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To resuscitate or not to resuscitate PIP insurance — a South Florida pocketbook issue

By Amber Statler-Matthews, BrowardBulldog.org 

The tug-of-war may be in Tallahassee over personal injury protection insurance, but at the heart of the battle are drivers in Broward and Miami-Dade counties who are paying more each year in premiums.

Florida lawmakers are struggling over two bills that would reform or do away with the system altogether.

Time is running out.

The legislative session ends Friday and Gov. Rick Scott is pressuring lawmakers to have a new law in place by then.

“Big insurance companies embroiled in PIP litigation want to either eliminate PIP or create a system where they have virtual immunity from claims delays and wrongful denial,” said Dave Bierman, a Broward insurance claim attorney and certified insurance fraud examiner. “Neither one is good for Floridians.”

Special interest groups have been holding up the legislative process. Trial lawyers, medical providers, small business owners and the insurance industry are feverishly lobbying to protect their bottom line.

If a new bill is passed it will likely be a compromise that includes key parts of both bills. But many on both sides of the issue wonder if it will be enough to bring relief to drivers paying elevated insurance premiums.

THE COST OF FAKE CLAIMS

“Insurance fraud costs the average Florida family between $400 and $700 a year in increased premiums,” according to Florida’s Chief Financial Officer Jeff Atwater.

The top four cities for PIP fraud include Miami, Hialeah, Tampa and Orlando.

According to insurance industry “Fast Track” data, in 2008, the average driver paid $500 for PIP. Today, those same drivers in Miami-Dade County are paying as much as $4,000.

Florida is one of 10 states in the nation that requires drivers to carry personal injury insurance protection to pay for medical expenses no matter who is at fault in an accident. Florida’s No-Fault Law requires a minimum of $10,000 of Personal Injury Protection (PIP) and $10,000 of property damage liability (PDL).

The crush of bogus claims has caused insurance companies to restrict coverage.

“Because of the over abundance of claims in areas such as Broward, Miami-Dade and Palm Beach counties, insurance companies are already underwriting in a way that denies some drivers the ability to purchase insurance at all,” says Steven Marcus, chairman of the Insurance Committee for Broward Days.

He says some insurance companies look for people who’ve had 5 years of coverage with the same company before they will write a policy.  Others may deny anyone who want coverage of less than $25,000 per person and $50,000 per incident.

“That’s probably going to eliminate 60 percent of the public,” Marcus added.

But the insurance system is not as broken as the insurance companies want people to believe, according to Bierman.

“The insurance industry is blowing up examples of a few bad apples to turn the ‘no-fault system’ into a ‘no-pay system,’” he said.

WHICH APPROACH TO CHOOSE

Trial lawyers like Bierman, the Florida Hospital Association and the lobbying group Floridians for Fair Insurance are backing Senate Bill 1860 introduced by Republican Sen. Joe Negron, of Palm City.

This bill targets fraud by targeting bogus health facilities that file false claims.

Negron’s bill gives hospitals priority standing in PIP claims, tightens licensing requirements on medical clinics and eliminates massage therapists and acupuncturists from filing claims under the PIP system.

What the Senate bill does not do is place specific limits on when drivers or their passengers can seek treatment; nor does it put a cap on attorney fees.

“Negron’s bill is like putting a band aid over a 12-inch slash,” said Marcus, who owns an insurance agency in Coral Springs. “It’s too weak because it doesn’t include criminal penalties for fraud. If this bill gets through, it will be more of the same.”

Marcus, the insurance industry and business groups like the Florida Chamber of Commerce and Associated Industries of Florida, support House Bill 119 sponsored by Republican Jim Boyd, of Bradenton. This bill basically repeals the current PIP system and requires people injured in auto accidents to go the emergency room.

In an effort to reduce fraud, hospital physicians must diagnose injuries within 72 hours after an accident. This process is designed to keep injured motorists away from fraudulent physicians and suspect medical clinics filing bogus PIP claims.

The Latin American Association of Insurance Agencies, which includes Allstate, State Farm and Geico, also supports the House Bill.

PIP INSURANCE TO LIVE OR DIE

With rising costs fueled by fraud, the state would appear to have reached a critical fork in the road that requires it to either resuscitate the current system or take it off life support.

Insurance companies believe going after fraud is the best approach. The industry backs House Bill 119, which gives them more control of accident investigations.

Floridians for Fair Insurance, made up of lawyers and business leaders, insists supporting the House bill means supporting a “bail out” for the insurance industry.

“Insurance companies want to raise rates and cry poverty but they’re still making massive profits,” said Russell Lazega, an insurance litigator with the group. He is also Bierman’s law partner.

“The solution is simple,” he said. “Just spend the money to prosecute the bad guys and move on to putting Florida back to work. Enough with the insurance industry bailouts.”

Past attempts to reform PIP have failed. But all sides are hoping 2012 is the year for real change.

If lawmakers fail to reach an agreement on a new bill, Florida residents will be left to foot the bill.

According to Bierman, “Big insurance companies embroiled in PIP litigation want to either eliminate PIP or create a system where they have virtual immunity from claims delays and wrongful denial. Neither one is good for Floridians.

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  • I don’t ordinarily comment but I gotta admit regards for the post on this one :D.

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