigation, absolutely.
“Me thinks thou doest protest too much”, Shakespere
Bill Montfort said “It’s not perfect, but…” [it’s a good start]
Try being a Florida PIP adjuster for a while and then tell me how they are wrong!
WHY can’t they just make PIP an option. If you have health insurance you don’t have to buy PIP, if you don’t have health insurance, buy it. Why does it have PIP have to be mandatory? Never made sense to me.
Only 1 out of 4 Florida drivers carries enough insurance now. I routinely treat patients who are hit bu uninsured or under insured drivers. You could eliminate PIP but you’d have to make BI mandatory. people are just not responsible
The lawyers can not split $2,500 with the injured party? No way. So, the injured party now gets nothing as the lawyers need their cash.
Making someone actually PROVE they are injured before handing them $10,000 is unreasonable?
Idiots….
Susan / AZ: PIP is mandatory in Fl because it is part of the No-Fault tort law. There’s plenty of room for reform of abuses there also; but it’s done one step at a time. The money for the mill-lawyers comes from the bad faith scenarios they eternally construct. Hopefully, they will now have to rely on the timely evaluations of licensed physicians to establish their grievous and life altering pain & suffering.
You referenced something very important Bad Faith. Florida is miasma when it comes to bad faith law. First thing it ought to do is get rid of Third Party Bad Faith which would take a lot of pressure off of insurers. Then it should get rid of the “subjective bad” faith standard that it employs. As a claims adjuster (although not auto and not PIP) I can tell you that bad faith law in florida is like a spider’s web if you get caught in the trap (oftentimes by doing your job correctly) the more you struggle the tighter it ensnares you. Its a mess.
here’s the problem with the no-fault! if you have gone and used my PIP for 10k and my med is 30k — who’s going to pay the other 20?! that person who was at-fault for the accident! that is the key… we need to remove the PIP and have BI and UM cvgs mandatory! this will help the insurance 1) decide who’s at-fault, 2) challenge the fraud medical…
You mistakenly believe that the insured actually receives PIP money. PIP money is only allotted for medical bills when someone gets medical treatment following an automobile accident. PIP is paid at the rate of 80% of an adjusted medical bill with the 20% balance being the responsibility of the injured insured person. The insured person NEVER gets PIP money unless they are out of work, have a doctor’s note, and do not get paid by their employer. In that case, whatever amount of time they lost from work at their pay rate, they are paid at the rate of 60% of their wages. The total amount of benefits paid out is the amount purchased (as you can purchase higher limits) but is the usually the state-required amount of $10,000.00. In fact, Florida law only requires that its drivers purchase PIP known as “No Fault” insurance and Property Damage Liability (for damage you may cause to another’s property). As to the PIP, that means regardless of who is at fault in the accident, YOU are required to carry the state required “PIP” a/k/a “No Fault” insurance to pay for YOUR OWN medical bills. Any other insurance you purchase is optional, which includes Bodily Injury – “BI” – liability (which will pay the other person for an accident YOU cause, and uninsured/ underinsured motorist (“UM”) coverage – which covers YOU if the other person is at fault and has NO “BI” insurance or has low limits and YOUR injuries far exceed the coverage they purchased. What I find ironic, is that a Florida driver is not allowed to purchase UM insurance (to protect themselves first against the many uninsured drivers in Florida) without first choosing to buy BI insurance. And, the BI insurance limits must be equal to or greater than the insurance you carry to protect yourself – the UM. Frankly, I think that set up just promotes lawsuits because if the BI is not available, the injured driver cannot pursue a claim because there is nothing to pursue from. People should be able to purchase UM only if they so choose – because it is well known that their are extremely high amounts of either uninsured drivers on the roadways. Again, PIP only pays medical bills, and unless the injured driver has UM, there is no money to collect. Just way too many misconceptions in the industry, unfortunately. I have driven for 40 years and never made a claim for medical treatment. But I have always paid quite a bit of money for insurance – even though it may be considered on the low end – insurance premiums are high, whether it be automobile insurance, health insurance, homeowner’s insurance. While there are scams out there, no doubt, the average person pays for it, NOT the insurance companies. Some of them made record profits in the beginning of the recession (especially here in Florida after all the hurricanes when they were raising our “hurricane” protection insurance from under a $1,000 to over several thousand). This PIP law no doubt has been done to protect the insurance companies. I don’t foresee our auto ins rates going down despite this law, yet it is always cast as the reason why premiums are so high as its due to all the fraud out there – and yet they never seem to pass the savings on to the average consumer. Insurance companies rule the country, the government, and the average (unwillingly) person. Once you have bought their insurance, by the way, the first thing PIP claims does after you initiate any medical treatment, is set you for an appointment to see ‘their’ doctor who always writes the same report: you DON’T need any further medical care. WHY? Because the insurance company never wants to pay a claim, EVER. This is routine practice, and the average person is not aware of this UNTIL they are hurt. They cut off your benefits – the very thing you have been paying premiums for. They employ whole departments for this purpose. Nothing is ever done for the consumer where insurance is concerned…
The lawyers are never paid through PIP that is only to the provider of medical treatment.
