Category: <span>INSURANCE COVERAGE</span>

The Florida Agency for Health Care Administration recently issued a three-page memorandum that was designed to eliminate a flaw in House Bill 119, the state’s new personal injury protection (PIP) law that was signed by the Governor in early May. As written, the law created a six-month eligibility gap beginning July 1st for health care providers such as doctors, dentists, and chiropractors. Although eligibility would have automatically been restored on January 1, 2013, insurance companies could arguably have refused to pay health care professionals who treated accident victims as part of the PIP insurance program in the interim.

PIP insurance was adopted in Florida in 1972. During the recent legislative session, Governor Rick Scott lobbied for changes to the law which requires Florida vehicle owners to carry $10,000 in mandatory no-fault accident injury insurance. Proponents of the new law say the changes are aimed at combating staged accident fraud. The law now includes tightened restrictions regarding who constitutes a medical provider, requires the name of all passengers involved in an accident to be noted by police officers, and creates a 14-day medical treatment window following an accident. Insurers are also required to lower the cost of premiums so long as certain specified criteria are met.

Critics of the new law believe it does more for insurance companies than consumers. Bill Newton, Executive Director at the Consumer Action Network, said recent changes to the PIP law will result in more limited services without the benefit of lowered insurance premiums. He also stated the law has shifted the burden of injury accidents onto the victims.

It is currently unclear whether the Agency’s memo is sufficient to eliminate the purported eligibility gap. According to Mark Seidenfeld, a Florida State University administrative law expert, the document may be useful to influence a court regarding the intent of the law, but whether it would have an actual impact on a court’s decision following a challenge is not apparent. Seidenfeld believes it is only a matter of time before someone challenges the state’s new PIP law based on either the eligibility gap or the constitutionality of the measure.

If you were hurt in an auto collision, it is a good idea to consult with a skilled Florida car accident lawyer as soon as possible. You may be eligible to receive compensation for medical bills, suffering, pain, disability, lost wages, lost earning capacity, and loss of enjoyment of life. A knowledgeable car accident attorney can explain your options and help you preserve your rights under Florida law.
Read more “Memo Seeking to Correct Florida PIP Eligibility Gap Issued”

Florida’s recent legislative session was filled with victories and losses for both parties. Surprisingly, one issue that is costing Floridians every year received little reform.

Auto insurance fraud has risen dramatically in Florida and has driven up costs associated with auto accidents for policyholders around the country. A recent article by Fox Business noted that Florida is the leader in staged accidents. The article discussed some of the negative impacts of Florida’s no-fault insurance system – a system utilized by 11 other states and Puerto Rico – which, as the article contends, has created a pool of funds that offenders exploit by staging accidents and utilizing crooked medical professionals to operate clinics that file false claims. Consequently, over 2,700 Florida claims were referred to the National Insurance Crime Bureau last year and it is estimated that insurance fraud costs Florida about $1 billion a year.

In light of these problems, lawmakers made efforts to tackle the issue. In April, the Miami Herald highlighted two bills, SB 1930 and SB 1694, aimed at combatting insurance fraud. SB 1930 would provide insurance carriers 90 days to investigate a claim before making payment medical payments (as opposed to Florida’s 30-day requirement) and SB 1694 attempted to limit fees for attorneys in PIP lawsuits. Critics feared that the bills would discourage injured parties with legitimate claims. Ultimately, the bills died in the judiciary.

Whether we see reform or stricter enforcement in the future, the numbers don’t lie: everyone pays for auto insurance fraud. As attorneys, we believe that it is our responsibility to protect the rights of auto accident victims and to represent their interests in a moral and ethical manner.

A federal award of $1 million will help the state of Florida fight unreasonable insurance premium hikes, officials announced today. The Department of Health and Human Services, along with the Affordable Care Act, is providing the funding so that Florida can review insurance rate hikes before they are enacted to ensure their fairness.

Further, the state intends to use the money to take action against companies who gouge policyholders and/or unreasonably deny their legitimate claims. The award is designed to fund a review process of insurance companies that will require them to provide more information about their individual and small group health insurance plants before approving a rate increase.

Basically, the funding will give the state the power to call into question arbitrary rate hikes, hopefully preventing them across the board. Additionally, the money gives the state the ability to seek legislative authority in 2011 to really crack down on companies who are just out to make a buck.

