Medical providers and patients in Florida are going to benefit from a December 28, 2018 ruling by Florida’s Supreme Court. The ruling, made in favor of several cases (among them one of LaBovick Law Group’s), addresses the issue of how insurance companies are permitted to apply deductibles to personal injury protection (PIP) medical bill claims.
UNDERSTANDING PIP INSURANCE IN FLORIDA
Florida state law requires all car owners to carry personal injury protection (PIP) insurance. PIP is designed to cover medical costs, as well as lost wages and funeral expenses. PIP insurance is also called “no-fault coverage” because you must use your PIP – even if you are not at fault for causing the accident. PIP is also mandatory in Florida. That means all medical providers must bill PIP first for medical services provided to an automobile accident victim.
APPLYING DEDUCTIBLES TO PIP MEDICAL BILL CLAIMS
Before the Florida Supreme Court ruling, PIP insurers were reducing medical charges by the PIP fee schedule before applying the deductible. They should not have done that. They must use the PIP deductible against 100% of charges. This pays off a greater percentage of the total medical bill and saves the patient money.
This landmark, 7-0 unanimous ruling sets Florida law in a way that helps medical providers and patients going forward. It also means that medical providers and patients are likely to have money owed to them for all PIP claims over the past 5 years. PIP carriers are not going to hand over this money without properly executed documents being filed.
Previously, Florida’s Circuit Courts muddied the waters with regard to how insurance companies were permitted to apply deductibles. Specifically, on February 9, 2018, the Fifth District Court of Appeal (5th DCA) ruled against the insurance companies. Then, a month later on March 14, 2018, the Fourth District Court of Appeal (4th DCA) ruled in favor of the insurance companies on the identical issue. Sadly, the 4th DCA ruling was on the LaBovick Law Group’s case. Had the 4th DCA agreed with the 5th DCA, this matter would have been settled last year.
The Florida Supreme Court took on the case to decide which DCA ruling was correct. December 28, 2018, Florida Supreme Court ruling settled the matter in favor of the LaBovick Law Group. The law firm’s PIP team is celebrating this big win for its clients. “We took this case confidently from winning at the trial level to a close loss at the 4th DCA. We were honored to be a part of the Supreme Court’s decision. This is great for our clients, but it is even better to be a part of something universal that helps every patient and medical provider across the state,” said Brian F. LaBovick, managing shareholder at LaBovick Law Group.
RECOVERING UNPAID OR UNDERPAID PIP BENEFITS
The PIP team at LaBovick Law Group assists Florida medical providers – including hospitals, ER doctors, surgeons, chiropractors, MRI centers, clinics, and physical therapy rehab centers – in recovering unpaid or incorrectly paid PIP benefits. We are experts in PIP automobile accident law. If you are a Florida medical provider who would like help recovering the PIP your medical office deserves, request a free PIP consultation or simply give us a call at (561) 623-3681. Our experienced PIP team knows how to hold insurance companies accountable for unfair, unjust, or improperly calculated PIP reductions. Whether you need help getting your PIP billing and demand process organized and in line, or you need expert, risk-free litigation assistance, the LaBovick Law Group is here to help. Don’t navigate the nuances of PIP billing and collections alone!