If you’re involved in a car accident and are injured, then you’ll need money right away to take care of your medical costs. This is why Florida law requires auto insurance companies to offer a maximum of $10,000 in what’s known as PIP – which stands for personal injury protection. This is to ensure that injured parties are able to get the medical attention they need. As it stands now, it’s possible to get this coverage no matter who’s deemed at fault for the car accident.

In most cases, a PIP insurer must pay for these medical costs within 30 days. This is known as the “prompt payment” requirement and it’s very helpful to people who are injured and to the medical care providers who treat them. However, there are some cases in which medical costs may be extremely high.

If the bill a medical provider presents to an insurance company is excessively high, then there are cases where if the insurer pays a single medical bill, they’re completely exhausting the benefits available in PIP – which means that the person injured may not have the finances and available insurance to get the continuing medical care they need.

Insurance companies have become concerned about this situation, which is they they’re only required to pay medical care facilities and providers what is considered a reasonable sum for provided car. Of course that leaves the question: What is a reasonable sum? There is no short, easy answer to that. In fact, it’s often a jury that makes that decision.

Health care providers and Florida insurance providers have spent years in the legal system arguing over what exactly a reasonable cost is. As a result, Florida lawmakers changed the PIP statute to say that insurance companies can legally limit what they’re paying to 80% of the maximum charges. As a result, health care providers have filed lawsuits against these insurers to try and get the rest of the money for their claims.

In the end, this situation made it all the way to the Florida Supreme Court. There, the Court found that there is a requirement for notice to be presented to the insured party so that their insurance company can restrict their payment if necessary. Insurers have responded by changing the language within their policies.

The hope is that these changes have simplified the process. At Gilbert & Smallman, we know how complicated things can get after a car accident. If you’ve suffered in any type of accident, feel free to reach out to us for a free case evaluation.