Rick Scott's "PIP Dream" Comes True

04/20/2012 10:25 am ET | Updated Jun 20, 2012

Rick Scott declared a holy war against auto insurance fraud when he made it a "top three" priority for his first term as Florida's 45th Governor. I am not sure how, with all of the educational, economic, social and environmental issues plaguing Florida, this even made the top 10 priorities. However, make no mistake about it, the real victims of his crusade are not the hard-working Floridians who he claims are shouldering the burden of a "billion dollars" of insurance scams causing increased auto premiums, but any Floridian who gets injured in a car accident after his new legislation takes hold in January 2013.

Backed by a narrowly passed legislature, Governor Scott has restructured Florida's Personal Injury Protection (PIP) laws in such a way to keep both insurance premiums and insured's benefits in the accounts of those mighty few who insure Florida's drivers.

In Florida all car and truck owners are required to have PIP insurance. PIP was designed to ensure anyone injured in a Florida car accident would have access to medical care and treatment as well as recover lost wages regardless of who actually causes the accident.

I have represented car accident victims across Florida for over 20 years. During my entire legal career Florida's PIP insurance has paid 80 percent of an injured person's medical bills and 60 percent of lost wages up to $10,000 regardless of who or what caused the car accident and where and when they received medical care and treatment. Thanks to Governor Rick Scott, that will all soon change.

Florida's new PIP law will require anyone injured in a car accident who wishes to have their medical bills paid by their PIP insurance, to seek medical care and treatment within 14 days of the accident. And those injured are not free to seek care from just any health care provider for just any ache or pain. Now only medical doctors, osteopathic physicians, dentists, physician's assistants or advanced registered nurse practitioners are approved to for PIP reimbursement, provided that they also find that the injured victim has an "emergency medical condition." The law specifically excludes treatment given by either a chiropractor or acupuncturist.

The new law also has teeth, giving the insurance companies the right to question you under oath about the care and treatment you received and why. These interrogations are referred to as EUOs but they are conducted by insurance fraud adjusters. Curiously, the law does not require that a lawyer be provided to the insured during these interrogations. If the EUO is not enough, insurance companies are not legally permitted to force the injured insured to submit to a physical examination by a doctor of the insurance companies choosing. Ironically, the law refers to these physical examinations at Independent Medical Examinations (IME). Failure to attend an IME can result in having the PIP benefits denied.

Let me illustrate how the law will work: On your drive to work tomorrow you get rear-ended. Thankfully, the injury is not life threatening and you make your way to work. As the day and week goes by the pain in your neck increases. Not wanting to miss work or sit in an emergency room for three days, you hope the pain goes away. It does not. Finally, the following Monday you call your primary care doctor. Her next appointment is a week away, if she will even see you for an accident related injury. Wait till then and your bill will not get paid.

Want to see the chiropractor who helped you a few years back when you had an accident? Your bill will not get paid.

Make it in time to see your primary care doctor who refers you to an orthopedic surgeon but fail to attend the appointment State Farm arbitrarily schedules for you to see their IME doctor at 2:30 p.m. on a Thursday and your bill does not get paid.

What Governor Scott has done with his crafty new PIP law is create a scheme so complex that the average person who is injured with anything less than a broken bone requiring surgery will essentially not receive the care and treatment paid by the PIP insurance premiums he or she is legally mandated to pay. In the end, Florida's new PIP law will keep both the premiums and benefits in the accounts of State Farm and Allstate, while those who suffer anything but the most catastrophic personal injuries will either go untreated or reimbursed.