First, most people do not readily understand what a “PIP suit” is. Often, it gets confused with personal injury cases that most are familiar with. In a typical personal injury case an injured party sues another party for damages caused by the negligence of another party. Typically this is referred to as tort law.
“PIP” suits are governed under Florida statute 627.736 with a statute of limitations of 5 years. “PIP” stands for personal injury protection and in “no-fault states” like Florida; it is required insurance coverage through your personal auto insurance company.
Essentially, when you are involved in a car accident, PIP pays 80% of your medical expenses, lost wages and other incidentals up to the required $10,000.00. The legislative purpose behind the “no fault” statute is to allow for expeditious medical treatment regardless of who was at fault. In other words, if not for the “no fault provision,” an injured party would have to wait for a Court of Law to determine and opine on liability before an insurance carrier would tender payment for medical services rendered. In such a scenario, physicians would be hesitant to evaluate and offer treatment to an individual injured as a result of an automobile accident due to the inordinate wait to receive payment for services rendered. Additionally, such a scenario would create a serious logjam and delay in cases reaching trial. In turn, this would create an impermissible burden for consumers seeking recourse if physically injured.
So, why the need for PIP suits? In theory, an insured party would be involved in a car accident and seek treatment for his injuries. The medical provider in turn bills the insurance company to pay off the medical bills incurred under “PIP”. Again in theory, the insurance company will reimburse the medical provider after receiving the bills and everyone is happy. Not so fast. Why are there thousands of PIP claims filed in our courts every year? Easy. In some cases the insurance carriers delay or deny payment of the bills for valid reasons such as falsehoods contained in an insurance application or due to the insured failing to comply with their insurance policy (i.e., submitting to an independent medical examination with a physician selected by the insurance carrier following an automobile accident). When this occurs, a medical provider has the right to go after the insurance company to pay such bills in order to be properly reimbursed for services rendered.
Claims range from a few hundred dollars to as much as several thousand dollars. The legislature allows medical providers a cause of action in this case under FL. STAT 627.736. In a situation as described, a medical provider may retain the services of competent legal counsel to handle the matter and collect what is due and owing. In many cases, medical providers are not aware that they may seek action against these insurance companies. It is common for these medical providers to have hundreds of bills that were either partially paid by the insurance companies or not paid at all. Essentially, this adds up to thousands of dollars sitting unpaid within their files.
PIP suits have come under fire by insurance carriers who tend to focus on cases wherein a plaintiff lawyer has filed a lawsuit on what they may deem is a nominal amount (an example would be a lawsuit filed over a reduction of a few dollars). Florida insurance carriers such as United Automobile Insurance; will cry foul and characterize the PIP suit lawyers as greedy. They have attempted to portray plaintiff lawyers as the reason why insurance premiums continue to rise. This is a complete fallacy. What these same insurance carriers fail to state, is that they many reductions are for far greater sums that a dollar. It is much easier to focus on the most egregious cases, and then paint all attorneys with one brush. Further, they also fail to explain that a small reduction of even a few cents multiplied by thousands upon thousands of claims results in a big savings for the insurance carrier. There is a reason behind every decision the insurance carrier makes. Their sole purpose is to maintain and increase profitability for their shareholders.
Hiring competent legal counsel to handle your PIP claims is effortless. Since statute of limitations on these cases are 5 years, we can go back and demand that the insurance companies pay the bills that they were contracted to pay through PIP. The legislature did even better by providing that attorney fees be paid to the prevailing party. This allows a medical provider to not invest money into their accounts receivable to get money that is OWED to them. We do all the work and the insurance carrier pays our legal fees should we prevail. Every medical provider that submits payment under PIP should have a competent legal office with PIP experience ready to demand payments from the insurance carriers. We will happily come to your office and audit all paperwork and billing records to locate potential PIP claims. We will handle the entire process from demand all the way through lawsuit, if necessary.