what are you smoking, do your homework what a stupid comment, must be a pip lawyer
RICK SCOTT IS SO FULL OF HIMSELF. HOW DARE HE TAKE AWAY MY FAMILIES RIGHT TO CHOOSE. IF I AM INJURED IN A MOTOR VEHICLE ACCIDENT I CHOOSE CHIROPRACTIC EVERY TIME. TAKING AWAY MASSAGE IS WRONG. PRO CHOICE!!!!!!! I HAVE RIGHTS!!!! IM A PPO PERSON NOT A HMO PERSON!
The epidemy of ignorance! CAPS and all.
‘epitome’ but I get your drift.
Do you have any idea how many massage therapists and acupuncturists will be unemployed due to this bill? We are not fraudulent: we are licensed professionals who work to bring our patient’s relief. Our company used 13 independent contractors who were highly trained, licensed Massage Therapists. We worked on over 80 people with Developmental Disabilities. The incredible benefits they received from our massage is documented. In 2007 it was written out of the state and federal budget. Now, our therapists have once again been written out. Never were our patients asked about the benefits received…
I would question any massage therapist whose business was based solely on PIP claims. That would be a huge red flag.
I, too, am a licensed massage therapist, who works part time for a doctor who treats both MVA victims and private-pay endocrine patients. He hired me to work on the MVA victims, because massage has proven to be useful in relieving pain and shortening the time needed for recovery. Some of our patients were referred to us because they were not seeing any improvement in their condition at other facilities, where massage was not part of the treatment protocol. Most of our patients have remarked on how quickly we get them out of pain and on the road to full recovery. The majority of these accident victims would not have been able to afford massage therapy on their own. I feel very sorry for anyone in FL who becomes involved in a MVA and suffers soft-tissue injuries (like whiplash, for instance) after December 1st. I WILL lose my job, as will any other massage therapist who works for those who treat MVA victims. It is my understanding that most health insurance companies will not pay massage therapists, either. If that were the case for physical therapists, and PIP was reformed to exclude payment for physical therapy, how many of them would become jobless?
How much more should Floridians pay in auto insurance just so massage therapists will have a job?
I’m a P&C agent, but my girlfriend is a DPT (doctor of physical therapy) and she loves theraputic massage for the medical benefits it provides. She works with kids who have birth defects and it’s very helpful. I can also tell you that I’ve got soft tissue damage in my shoulder area (do not *EVER* drive with your arm behind the passenger seat – if you get rear ended, everything goes bad) and theraputic massage has helped me in ways I cannot describe.
Neither of us are in FL and it may be heavily abused there; I cannot speak to that. I can say that dismissing theraputic massage (if any are in fact doing so) is a mistake. It can be very helpful in reducing pain.
I don’t think my shoulder will ever get better, but it’s over and I pay for a massage once in a while to help.
*shrug*
-Bartleby
The Chiropractors and Attorneys Tag team the insurance companies. Take the Chiropractors out of the picture. The MD’s are not AS bad as the Chiro’s. THen make the auto insurance companies accept electronic claims like everyone else, reducing the man power and expense needed at the doctors office, then reduce the amount of money that is paid per procedure. Right now the pip laws state that the DR gets TWICE as much money for the same procedure performed on an auto injury patient vs a medicare or commercial health insurnce patient. And that is only if the doctor has not figured out the loop hole yet. That actually allows them to collect what ever they bill. ( Except with Windhaven or Direct General)This should reduce the funds paid out by the ins. Co. and allow them to pass the savings on to the consumer.
Why is to doctor being paid 200% more just because the patient was in an accident? The doctor shold get paid the same amount of money regardless of the patients insurance. What is this loophole that allows them to recover “whatever they bill”? PIP could save millions just by paying out the same as everone else.
