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New Auto Insurance Law That Will Impact Everyone Effective 1/1/2013

During the 2012 legislative session, the Florida Legislature passed new laws for the primary purpose of reducing insurance fraud. Unfortunately, this new law, most provisions of which become effective January 1, 2013, will have a negative impact upon Florida consumers and could leave one without insurance coverage in the event you are injured in a motor vehicle accident.

Since 1972, Florida law has required every motor vehicle insurance policy to provide for Personal Injury Protection (“PIP”) benefits for each person injured in an accident. This part of your Florida auto insurance covers up to $10,000 to pay for 80% of medical expenses, 60% of gross wage loss (if you cannot work because of your injuries), plus all expenses reasonably incurred in obtaining services, such as housekeeping and child care, that except for the injury, you yourself would have performed for the benefit of your household. PIP also pays reasonable mileage or expenses for transportation to and from doctors’ offices for medical treatment. All PIP payments are made by your own insurance company, regardless of whose negligence caused the accident. That is why PIP is often referred to as “No-Fault” coverage. PIP is payable for any injury which arose out of the use, operation or maintenance of a motor vehicle (but not a motorcycle).

With the new law, as of January 1, 2013, your entitlement to this important insurance coverage may be lost if you are not aware of the new PIP restrictions and limitations. Here are some of the important ones of which you must be aware if you are injured in an accident, regardless of who caused the accident:

  1. Fourteen (14) day time limit to seek medical treatment. If you are injured in an accident, the new law requires that you obtain medical treatment within 14 days or there is NO PIP COVERAGE FOR ANY MEDICAL BENEFITS. The first or initial medical visit for services or care MUST BE AT A HOSPITAL FACILITY, or by an M.D. (medical doctor); D.O. (osteopathic physician); D.C. (chiropractor); or a D.D.S. (doctor of dental surgery). If you don’t seek medical treatment within fourteen (14) days of the accident, you will have no PIP benefits at all to cover the medical bills you incur. In other words, even though you have been paying insurance premiums for PIP coverage, you forfeit the $10,000.00.
  2. Medical coverage is limited to $2,500.00 unless you are diagnosed with an “Emergency Medical Condition”. With the new law, you will only receive up to $2,500 of PIP benefits out of the $10,000.00 unless your doctor diagnoses you with an emergency medical condition. An “emergency medical condition” is defined as a “medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:
    1. Serious jeopardy to patient health;
    2. Serious impairment to bodily function;
    3. Serious dysfunction of any bodily organ or part.

    With the new law, a chiropractor (D.C.) cannot make the diagnosis of emergency medical condition. Only an M.D., D.O., D.D.S., or an advanced registered nurse practitioner (A.R.N.P.) may make this diagnosis.

  3. Massage and acupuncture are no longer covered by PIP.
  4. § 316.066 written reports of crashes. Police agencies will be required to prepare a LONG FORM crash report if there is any indication of complaints of pain or discomfort by any person involved in the accident. It can certainly be expected that the PIP insurance carrier will try and use the officer’s failure to generate a LONG FORM report as a reason to deny or curtail PIP benefits.

These above is just a summary of certain of the new provisions affecting your entitlement to PIP benefits that will impact anyone who is injured in a motor vehicle accident. There are many other changes under this new law. If you are injured in a automobile accident, whether you are a driver, vehicle owner, pedestrian or passenger, or even if you don’t own a motor vehicle, this new law may have a serious negative impact upon your ability to obtain important insurance benefits which you are paying for in your insurance premiums. You should therefore consult with an experienced accident attorney if you have questions. If you are involved in a motor vehicle accident and have injuries, regardless of whether or not you believe that they are serious or minor, you should consult with an experienced accident lawyer as soon as possible.

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