Changes in Florida No Fault Insurance Law Affects Right to Treatment

Prior to January 1, 2013, Florida’s No-Fault Law stated if a person was injured in an auto accident, they were entitled to receive up to $10,000 in medical treatment through the Personal Injury Protection (PIP) Coverage on their auto insurance policy.

Last year, the Florida Legislature passed substantial changes to Florida’s No-Fault Law, that went into effect on January 1, 2013. One of these changes specifically states that if you have been injured in an auto accident, you must seek treatment within 14 days of the accident – otherwise you are not entitled to receive PIP coverage. In other words, if you decide to seek medical treatment more than 14 days after the accident, you will have to pay for the treatment out of your own pocket or use health insurance to pay for the treatment. Oftentimes, a person doesn’t realize that they have suffered a serious injury as a result of an accident until weeks or even months after the accident. They take Tylenol or Advil and hope that the aches and pains will just go away. The 2013 change to the No-Fault (PIP) law now punishes people for not rushing to a doctor.

Another dramatic change to the statute requires that a person injured in an accident to be diagnosed with an “emergency medical condition”, in order to be eligible for the full $10,000 in PIP benefits. An “emergency medical condition” is defined as a medical condition that manifests itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to patient health, serious impairment to bodily functions, or serious dysfunction of a body organ or part. If the person is not specifically diagnosed with an “emergency medical condition”, the person is only entitled to receive up to $2,500 in PIP coverage. The diagnosis of an “emergency medical condition” must be made by a physician, osteopathic physician, dentist, physician’s assistant or advanced registered nurse practitioner. The determination or diagnosis of an “emergency medical condition” may not be made by a chiropractor.

One other change in the new law that may affect quite a few accident victims is a provision that prohibit payments for massage therapy and acupuncture. Even if your physician or chiropractor prescribes massage therapy or acupuncture, insurance companies will not be required to pay for those treatments under PIP coverage.

If you, a friend or loved has been involved in an auto accident or is involved in an auto accident in the future, it is important to be aware of these changes in the No-Fault (PIP law). You MUST seek treatment within 14 days of the accident and you MUST be diagnosed with an “emergency medical condition” in order to recover the full benefits under the PIP portion of your policy, for which you have paid hefty premiums.

If you have any questions or concerns about the changes in the No-Fault law and how it affects your treatment and injuries from an accident, please contact our office immediately at (800) 443-4LAW or www.SmithVanture.com