When an insurance company denies a policyholder’s Delray Beach personal injury protection (PIP) claim, their medical care provider is not paid. This creates a problem for the facility or care provider. A Delray Beach personal injury protection (PIP) lawyer from our team can help you seek the payment you need for your services.
A PIP attorney from Ged Lawyers can help you fight the denial and seek the money owed to you. Our team provides free initial case consultations for medical providers and healthcare facilities. We handle these cases so doctors and administrators can focus on their job while we pursue the payout they deserve.
Trust Your Case to Our Delray Beach Personal Injury Protection (PIP) Attorney
At Ged Lawyers, we do not handle PIP cases until after a denial. To this end, our legal team only represents doctors, other medical care providers, and healthcare facilities in these cases. We fight for those who treated patients with car accident injuries who now struggle to get the money they deserve for the services and care they provided.
Our attorneys are proud of the wins they can secure for our clients, including a long list of case results showing our ability to deal with insurers and recover appropriate payouts for our clients.
Representation generally occurs on a contingency-fee basis. We do not ask clients to pay us upfront for legal services. This makes it easier to hire our team and let us go to work for you. We will answer any questions you have about this process during your free initial consultation.
How Can Our Delray Beach Personal Injury Protection Attorney Help You?
When patients hurt in crashes require immediate care for traumatic injuries in Palm Beach County, they generally receive ambulance or medevac transportation to one of the county’s trauma centers:
- Delray Medical Center
- St. Mary’s Medical Center
For less serious injuries, they might see a private physician, go to a walk-in clinic, visit urgent care, or walk into the emergency department of another hospital. If they receive care within the time set by the state’s no-fault laws, 14 days, their care should be covered. However, our team knows this does not always go smoothly. This is why we are here to help you.
We Can Determine the Reason the Claim Was Denied
We can get to the bottom of why the PIP provider denied the claim and help you challenge the denial. Some possible reasons for a claim denial include:
- They say the policyholder waited too long to see a doctor
- They believe the prescribed services or charges are unreasonable
- They demand an independent medical examination
- They request an examination under oath of the care provider or policyholder
- They accuse the policyholder or care provider of misrepresenting the injuries
Any of these allegations from the insurance company could be false. They might have missing information, misinformation, or other problems that lead them to deny a claim. Alternatively, steps could be taken to prevent the denial from occurring, such as participating in an examination under oath.
Our team will formulate a plan and discuss how we will approach the insurer, demand fair compensation, and sue if necessary to recover the money you deserve based on the services provided.
Florida’s PIP Laws Leave Medical Care Providers Waiting for Compensation
Like 11 other states, Florida recognizes no-fault auto insurance laws. These unique statutes require all drivers to carry personal injury protection (PIP) coverage that will pay for their basic expenses after a crash. Florida Statutes § 627.736 outlines how this system works in the state.
Generally, all Florida drivers must carry $10,000 in PIP coverage. This policy is meant to help them get their medical care and lost income paid for quickly after a collision. The doctor files the policyholder’s claim, and the insurance carrier pays the medical care provider directly. At least this is how the process should work.
The insurer should submit a payment that covers the policyholder’s accident-related injuries, including:
- Emergency department assessment
- Ambulance transportation
- Surgery or other treatment
PIP policies cover more than just the policyholder. In addition, those who can file claims based on these policies include:
- Other occupants in their vehicles who do not have their own policies
- Family members living in their homes who do not have their own policy
- Their children
- Pedestrians and bicyclists were hurt in a crash caused by the policyholder
Only if they suffer injuries deemed “serious” under state law can a crash victim pursue a fault-based injury claim and bypass the PIP policy.
What Is the Timeline for a Delray Beach PIP Denial Case?
Per Florida Statutes § 627.736, there are several deadlines parties must meet as a part of the PIP payment process. First, policyholders and others hurt and covered by a PIP policy must see a doctor within 14 days of the collision. Failure to do so will mean the insurance carrier can—and likely will—deny the claim.
Next, the insurance company must pay medical bills quickly. They have up to 30 days from the date of claim submission to pay it or send a denial notice. When the doctor or policyholder submits the bill for a covered loss, the insurance carrier must act quickly.
If the PIP insurance provider does not pay the medical care provider within 30 days of the written notice of a covered loss, a lawsuit is possible. The facility, clinic, or doctor can proceed with filing a case against the insurance company and demanding fair compensation.
Connect With Our Delray Beach PIP Lawyers Today for a Free Case Review
If you are a medical provider assigned to a PIP patient whose insurance carrier denied their claim, our attorneys from Ged Lawyers will review your case with you for free today. We know how to challenge denials and sue insurance companies when necessary to help recover the money owed to you.
Contact us online or over the phone for your free initial consultation.