PIP "reform" bills make it easier for insurance companies to deny plicyholders' claims

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The Senate Banking and Insurance Committee today will hear two bills ?SB 1694 and SB 1930 ?that will significantly alter the laws governing mandatory Personal Injury Protection (PIP) insurance. While both proposals purport to fightPIPfraud, the bills contain provisions that will make it easier for insurance companies to deny policyholders?claims, discourage medical care providers from treating patients injured in auto accidents and limit access to the courts. Similar bills ?HB 967 and HB 1411 ?are also making their way through House committees.

In their current form, these bills will:

?Require physicians and medical care providers to undergo deposition-style questioning (known as Examinations Under Oath or EUOs) by insurance company attorneys before receiving payment.

?Enable insurance companies to enforce new ?rovisions, schedules and procedures?in existingPIPpolicies without making changes to those policies.

?Limit the attorney? fees insurance companies are required to pay when they force a lawsuit and lose.

?Require physicians and other medical care providers to participate in mandatory arbitration prior to litigation and before they can get paid for services already rendered.

?Automatically suspend benefits to policyholders if they are unable to attend an insurance company-mandated EUO.

?Lengthen the amount of time insurance companies have to pay or deny aPIPclaim from 30 to 120 days.

?he claim ofPIPfraud is being grossly exaggerated by the powerful insurance lobby to justify draconian changes to thePIPstatute, which would discourage good doctors from treating car accident victims and make it extremely easy for insurance companies to deny claims without any penalty,?said Cris Boyar, President of Floridians for Fair Insurance. ?hile we agree we should fight fraud, there is no reason to support these proposed laws sincePIPinsurance is very inexpensive and the insurance industry is raking in record profits. Additionally, there is no shortage of insurers fighting for new business.?/span>

On Mar. 23 before the House Civil Justice Committee, Rep. Matt Gaetz, R-Fort Walton Beach, attempted to amend HB 967 to ensure the bill contained true fraud-fighting measures. Instead, the Legislature used procedure to prevent the amendment from being presented and to avoid the real issues related toPIPfraud.

If presented and passed, Rep. Gaetz?amendment would have:

?Required that law enforcement officers investigating a motor vehicle crash complete a Florida Traffic Crash Report, Long Form.

?Expanded the statutory definitions related to ?linics?to include other licensed practitioners beyond physicians and close a loophole that has led to huge growth in the number of unlicensed clinics.

?Made it a criminal offense to submit a false, misleading or fraudulent health care clinic application.

?Increased civil penalties for those who commitPIPfraud.

While HB 1411 and SB 1930 still include several onerous provisions, both bills do contain many of the good anti-fraud measures outlined in the proposed amendment by Rep. Gaetz.

During the Mar. 23 House Civil Justice Committee meeting, Rep. Gaetz said this of his amendment, ?t attacks fraud with an X-ACTO knife and it? doesn? put us in a situation where we?e killing a mosquito with a sledgehammer.?/span>


Peter Schorsch is the President of Extensive Enterprises and is the publisher of some of Florida’s most influential new media websites, including SaintPetersBlog.com, FloridaPolitics.com, ContextFlorida.com, and Sunburn, the morning read of what’s hot in Florida politics. SaintPetersBlog has for three years running been ranked by the Washington Post as the best state-based blog in Florida. In addition to his publishing efforts, Peter is a political consultant to several of the state’s largest governmental affairs and public relations firms. Peter lives in St. Petersburg with his wife, Michelle, and their daughter, Ella.