Another key component of the award is that it will add transparency by creating a search tool on the state website that allows visitors to see rate increases easily. HHS Secretary Kathleen Sebelius estimates that this will help drop premium costs 14 to 20 percent by 2014 by spurring competition and creating better risk pooling.

If you’re being denied coverage or aren’t getting the amount of money you should from an insurance company, call an attorney today. You have rights and should not have to suffer at the hands of a big insurance company.

According to Bloomberg News (June 28, 2010), insurance fraud in Florida has reached new levels as more and more policyholders are intentionally causing auto accidents to generate medical claims. The National Insurance Crime Bureau reports that “staged” accidents in the state of Florida climbed 58 percent to nearly 2,000 in 2009. Tampa is one of the cities where many reports of fraud have been filed recently, with the number of intentional accidents quadrupling in this city alone last year.

Throughout the state, insurance companies are taking a hard look at crashes that may show signs of fraud. In addition to pursuing drivers, a conglomerate insurance board called U.S. Car Insurers is also on the lookout for doctors who engage in these schemes and who are suspected of medical claim fraud. According to the USCI, auto insurance fraud for coverage of bodily injury totaled between $4.8 billion and $6.8 billion in 2007, and they are looking to reduce that amount drastically by cracking down on guilty parties. In the process, some people who have legitimate claims are being refused adequate coverage or are being made to jump through hoops just to receive compensation for their injuries.

Experts believe the economic hard times since 2007 may be to blame for the recent surge in deliberate car accidents in Florida. The insurance industry is now looking to raise insurance rates across the board in order to cover the costs of fraud. In addition, other drivers on the road have to be extra cautious of people willing to cause accidents to receive payments for medical care they don’t need.

If you have been injured in an auto accident in Fort Lauderdale, Miami, Orlando or any other Florida community, it is vital that you contact a reliable auto accident attorney to fight for your case. A lawyer can help you defend your rights against an insurance company or another driver who isn’t willing to pay what you’re owed.

The Law offices of Lazarus and Lazarus, P.A. frowns upon fraud of any kind, especially insurance fraud, which makes it more difficult for our clients who have legitmate claims. If you know of anyone engaging in Insurance fraud, please contact the Florida Dept. Of Law Enforcement immediately.

Since 1972, Florida has been a “no-fault” state with regard to automobile accidents. That simply means irregardless of who causes an automobile accident, each party must submit the first 10,000.00 of their medical bills to their own insurance company for payment. (This is known as P.I.P.) The P.I.P. law (Personal Injury Protection) requires your insurance company to pay 80% of your medical bills up to the $10,000.00 limit.

This vitally important law provides a number of other benefits to Florida citizens who are involved in auto accidents, namely a $5,000.00 death benefit and a lost wage benefit. For those drivers who do not have health insurance, P.I.P. provides the only avenue to have one’s medial bills paid. (Medical debt is one of the leading causes of personal bankruptcy in the United States.)

What does this mean for you and what should you do? First, please call your auto insurance agent immediately to discuss the alternatives to P.I.P. Specifically, obtain a quote for “medical payments” coverage, which is separate and apart from P.I.P. Even if you have health insurance, consider the inconvenience associated with obtaining referrals to specialists and other red tape. Medical Payments coverage will allow you to choose any doctor you wish without the need for a referral. This becomes especially important when one requires treatment with a medical specialist.

Another potential problem that you may encounter in Florida is being struck and injured by an uninsured driver. There are far too many drivers on Florida roads without insurance. This creates a danger for all of us who incur medical bills for accident related injuries. However, there is a very simple solution to this problem. It’s called U.M. Insurance. Uninsured Motorists (U.M.) Coverage is perhaps the most important type of auto insurance you can have in Florida. In the event that you are struck and injured by someone without auto insurance, U.M. Insurance allows you to turn to your own insurance carrier and force them to “stand in the shoes” of the uninsured driver.

U.M. Insurance requires your own insurance carrier to compensate you for all of the damages that you would have been entitled to receive from the uninsured driver. Unfortunately, many insurance agents do not explain this essential layer of coverage properly and often advise their clients to reject U.M. insurance in writing.

Finally, it is extremely important to protect yourself and your family should they be injured in an accident. The purchase of “medical payments” coverage and “Uninsured Motorist” coverage will provide that protection.