Florida Supreme Court to Hear PIP Fee Dispute

The Florida Supreme Court recently agreed to hear an appeal brought by Allstate Insurance Company in a dispute about fees paid to medical providers under Personal Injury Protection (PIP) Benefits.

Florida is a “No-Fault” state, which means that by law, vehicle owners are required to carry, at minimum PIP benefits, which generally will pay for 80% of medical bills and 60% of lost wages, up to $10,000, for injuries arising out of an automobile accident.  PIP coverage makes each individual’s insurer responsible to pay for these accident-related injuries (up to these statutory limits) regardless of who is at fault in the accident.  This coverage is especially important in areas like Fort Lauderdale, Miami, and South Florida in general, due to the high number of underinsured drivers present here.

The appeal comes from the 4th District Court of Appeals, which includes Broward and Palm Beach Counties, that ruled in favor of medical providers.  A key issue in the case is whether policies were unambiguous that Allstate would reimburse medical providers under a fee schedule derived from the Medicare program, which limits payments for certain services.

Medical providers argue that the policies were ambiguous on this issue, and a majority of the three-judge panel agreed.

The Supreme Court has yet to set a date for arguments to be heard, but when this case moves forward, the ruling could have a serious impact on the PIP insurance system in Florida.  This critical insurance coverage provides vehicle owners and their passengers involved in car accidents some certainty that they will have medical coverage for treatment they may require.  And again, with the prevalence of underinsured drivers throughout the Fort Lauderdale and Miami areas, this insurance coverage is especially important for local drivers.

For more information on this topic or any other, feel free to contact the Schulman Law Group at (954) 349-3300 or at info@www.schulaw.com