The car insurance industry in Florida works differently than in other states. Florida is a rare, no-fault state. What that means for drivers is that their own Florida car insurance pays for their injuries. They can’t jump to a third-party claim or a lawsuit based on bodily injuries.
For medical providers, patients who are car accident victims go through first-party claims. You’ll bill the victim’s health and auto insurance providers. Fingers crossed—the insurance companies will pay quickly. But we know you might run into trouble recovering compensation. When your bill is wrapped up in a car accident case, contact GED Lawyers for help.
Florida Auto Insurance Laws
No-fault insurance in Florida means drivers must have at least $10,000 in personal injury protection (PIP) insurance and $10,000 in property damage liability insurance.
During a car accident PIP claim in Florida, the crash victim communicates with their insurer. The payout they receive is based on Florida law and the policy language. PIP covers 80% of all necessary and reasonable medical expenses and 60% of lost income up to $10,000. The insurer pays you directly for the care you provide while paying the victim for their lost wages.
There are benefits to going through a first-party claim instead of a third-party claim. Your patient has a direct contractual relationship with their insurance company. If the insurer doesn’t uphold the contract, the patient (and your practice) may have a claim for bad faith.
What Does PIP Cover?
PIP coverage is helpful. Neither you nor your patient have to worry about proving fault before an insurance company pays. The whole point of PIP insurance in Florida is that it covers medical expenses without worrying about who caused the crash.
But the PIP insurance system in Florida is far from perfect. Your patient’s PIP insurance covers some of your fees—not all. It explicitly pays up to 80% of reasonable and necessary medical expenses. The other 20% is the patient’s responsibility.
If your patient has health insurance, you can bill that provider, as well. Or the patient will have to go after the at-fault driver for more compensation.
There’s also the policy limit to consider. The $10,000 limit includes payments for your patient’s lost income, which reduces how much is slated for medical bills.
The Difference Between Fault and No-Fault Insurance Laws
When someone’s hurt in a crash, Florida personal injury law dictates they file a claim against their PIP insurance for help. That’s different than most other states, which have fault-based car insurance systems. A car crash victim pursues compensation through a third-party claim.
In fault-based states, the accident victim’s financial recovery depends on another person’s insurance policy. Motorists often have to carry a minimum of between $15,000 and $25,000 in bodily injury liability coverage.
You’ll notice most states require more bodily injury liability insurance than Florida’s PIP minimum. Unfortunately, Florida’s minimum requirement is fairly low, making it harder for medical providers like you to recover their costs fully.
Car Accident Lawsuits
Car accident victims often wonder when and how to file a lawsuit after a car accident. If your patient’s injuries lead to damages worth more than their insurance policy, they have the right to sue the at-fault driver. For example, serious injuries could easily lead to tens of thousands in medical bills. The at-fault driver is responsible for those. Your patient can also sue after suffering a serious, permanent injury.
In either of these situations, you’re probably owed compensation for the medical care you provided. There are ways to make sure you get paid. Talk with an experienced car accident lawyer at GED Lawyers. We have years of experience helping medical providers recover expenses after handling a serious car accident case.
Another situation where you’re left waiting for payment is if the patient’s insurance company wrongfully denies their no-fault accident claim or refuses to pay your invoices. Sometimes insurers have valid reasons for denials, but more often than not; the insurance company is hoping to save some money.
Most likely, you had your patient sign an Assignment of Benefits (AOB). If you haven’t yet, talk with GED Lawyers about this. An AOB is crucial if you need to take matters into your own hands.
Through an AOB, you have the same rights the patient has concerning their insurance coverage. Instead of waiting for your patient to file a lawsuit against their auto insurance provider, you can file a PIP suit.
What to Expect From PIP Insurance Providers
You wouldn’t be the first medical practice to have problems with a PIP insurance provider.
The insurance company might:
- Fully deny your patient’s claim
- Approve the patient’s claim but refuse to pay all or specific medical bills
- Deny one or more invoices by claiming a treatment wasn’t reasonable and necessary
- Unreasonably delay payment
- Try to negotiate the bills down
When an auto insurance company gives your practice trouble, call GED Lawyer for help. We’re highly experienced PIP lawyers who represent both car accident victims and medical providers. We can begin by reviewing your billing records related to your patient’s case. There may be minor issues to correct before an insurer pays.
Most importantly, we can gauge your likelihood of success. We evaluate why the insurer is denying your invoices and whether or not we can correct or appeal the issue. When necessary, we can represent you in a PIP suit.
Call Our Florida PIP Lawyers Today
Caring for patients injured in car accidents can be challenging. But at the end of the day, you give them the best care possible without regard for the cost. You should be able to rely on the insurance system. When that doesn’t happen, reach out to GED Lawyers to discuss your options.
We have offices throughout Florida. Our headquarters is in Boca Raton, and you can reach us at 561-995-1966 or through our online form.