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Wednesday October 22nd 2014

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Viewpoint: Bare Knuckle Politics Leaves No-Fault Consumers Defenseless

Guest Viewpoint from Robert Heath:
Suppose that you are stopped at an intersection, minding your own business, when you are suddenly hit from behind by another car whose driver was texting at the time. You’re shaken up but get out to inspect the damage. The police come and ask if you want to call an ambulance and go to the hospital. Even though your back and neck are hurting and you have a terrible headache, you decline and decide to go home and lie down, thinking that you’ll be better in a few days. Over the next several days, the pain gets a little better but doesn’t go away and you’re debating whether to go get “checked out.” A week goes by and the pain is still there, so you decide to call your doctor for an appointment. His schedule is busy so you can’t be seen until the following week, fifteen days after the accident. By then you’ve noticed a tingling in your left arm and you report that to your doctor. He orders some x-rays and, unsatisfied, an MRI and other tests to determine whether you have nerve damage.

The bills total $3,850.00 but you are not concerned. You have personal injury protection (PIP) insurance – that insurance that Florida law requires you to buy. You’re covered, right? Wrong.

Suppose that you are aware that you are injured and elect to see the chiropractor that has treated you for the past twenty years who can get you in this afternoon. No worries, you have $10,000 of mandatory PIP coverage, right? Think again.

What if you decide to make a claim for your PIP insurance benefits but the insurance company demands that you appear at their attorney’s office, without an attorney of your own, orders you to bring copies of your tax returns and medical records for the past ten years and then grills you for three hours under oath about everything from your sex life to your last gynecological exam. You don’t have to put up with that just to get your medical bills paid, do you? Sorry.

Welcome to the Auto Insurance Company Relief Act of 2012.

That’s not what it’s called officially, but that is still the effect of the “reform” bill passed by the Florida Legislature late in the night on the last day of the session.

No Fault Auto Insurance was created in 1971 to provide payment of medical expenses and lost wages to Floridians regardless of whether the accident was their fault. It requires each and every car owner to purchase a minimum of $10,000 of insurance and to show proof of insurance coverage when renewing the vehicle’s license each year. The Florida Supreme Court has said time and time again that the law was designed “to provide swift and virtually automatic payment so that the injured insured may get on with his life without undue financial interruption.” When the insurance company failed to do so, the policyholder or his doctors, could sue the company and, if it was determined that the insurance company wrongfully denied the benefits, require that the company pay the claimant’s attorney’s fees. That was before Governor Rick Scott and the Legislature decided to help out the insurance industry.

Over the past several years, fraudulent insurance claims have increased in areas such as Miami, Tampa and, recently, Orlando. The problem has become so pervasive in South Florida that insurance rates have gone up as a result across the state. It is a legitimate concern for lawmakers to address. However, instead of beefing up funding for law enforcement to fight these criminals, the Governor and the leaders in the Legislature seized upon the opportunity to eliminate the “fraud tax” by completely gutting the benefits available to the honest, legitimate claimants they claim to be concerned about and delivering the insurance industry its fondest wish list.

Now, despite the fact that you are truly injured and your claim is completely legitimate, if you don’t get to a doctor, hospital or urgent care center within 14 days, you have no insurance coverage. Unless your injury is extremely serious, you will only get $2,500 in insurance coverage, not the $10,000 you paid for. Although massage therapy or acupuncture may be beneficial to you and your preferred method of treatment, it’s not covered. And, yes, you still have to show up to be grilled by the insurance company’s lawyer. If you don’t, you have no coverage. If you are a doctor, you won’t get paid if your patient, or in some cases your patient’s passenger, refuses to attend. You won’t even know if the insurance coverage has run out unless you file a lawsuit because the Governor doesn’t think that’s important information for you to have.

What began as an effort, at least in the Florida Senate, to draft a law that dealt strictly with the fraud issues eventually became a dream come true for insurance companies in the waning days of the legislative session thanks to immense pressure from the Governor, Lt. Governor, House Speaker Dean Cannon and Senate President Mike Haridopolos. Undoubtedly, the $100,000 contribution by United Auto Insurance Co. to Gov. Scott’s political action committee two days before the vote got the Governor out of his chair. Those that resisted were snatched aside and threatened with vetoes of their bills or other bare knuckle political moves that would send their political careers into oblivion. The intimidation worked. The Senate caved in at 9:30 p.m. on the last day of the session and passed the bill by one vote. Florida consumers lost.

The one thing they didn’t change? You still have to buy $10,000 worth of insurance, although it’s unlikely you’ll ever qualify for those benefits.