By: Carol Gentry
Health News Florida
blasting it as anti-consumer and anti-doctor, a House
justice panel nevertheless approved a PIP reform bill
today so that the effort to fight auto-accident fraud
Members of the House Civil Justice Subcommittee voted for CS/HB 119 after its sponsor, Rep. Jim Boyd, assured them that he would make major changes to the bill before it gets to the floor.
The bill, which would create a whole new system for auto-accident coverage, would require treatment to take place within 72 hours and only in a hospital emergency room -- a provision that even the bill's supporters warned would overwhelm ERs and lead to unnecessary costs.
Boyd, R-Bradenton, said his main concern is the relentless rise in auto-insurance premiums to cover the soaring cost of Personal Injury Protection coverage. PIP, required for all drivers, covers up to $10,000 in treatment after accidents, regardless of who is at fault.
Boyd said PIP has led some unscrupulous lawyers and clinics to stage accidents, fake injury claims and charge for unnecessary scans and treatments. PIP premiums have soared in Florida, state agencies are reporting, and four Florida cities made a top-10 list for stage accidents and insurance fraud put out by the industry.
Members of the panel agreed with Boyd about the severity
of the problem.
“We are the only thing that stands between ...organized crime and Florida policyholders,” said Rep. Bill Hager, R-Boca Raton.
Last month, the state's Insurance Consumer Advocate
issued a report
that called PIP fraud in some areas of the state
"pervasive" and said it imposes a fraud tax on consumers
of nearly $1 billion a year.
With Boyd’s promise, Rep. Matt Gaetz, who had called parts of the bill “indefensible,” agreed to withdraw two major amendments.
One would have wiped out the section of the bill that limits attorney’s fees in PIP cases for the driver, but not for the insurance company. Several members of the justice panel said they felt that was grossly unfair.
Gaetz also wants to kill the part of Boyd’s bill that allows expanded “examinations under oath,” in which insurance-company lawyers depose policyholders and health-care providers at great length in a fashion that Gaetz said could be threatening and intrusive.
A parade of attorneys from around the state, especially the Orlando area, testified at the subcommittee hearing that insurers are already using the depositions to intimidate policyholders and those who provide treatment into accepting lower payments than they are entitled to. The bill would make it worse, they said.
The issue is extremely complex, filled with
mind-boggling jargon such as “contingency-risk
multipliers,” and pits the insurance industry against
the trial bar and some medical groups, especially those
who represent chiropractors, acupuncturists and massage
The bill’s first stop was the House Insurance and Banking Subcommittee, which substituted its own language and passed it on Jan. 11. In addition to the Civil Justice Subcommittee, it was assigned to Economic Affairs.
Senate leader Joe Negron has introduced a bill that would allow patients to be treated either at hospitals or doctor-owned clinics, but rules governing the clinics would be tighter. Penalties for fraud would be heavier.
Negron's bill would set new fee schedules on four types of treatment that often lead to a court case.