Matt Reed: Rights, payments to change after car wrecks
In case youre ever hurt in a car wreck, you should know about changes the Legislature just made to your auto insurance coverage and your legal rights. Melbourne plaintiffs attorney Steve Charptentier says the bill raises new questions about what qualifies as an emergency medical condition and could cut claims payments for medical treatment by three-quarters in most cases. Meant to discourage fraud, the bill also might increase trips to the emergency room and inspire new lawsuits, he says. Gov. Rick Scott is likely to sign the bill. For the consumer-rights perspective, I questioned Charpentier in an interview that aired Wednesday on WBCC and FloridaToday.com. Excerpts: Question:The Legislature restricted accident coverage through our personal-injury-protection policies, or PIP, and limited the types of doctors and other providers who can evaluate patients. What should policyholders watch for? Charpentier: In the short run, an elimination of certain types of care. Acupuncture and massage are gone. The bill tries to address fraud, and I think it did a pretty good job of that. It talks about a roll-back of insurance rates on the PIP portion of your premium, not to your overall premium. The most important change: If youre involved even in a minor motor-vehicle crash, unless you seek treatment within 14 days from a qualified provider, you get zero PIP. Where I think its a bit unfair, it mandates changes for the consumer but qualifies the changes for insurers. The insurance companies have the option of saying to the state, Look, this isnt working out like we thought we cant afford a rate rollback. Q:To clarify, PIP is our mandatory nofault coverage, meant to ensure we get care? Charpentier: Personal-injury protection coverage was established in 1972. The idea is, regardless of whos at fault, your Advertisement insurance company provides $10,000 in medical coverage. A portion of that could go to wage-loss coverage. Remember, this started in 1972, and its still the same amount. And now you could get less. This bill says that if you dont have a qualified emergency medical condition as determined by a qualified provider, your protection is limited to $2,500. Q:So for an injury that doesnt send you to the hospital right away, but continues to nag you, you get onequarter of your previous coverage? Charpentier: The probability is, from my 31 years of doing this, the vast majority of cases do not qualify as emergency medical care. Most people injured in car crashes will be limited to $2,500 in PIP. And thats assuming that a person whos busy and thinks going to the emergency room would cost them a lot of money it assumes they go within the 14-day window. A lot of my clients over the years have not gone right away. They try to deal with it or think Im young, Ive gotten over everything else. I would suggest, go to the emergency room. That would be my legal advice. That portion of the law takes effect on Jan. 1. Q:The Legislatures goal was to cut down on fraud. Mainly, it seems to cut potential payments to rehab clinics and chiropractors that are still considered legal, not fraudulent. How will it cut fraud? Charpentier: There were certain (players) in the medical community that would exploit the $10,000, and it would be gone. The Legislature thought this was inappropriate and costing Floridians too much money. What concerns me is that the vast majority are legitimate providers and legitimate citizens, and those folks are getting the short end of the stick. Q:The reform bill gives insurance companies the power to question policyholders under oath after wrecks. Whats your take on that? Charpentier: Well, Id like the same opportunity to examine adjusters under oath. Lets make it fair. They have the right, in any lawsuit, to take a deposition under existing law. Thats a statement under oath. And they can take statements Advertisement not under oath. I dont think its fair for a trained insurance company adjuster or lawyer to take the statement, under oath, of a citizen involved in a crash who isnt represented by an attorney. Theyre not on equal footing. The citizen can easily be manipulated to their detriment. Q: The Miami Herald reported that most lawsuits related to personal-injuryprotection have been filed by doctors in payment disputes with insurance companies. Given the new definitions and restrictions, could this bill cause more litigation? Charpentier: Under the new law, I see a lot of areas for litigation. Did they treat within 14 days? Was it an appropriate provider? Was it an emergency medical condition? I m going to hire an expert that says it was. The insurance company is going to hire an expert that says its not.
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