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The Yau Law Firm
Focused on Protecting Businesses and Representing the Injured

PIP Benefit Exhaustion May Leave Medical Providers Looking to Patients for Answers

by Stockimages

At the Yau Law Firm, we see many claimants suffering from personal injuries sustained from automobile accidents. Unfortunately, in Florida, personal injuries from car crashes are just too common. Insurance companies know this, and have set up a system where the injured person can receive benefits from a medical provider without paying the upfront costs. This system establishes an agreement between the doctor and the insurance company where the doctor is reimbursed by the insurance company, and the insurance company is reimbursed by the lawsuit against the at-fault driver. But what happens when the doctor is not paid what he feels is fair for the medical care he performed? The answer is not simple, but ultimately the courts have decided that it is not the insurance company’s problem. While this hot topic becomes a common problem in Florida admist the new PIP law reform,  the Yau Law Firm does not want you to have to find out the hard way.

On March 5, 2014, Florida’s Fourth District Court of Appeals held that an insurance company is released of any responsibility to pay a doctor’s bill after the injured person’s insurance benefits have ended (Northwoods Sports Med. and Physical Rehab., Inc. v. State Farm Mut. Auto. Ins. Co.) This is especially important because insurance companies often do not pay the full asking price of the doctor’s services.

Injured claimants are also concerned about how they will be able to foot the bills. Most injured claimants do not have health insurance (and sadly, this remains a problem despite the Affordable Care Act), which means that most injured claimants cannot afford medical treatment. Despite Florida’s No-Fault Insurance laws, which requires auto-insurance companies to pay at least 80% of the medical expenses, this still leaves patients with the remainder 20% of the bill.

At the Yau Law Firm we can prepare for these types of situations by setting up an understanding between the client, the doctor, and the insurance companies. For more information about how car insurance can affect your case, give us a call, or e-mail, if you or someone you know is dealing with this type of situation.

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