On May 4, 2016, the Florida Supreme Court will hear oral arguments regarding a dispute between State Farm and Shands Jacksonville Medical Center involving contracts and other documents that contain revealing information about how much the hospital charges different insurers for the same or similar services.
State Farm is attempting to obtain access to these documents to determine what the hospital charges various health insurers for certain medical services, as opposed to what it charges auto insurers like State Farm for services provided under personal injury protection or “PIP” insurance policies.
The hospital contends that its agreements with health insurers are confidential, and they should not be compelled to provide them to State Farm. Conversely, State Farm argues that without adequate information about the costs of these services, it must either trust the provider and pay the bills in full, or choose to pay a reduced amount instead.
The issue with auto insurers like State Farm unilaterally paying reduced rates is that it could leave them vulnerable to legal claims under the PIP statute. Any time a medical provider treats a patient for injuries arising from a car accident, and a PIP insurer pays less than what is allowed, medical providers can sue the insurer for the balance under the state’s PIP law, no matter how small the amount.
Because of the prevalence of car accidents in South Florida, especially in Fort Lauderdale, Miami, and other areas throughout Broward and Dade counties, PIP lawsuits are commonplace in local courthouses.
While you won’t find many personal injury attorneys defending State Farm, it is certainly a valid concern that PIP patients injured in car accidents are charged reasonable a rate. PIP insurance only extends a maximum of $10,000 in coverage, and this small amount of benefits can be exhausted after just a single visit to the emergency room, leaving many injured drivers without any coverage to seek much-needed additional care.
One may also wonder how accurately State Farm discloses their billing preferences as well!
For more discussion on this topic or any other, feel free to contact the Schulman Law Group at (954) 349-3300, or at info@www.schulaw.com
