A warning to those injured after being in a car accident; you may continue to be victimized by the very medical provider you went to in order to get better. What we continue to uncover is that if an unsuspecting patient goes to the wrong provider, the desire to bill motor vehicle insurance PIP benefits can take priority over your medical treatment.
How Much Does Personal Injury Protection Cover?
In Florida, PIP insurance benefits are required on all motor vehicles. Also called Personal Injury Protection, PIP benefits pay up to 80% of a person’s medical bills and lost wages, up to a total of $10,000. While the PIP benefits law in Florida was originally developed to simply provide for the payment of medical bills for both injured parties, the law has devolved into something much different.
The Florida Legislature continues to try to eliminate PIP during every session, but the system has created so many industries reliant on the payments that it would cause massive disruption. Most important to our legislature is the dependence of Florida hospitals on the money they receive from PIP. The hospitals claim that they need the money they receive from PIP benefits in order to offset the costs they incur by treating uninsured patients. Thus, the PIP system is essentially a way to require motor vehicle insurance companies to keep hospitals afloat even when the majority of the patients have nothing to do with an auto accident. This abuse is often illustrated by the volume of expensive tests ordered in the emergency room. In Pinellas County, we see first hand which hospitals run up unnecessary tests such as CT or CAT scans simply to make more money off of the PIP insurance money. The disservice to the patient is that they have little to no money left for continuing treatment after the hospital visit.
PIP benefits also can be abused by secondary providers. Secondary providers are normally auto accident care centers, chiropractors or physical therapists. The most pronounced abusers of the PIP system are normally medical providers who are affiliated with call centers. If you are dialing a number on a bus or billboard to get medical care, you can be certain that much of your insurance benefits are going to pay for those ads, not for your treatment. It is extremely frustrating when a client hires us as their personal injury lawyer after a car accident and the provider has already billed out the entire $10,000 without even sending the client off for an MRI or to see a specialist.
It is obvious to us in the business that the rationale behind this is for the provider to keep all of the insurance money rather than some of it be spent for another medical service. These unscrupulous providers generally take advantage of unrepresented patients or patients whose lawyer is part of the system in order to get referrals. It is simply a terrible disservice to the client and many people have no idea they are being taken advantage of. Most people are inherently trusting of doctors and medical providers and do not realize that the PIP injury system is unlike other medical care they have previously received. The PIP system is a major reason why most general practice doctors simply refuse to treat people injured in a car crash.
How Can I Protect Myself from Being a Victim of PIP Fraud
My advice to all people after being injured in a car accident is to regularly watch the bills and ask questions as to why certain medical treatments are being ordered. If you think you are being asked to treat for an extraordinary amount of visits in a short period of time, you are likely being victimized by a provider who is attempting to bill out your PIP insurance before the benefits are exhausted. Please be careful of where you go and whom you hire to handle your case because there are many pitfalls for the unsuspecting patient.