OK, I’ve stopped laughing. I can catch my breath now. Pass the savings on to the consumer? In what parallel universe? Any savings will get passed along to the insurance coffers. As far as requiring the insurance company to justify rate reduction refusal – I can only imagine the creative writing that will go into that one. Bottom line – the consumer will never see any benefit from this, but the insurers certainly will.
Under previous administrations I’d agree with you. But my memory of CFOs/Treasurer-Ins.Comm.s goes back to Tom O’Malley; and I’ve met them all. I’ll tell anyone that our current CFO is by far the best of the lot and will do what he says, and more.
I agree that we will not see the savings. It’s a nice thought. And I just told them how to save money. Probably no one will listen. I guess if they want to throw away money they can,as long as we HAVE to give it to them, they will have it to throw away. They should quit complaining or do something logical about it.
It is sad that the fraud has been able to eliminate the benefits of such coverage to the consumers. If you ask me the insurance companies are the biggest frauders of all. They basically give you a benefits that are practically worthless with a claim that you the consumer will get some sort of break. No, they are getting the break bascially and we will all be paying for less coverage. Also what effects will this have on health insurance cost? It is sure to increase the cost of medical treatment for these injuries. Another really unfortunate side effect of this mess. I see patients all the time in our clinic that have to go through such trouble to have there claims paid for and do in fact have real injury. I think it is very sad that the insurance companies win again over the individual. I read a blog that accidents over all were down its interesting fact if fraud is so prevelent wouldn’t there be an increase in the number of accidents? Why not create penalties to those physicians found involved in fraud by taking their licenses? It seems to me that elliminating the benefits to the consumer to reduce fraud also puts the consumer on the sort end of the stick. But I think the true motive for all of this is to elliminate the cost of chiropratic treatment across the board. Therefore not only eliminating the fraud but also all of the benefit to the consumer, the real victim. It is easy to say from a desk a million miles away that someone doesn’t have real injury. But much more diffcult when they can’t form the functions of daily life the same anymore and are there asking for your help. This is another example of who runs our country and our lives…. Those that have the deepest pocketbook. Think of all those in the state that aid in this type of treatment
Amanda, you have know clue about lawyers being paid through PIP. do your homework before making comments.
Lawyers being paid through PIP? When does that happen? When the consumer has to file suit against their PIP carrier to get the benefits for which they paid insurance premiums, that’s when. If a consumer is FORCED to file a PIP suit against their auto insurer and that consumer wins that PIP suit, then the insurer can be responsible for the attorney’s fees for filing that PIP suit only. The PIP benefits are paid directly to the medical provider or the consumer for reimbursement of medical bills and/or wages. I think YOU need to do your homework before making comments.
THE NEW PIP REFORM 2012 LAW, THE BIGGEST FRAUD OF ALL ON THE FLORIDA CITIZEN BY THE INSURANCE LOBBY MACHINE
WOW – the newly passed PIP reform HB 119 is the biggest fraud of all on the Florida citizen. Instead of going after the fraudsters (as they promised), they passed “PIP REFORM” decreasing citizen medical benefits, access and choice…and the poor citizen gets to pay the same high premiums.
Here’s what happened (read it yourself at HB 119):
• The insurance companies can continue to charge the same high premiums, BUT the citizen only gets $2,500 in medical benefits instead of the previous $10,000 – unless they’re severely injured, good luck with only $10,000 on that one.
• Instead of going after the true fraudsters (as they promised and should have done), the insurance lobby went after the Florida citizen.
• The insurance companies will make record, record profits (as they always make…year in, year out) off this law. Same high premiums, 75% less benefits ($2,500 versus previous $10,000), you figure it out!
• The insurance companies have already started donating (paying back for their vote) money to the political cronies that voted for this travesty on the citizen – in the sum of millions of dollars.
This is “great for the Florida consumer,” says Gov. Scotty and his cronies…really???? WOW! Talk about crony corruption/capitalism, WOW!
WAKE UP Florida citizens/voters…these cronies didn’t go after PIP corruption (as they said they would and should have done – they just used that excuse to short-change the Florida citizen); they passed “PIP Reform” so that their insurance buddies can continue to make record profits.
Instead of passing true PIP reform by going after the real crooks (as they promised), they defrauded the Florida citizens by once again stealing their money in the biggest fraud of all – throw the crooks out!!!!!
