What to do after a Florida car accident is confusing; however, in about six more weeks, it will be even more confusing because the new Florida No-Fault (Personal Injury Protection) law comes into effect. This law puts you at risk of losing the insurance coverage you paid for if you don’t follow its procedure.
As of January 1, 2013, here are a few things you need to know:
- You MUST Treat Within 14 Days of the Accident – If the insured does not “receive initial services and care” within the first 14 days of the accident, there is NO Personal Injury Protection benefits available. So, despite paying for coverage, you can be denied coverage if you don’t see a doctor within two weeks of the accident.
- Initial Care is Limited to Certain Providers. Initial care must be provided a medical physician, osteopathic physicians, a dentist, a chiropractic physician, or a hospital or in a facility that owns, or is wholly owned by, a hospital. You no longer get to pick the type of doctor you want.
- Follow Up Care is Limited to Initial Diagnoses. If the condition is not included in the initial diagnosis (“consistent with the underlying medical diagnosis rendered” on the initial care), the carrier is not responsible to provide PIP benefits for treatment for the condition.
- “Emergency Medical Condition” is Needed for $10,000.00 in PIP Benefits. Without an “emergency medical condition,” the carrier is only responsible for payment of $2,500.00 in PIP benefits (although you paid premiums for $10,000 in coverage). An “emergency medical condition” is defined as “a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:
- Serious jeopardy to patient health;
- Serious impairment to bodily functions.
- Serious dysfunction of any body organ or part.
- Only Certain Providers Can Diagnose an “Emergency Medical Condition.” Only a M.D.; D.O.; M.D. or D.O. physician assistant; dentist; or A.R.N.P can determine that an injured person sustained an emergency medical condition. Chiropractors cannot. Thus, if you want to receive the benefits you contracted for, but you have faith in your chiropractor, you will still have to see another doctor in order to be entitled to the $10,000 of benefits you paid for.
- PIP Benefits Will be Limited to $2,500 Without an Emergency Medical Condition. If the injured person is not diagnosed with an emergency medical condition by the mandated type of provider, PIP is only responsible to pay up to $2,500.00 in benefits.
- Only Initial Diagnoses Are Covered. If the condition is not included in the initial diagnosis, the carrier is not responsible to provide PIP benefits for treatment for the condition. SO, if the shoulder problem pops up one month later after the neck injury calms down with care, your insurance company is not required to pay benefits for the shoulder injury even if it is clearly related to the automobile accident.
- No Massage or Acupuncture. The PIP carrier is not responsible for any payment of any massage (manipulation of the soft tissues of the human body with the hand, foot, arm, or elbow, whether or not such manipulation is aided by hydrotherapy, including colonic irrigation, or thermal therapy; any electrical or mechanical device; or the application to the human body of a chemical or herbal preparation) or acupuncture (Acupuncture shall include, but not be limited to, the insertion of acupuncture needles and the application of moxibustion to specific areas of the human body and the use of electroacupuncture, Qi Gong, oriental massage, herbal therapy, dietary guidelines, and other adjunctive therapies, as defined by board rule).
What gets me the most is that the law has specifically written in it a provision that states that the insurance policies do NOT have to be rewritten and notice doesn’t have to be given to you despite that the fact that you paid for certain coverage after a car accident. The new law states that PIP changes pertain to all PIP policies and the carriers do not have to amend the policy language or expressive notify providers, claimants or insured on order to implement and apply the changes.
These new changes will impact you, your family and your friends after a car crash and the insurance companies don’t have to tell you about it. So, education is so important or you will lose the insurance coverage you were required to pay for after a car accident.
If you have questions about your rights after a car accident (now or after the new law becomes effective), contact Personal Injury Attorney Matthew Noyes for a free consultation. Attorney Noyes’ Clearwater personal injury law firm – Perenich, Caulfield, Avril & Noyes – has been caring for client after automobile accidents, motorcycle crashes, and other personal injury matters since 1955. As one of the oldest personal injury law firm in Tampa Bay, Attorney Matthew Noyes and his staff can help. Contact him today at 727-724-7853 or simply click here to schedule a free case consultation.