On January 1, 2013, significant changes to Florida’s personal injury protection (“PIP”) automobile insurance law will go into effect. PIP insurance, also known as “no-fault” insurance, is mandatory for all Florida drivers. The following summarizes some of the new changes to the PIP automobile insurance law and how your rights to PIP insurance benefits may be affected:
1. 14 Day Time Limit to Receive Initial Medical Care
You will no longer be entitled to receive any PIP medical benefits unless you receive initial medical care within 14 days after your motor vehicle accident. Initial medical care can be obtained through an ambulance, a hospital, an acute care clinic owned by a hospital, or through a licensed physician, chiropractic physician, or dentist.
2. Reduction in PIP Medical Benefits From $10,000 to $2,500 Unless You Had an Emergency Medical Condition
The total amount of PIP medical benefits available will be reduced from $10,000 to $2,500 unless you had an “emergency medical condition.” An “emergency medical condition” is defined as a 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:
(a) Serious jeopardy to patient health;
(b) Serious impairment to bodily functions; or
(c) Serious dysfunction of any bodily organ or part.
Only a physician, physician assistant, advanced registered nurse practitioner, or a dentist can determine that you have an emergency medical condition for purposes of PIP reimbursement.
3. Limitations on Reimbursable Follow-Up Medical Care
You must have a referral from a medical provider to receive PIP benefits for any follow-up medical care needed, and follow-up medical care will only be reimbursable by PIP if it is consistent with the underlying medical diagnosis rendered by a medical provider who provided you with initial medical care within 14 days after your accident. Accordingly, it is important that you report all of your symptoms and areas of injury to your medical provider(s) within 14 days after your accident.
4. Massage Therapy and Acupuncture No Longer Reimbursable
Massage therapy and acupuncture treatments will no longer be reimbursable PIP benefits regardless of who provides the treatment. Any treatment received from a licensed massage therapist or a licensed acupuncturist will not be reimbursable from your PIP insurance.
5. Examinations Under Oath and Independent Medical Examinations
Your PIP insurer may require you to sit for an examination under oath (“EUO”) or an independent medical exam (“IME”) in order to receive PIP benefits.
6. Effective Date of New PIP Law Changes
The January 1, 2013 changes to the PIP automobile insurance law will be in full force regardless of whether they are included in your automobile insurance policy, and insurers are not required to amend their policy forms or notify you or your health care providers for the changes to be implemented.
If you are the victim of an automobile accident and have questions regarding your legal rights, call us for a free consultation.