Luis, This comment doesn’t even merit a proper reply. Get your facts straight before mouthing off.
Luis, your facts are a bit skewed. As L said previously get your facts straight before mouthing off.
(The legislation requires an accident victim to obtain treatment within 14 days in an ambulance or hospital, or from a physician, osteopathic physician, chiropractic physician, or dentist. The full $10,000 PIP medical benefit is available only if a physician, osteopathic physician, dentist, or a supervised physician’s assistant or advanced registered nurse practitioner determines that the insured has an “emergency medical condition.” Otherwise, the PIP medical benefit is limited to $2,500.)
Maybe Luis you should have read the article Insurance Journal posted. The operative word in the article is “OTHERWISE”. All an injured party has to do is follow the rules and their PIP does not change. I understand following rules these days is difficult for this generation. It’s not “FAIR”. But the law states you can get treated from a “Physician” within 14 days. If you want the freedom of choice, use your “Physician”. Why shouldn’t insurance companies selling PIP dictate where to seek treatment, they are the payors? The legislature should have taken it a bit further and had payments based on the Medicare allowable, just like what happens with our individual health insurance, as a means of controlling costs.
Luis you are obviously in the pocket of an insurance company. I have worked for a physician for over thirty years and have seen more and more crazy rules that help insurance companys and hurt the medical community. A small percentage of medical providers commit 90% of the fraud. I personally know many friends who work in the insurance industry: pip, health, workers comp and none are or have been out of work. However, I personally know two orthopaedics, one neurologist, one podiatrist and several PCPs who retired from practice to enter another field due to inability to pay existing staff because of insurance cutbacks. I have also been severely injured in two mva’s (not my fault) and have been kept functioning without recommended surgery by a neurologist and a chiropractor @ 1/10 the cost of surgery that the IME DOCTOR recommended. You need to open your eyes and not get caught up in politics.
I have been a paralegal in personal injury law for 23 years. Wow, some of these posts are rediculous. I feel very sorry for ignorant people. I hope you people dont find yourself in a serious car accident and in need of medical care one day. We do our absolute best for our injured clients. We dont permote fraud in our practice. We deal with real people in need of real help. Oh, and please note, PIP does not pay 100% of the meical. They pay 80%. Some PIP carrieres also make adjustments and pay 80% of their allowable amount. You are paying premiums for these benefits, and in a time of need you may find that they will not be available to you. Hello!! Wake up people!
I’ve been an insurance agent for 35 years, and you are not entirely correct in your post. While basic PIP pays 80% of medical expenses up to $10,000 in FL, you can add Extended PIP that increases reimbursement to 100% up to $10,000. Some companies, though very few, offer Additional PIP that increases the limit up to $100,000. In my 35 years I have had very few insureds that have needed the services of an attorney to receive PIP benefits, including my 30 years in NY, where the top PIP limit is $175,000 per person.
While I am happy to hear you handle your clients affairs in a non-fraudulent manner, if a claim is presented in a straight-forward, non-suspicious way, insurance companies pay the benefits an insured purchased. In almost all cases, it’s unnecessary for a claimant to pay for an attorney’s services in order to receive their purchased benefits. I find it borderline unethical that some attorneys and pain clinics advertise that injured parties should call the police first and their attorney second. As an insurance professional, I am quite capable of guiding an insured through the claims process, without charging them a fee or contigency.
Well stated Kevin!
Absolutely a flat out lie. Attorneys file 1,000’s of PIP suits every week to collect benefits for doctors because auto insurance companies systematically refuse to pay benefits out to doctors.
Kokoemo
Its clear to me that you are unaware of a few facts. First, Florida is ranked #1 in staged accidents. Secondly we are second to New York in PIP claims. Something had to be done and while i would have loved to see PIP sunset, we all know how that did not happen in the past. Clearly no one goes in business not to make a profit, would it make you happier if like homeowners insurance auto carriers left the state therefore limiting your choices- ensuring higher premiums? These are the facts: fraud is rampant. Most of your cost for insurance is in the PIP coverage, clinics are making a killing on your PIP. Many only see auto accident customers. The clinics won a major battle against insurance companies which has caused you to pay more. There was a District court decision that allowed them to bill for and get more than the 80% of Medicare part B allowed by Florida statue. If u are looking to blame, look deeper. Change happens and while this bill offers less than i had hoped, its a pebble ripple on a large mountain of snow.
