Florida is one of only 12 states in the U.S. to have no-fault auto insurance. Rather than use personal injury law to determine which party is negligent, injured parties file a claim against the insurance company to receive compensation for lost wages, medical bills, and hospitalization.
PIP law in Florida mandates that motorists pay $10,000 in first-party personal injury protection coverage. While there are special cases where injured parties may sue for additional damages, the law is designed so that insurance companies can pay out these basic, no-fault claims simply, without litigation. In fact, the law allows injured parties to sign over their medical bills so that medical providers can collect directly from the insurance company. What could be easier?
Unfortunately, insurance companies don’t always comply. When they refuse to pay healthcare providers for services rendered after an auto accident, GED Lawyers can help. We specialize in providing PIP representation to medical providers and the facilities where they treat patients, ensuring that our clients receive the compensation they deserve.
What Types of Doctors Do GED Lawyers Represent?
Florida Statute 627.736, section (5)(a) explains that the PIP insurer “may pay [medical expenses] directly to such person or institution lawfully rendering such treatment if the insured receiving such treatment or his or her guardian has countersigned the properly completed invoice, bill, or claim form approved by the office upon which such charges are to be paid for as having actually been rendered, to the best knowledge of the insured or his or her guardian.”
In other words, the law is set up so that insurance companies make direct payments to medical providers and facilities. PIP coverage pays for the following medical expenses:
- Medical bills
- Cost of surgery and hospitalization
- Rehabilitation
- Ambulance services
- Prescription medicine
Thus, a broad range of doctors and other medical providers are “PIP doctors,” including:
- General practitioners
- Surgeons
- Emergency medical staff
- Dentists providing emergency care
- Physical therapists and physiatrists
- Hospitals
- Rehabilitation clinics
- Other medical clinics
If you’re a medical provider having difficulty recovering payment after providing treatment to an automobile accident victim, you’re entitled to seek representation under the law. GED Lawyers works on a 100% contingency basis to get you the compensation you deserve.
What Happens if Payment Fails To Occur?
Florida Statute 627.736 establishes a clear timeline within which insurance companies must either pay up or reject either all or part of the claim. Section (4)(b) states that “Personal injury protection insurance benefits… are overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same.”
If the PIP insurer hasn’t paid the bill within that 30-day period, doctors and medical facilities can proceed with filing a lawsuit against the insurance company.
There are two possible types of nonpayment responses from the insurance company. First, the insurer may reject either an entire or a partial claim, in which case, it needs to provide itemized documentation.
Common reasons PIP insurers may reject a claim are as follows:
- The claim was reduced due to an alleged usual and customary charge, i.e., they deemed the charge “unreasonable” under the law.
- The claim was denied based on an independent medical examination cutoff.
- The claim was denied for failure to appear at an examination under oath.
- The claim was denied based on allegations of material misrepresentation.
The second type of nonpayment occurs when an insurer simply fails to respond to the claim within the specified time frame. If that happens, the insurance company may be guilty of acting in bad faith, subjecting itself to additional litigation and extra payments.
The Settlement Demand Letter
When the insurance company either denies a claim or makes a partial payment, you or your legal representative need to respond with a demand letter. This document claims that you’re entitled to more money than the insurance company initially offered. Writing a demand letter for settlement is a necessary step that you take before filing a court action, and it can serve as a pre-trial notice.
The settlement demand letter must be sent via certified mail to the special PIP demand address and drafted according to stipulations laid forth in Statute 627.736. The insurance company has 30 days from the date of receipt to respond to the demand. If it agrees to pay, the insurance company will also owe a statutory interest payment and a penalty of 10% above the outstanding amount.
Who Pays the Legal Fees?
Although GED Lawyers accepts PIP representation cases on a 100% contingency basis, ultimately there is the question of who pays the fees pursuant to legal action. Fortunately, we make sure that insurance companies are responsible for the legal fees, even if we have to go back and do a five-year audit to check for discrepancies in the statutes of limitations.
GED Lawyers Gets Results
Lawmakers designed personal injury protection in the Sunshine State to make it simple for injured motorists to receive swift benefits without needing to file a lawsuit. Whether or not a motorist is at fault, they’re entitled to receive up to $10,000 to help defray the cost of injuries and lost wages. Moreover, they are able to sign over the responsibility for collecting payment to their medical providers.
Unfortunately, the cost of convenience may translate into lost income for doctors and medical facilities if PIP insurers refuse to pay.
At GED Lawyers, we are dedicated to providing PIP representation to medical providers—it’s what we do. Fully 85% of our legal team and support staff specialize in this area, and we have recovered millions of dollars in lost PIP payments for our healthcare provider and medical facility clients.
Headquartered in Boca Raton, Florida, GED Lawyers has offices conveniently located throughout the Sunshine State, and we are ready to speak with you whenever you’re ready. We are always client-centric and have invested in proprietary technology that makes it easy for our clients to log into the portal and see the status of their case at a glance. Contact us toll-free at 844-443-3529 or locally at 561-995-1966 and let us know how we can help.