Only the players are changed, but the fraud remains the same. Not a day went by before I was getting advertised to on how to create a “multi-disciplinary” practice (hire a medical doctor) to beat the new changes.
Our politicians are idiots. There is a way to eliminate fraud without cutting out any benefits. I submitted it to our politicians, but because they are too thick to understand healthcare, they do what the lobbyists with the most money tell them to do.
I wrote the real solutions here: http://drhaley.com/obama-did-get-healthcare-reform-suggestions/
I’m concerned if this is going to affect my job position. I am a Licensed Massage Therapist at a Chiropractic Office.. One thing I’ll never understand is the politics and the fraud behind all of this PIP situation.. But if it’s one thing I do know is that Massage Therapy has been a very effective treatment for patients. We manipulate the muscle tissue and help reduce tension. How can massage not be considered as something beneficial to the injured person? Am I wrong to worry if this could put thousands of therapists and acupuncturists out out of a job? Or am I just being paranoid?
JC! You are not even close. This is a big scam, The Gov. RS got a big payoff for this deal. He also violated civil rights. There are 50 to 60 thousand LMT’s in Florida, African American, Hispanic and Caucasion. All affected by deleting massage from the practice, also I have not seen our professional association , NAACP, ALCU step in to help, It goes on and on frome here.
Florida should look to Colorado. Colorado allowed PIP to sunset and returned to a tort system in 2003-04. The result? Auto insurance premiums dropped by 20%, essentially overnight.
The road to hell is paved with no-fault laws!
Correct me if I’m wrong, but this applies to PIP only correct? Wouldn’t all of this (massage, accupuncture, etc.) still be covered under Bodily Injury Liability or Uninsured Motorists coverage?
The no fault law was written to be self executing to promptly pay legitimate claims. That is, it was written so there would not be delays in payment. Currently, it works about 50% of the time. The other 50% is due to a cut off of some type, that is not what the legislature intended. I am not pointing fingers just saying it is broken.
I think we all agree there is a minority of medical providers in system who game the system that is to bill out the entire benefit as they have learned to extract every last penny from the policy.
The money extracted from the policy does not match the risk we consumers pay for because the injury although real should of clinically resolved sooner, unfortunately it is few medical providers who can walk away from an 80% reimbursement of medical bills.
As a result the insurers are almost guarantied a $10,000.00 risk on every motor vehicle accident case. That is the problem at hand the legislature was trying to fix albeit in-artfully.
The real tragedy is when someone is in the low speed accident category and is actually injured and then gets put through the inquisition of EUO, IME and then denial. Basically treated like a thug or fraudster when they are not. Truthfully, medical science cannot weed out with precision the fraudsters from the truly injured. When you through in the patient advocate medical provider and the IME who has inherent bias (If you do not think so read the Boecher decision in Florida)the system has turned into a Free For All (FFA you gamers will appreciate that reference.
The insurance industry now reacts the same way to almost every low speed case ( I will give some of you the benefit of the doubt I have seen fair results “some times”, and like an abused junkyard dog has become vicious callous “zealously” guarding the benefits, which is a problem also. Generally, adjusters are supposed to be neutral sound crazy in this system but that is a fact. Guys five hour EUO’s? really? If you want to see what happens when an EUO abuse is brought to the attention of the 3rd DCA read read Jose Deleon vs. Great American Insurance Company No. 3D09-646 (3rd DCA, it will be an eye opener for most adjusters on what is actually reasonable and also look at https://www.flrules.org/gateway/ruleno.asp?id=69B-220.051, the rules of ethics relating to adjusting then consider what the junk yard dog in your office has been up to for the last six months and whether that zealous conduct is actually permitted. A backlash is to be expected with so many medical abusers out there. However, when you squeeze the doctors by lowering reimbursements across the board expect them to seek to keep their standard of living, in that respect PIP is subsidizing Medicare, by subsidizing medical providers. Reduce PIP and we may lose doctors.
I am sure you all realize that EUO’s and IME’s are a thing of the past now right? if you do not lament the physical therapist, then you will not lament that your next career may be coming sooner rather than later. Because the Florida Legislature just made a lot of adjusting capacity needed obsolete with this law.
Ironically, this bill actually benefits the lawyers (guess what I do for a living) to the exclusion of consumers and that should be easy enough to figure out. If you cap PIP but do not cap medical damages the risk of payment of medical bills is shifted to the tortfeasor insurance.
The at fault party better hope the Health Care Act care is not overturned by the Supreme Court (in Florida anyway) and they have Health insurance because they are now capped at $2,500.00. This risk will also be shifted to some extent to health care insurers, or Medicare and medicaid to the taxpayers.
In the end the taxpayer foots the bill for the “serious injury” that is not an emergency within the meaning of the law.
Lastly, if you thought there was PIP litigation before get ready because the emergency issue as written is vague and will open the flood gates of entitlement law suits. Whenever the law is vague and subject to multiple interpretations litigation will ensue.
Lastly, I agree with the bill but the cap should be $5,000.00 not $2,500.00 Does it make any sense to any here it is reasonable in “every” soft tissue case to to bill $15,000.00 for palliative medical care?
When I started in this profession and had not a clue about same the first time I saw a bill like that I thought it was a mistake now a decade later I know it is the norm. Orthopedic medicine and chiropractic medicine treatises recommend about six weeks of physical therapy to resolve a soft tissue injury, you can double that as reasonable, but 18 months ? That is not treatment that is an annuity.
This law solves some problems and makes some new ones it hard to call that a success more like status quo. It is the at fault party who takes it on the chin here maybe that is as it should be in a society where we value responsibility.
The problem was not the PIP, but the attorneys, doctors, and clerk of the courts selling accident information. The three combined is a form of underground illegal tort organization scheming to undermined the victim of an accident and the insurer paying. At the end of the day, the victim lose half of their settlement to the doctors and lawyers. Now by giving the same crooks the final say within 14 days, will make it worst.
A new Law is sitting on Gov. Rick Scott’s desk waiting to be sign or better yet to be VETO.
Floridian “PIP, Personal Insurance Protection” are about to be limited; ask Gov. Scott to VETO.
Please request the petition at petition@againsthb119.com copy and paste this petition not only from your email but to all social media outlets and email database to spread the word. Please help us reach as many Floridians as possible before May 5, 2012.
Thank you for your time
Dr. J. Michael Lemus
Governor Scott will and should sign the bill – TODAY. Its not a perfect bill, but its a great first step to reducing fraud. Its a little soft on the trial lawyers. It doesn’t cap attorneys fees, which is a must. Its also a little soft on the doctors, and lets them get away with billing murder still – but he, its the Florida Medical Association and with their boy running the Florida senate next year, we should hope that insurance companies dont have to back up brinks trucks to doctors offices and pay them in gold anytime they ask.
Its a good bill. And the perfect example of what happens when you get hoggish (ie pigs get fat, hogs get slaughtered). Look, I agree that massage therapists are a quality profession. Many times, they get better results than going to the ER and blowing $5k on test and BS. But in the end, they were scamming the system, so they were shut out.
PIP will be an evolving system of reforms. I’ll just say this, and I know enough about what goes on in Florida government to know this – thank God State Farm is pushing this stuff. I know many of you other companies resent them, but they are about the only insurance company in Florida that can take on the trial lawyers, get votes and beat them, while the other companies just stand around, have conferences and talk to themselves.
First good step towards reform.
Yes! Its illegal to drive wioutht it. You will get a ticket if you’re pulled over.If you own a car(not financed) insurance is relatively inexpensive because you only need PIP. If you do finance, it is pricey because you need full coverage.You can get better prices by paying the insurance in sixth month increments, as oppose to paying it monthly. The insurance companies always give a better price when you pay it in full.Also, call around to all the major insurance companies and get a quote. Each company will give you a different price. You have to shop around to get a good price.
The fraud is advertised on the radio. 411-Pain. No need to look further. Massage is a cheaper and less destructive treatment for whiplash (real) than a chiro “manipulation”. I don’t see this bill doing much to eliminate the real fraud, but doing a lot to limit an injured person’s options.
Yuhmi,
Where are you living? Liability & PIP on a paid off car are NOT cheap for the young at least. Isn’t it funny we have the least money and are charged out the ass? As an unmarried female college student with 0 claims, 0 accidents, and 0 points I am expected to find $140 per month to put the bare minimum legal coverage on my 2005 Hyundai Accent (1.6L, less than 100hp, subcompact car). That was the cheapest rate I’ve been able to find. With my school schedule, I can maintain a part-time job that pays $9/hr for 15 hours a week. I am legally required to pay more than I make in a week every month for the privilege of being able to get to my classes and job – that insurance doesn’t do a damn thing for me. There’s nothing “cheap” about that.