The 2012 Florida legislative session resulted in several meaningful changes to t he Florida No-Fault (PIP) law.

The changes generally make it more difficult for an injured person to qualify for the same PIP benefits that used to be availabl e. Most of the changes take effect on January 1, 2013. A summary of the signifi cant changes is as follows: 1. “Use it or Lose it” – 14 days

An accident victim has to obtain medical treatment within 14 days of the date of the accident or there is no PIP coverage for any medical benefits. This means that if you think you might get better on your own and decide not to go to the d octor for a few weeks, you will not be entitled to any PIP coverage for medical bills. This is true even though you paid money for PIP insurance. This is a huge change in the PIP law since there was no time limit in the old PIP law. In addition, your first visit to a doctor must be at a hospital or emergency tra nsport, or by a medical doctor, osteopathic physician, chiropractor or dentist. Massage therapy and accupuncture are no longer covered by PIP. 2. Medical Coverage is limited to $2,500.00 instead of $10,000.00 unless you have an “Emergency Medical Condition” The old PIP law granted $10,000.00 in PIP coverage for medical bills. The new PI P law changes this by creating 2 different categories of injured people. One cat egory of injured people is limited to $2,500.00 in medical coverage. The other category is limited to $10,000.00 in medical coverage. The categories are as fol lows: Category #1: If a person has an “Emergency Medical Condition,” the injured person is entitled to $10,000.00 in PIP medical coverage. An “Emergency Medical Condition” is defined as A medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical atten tion could reasonably be expected to result in any of the following: A. Serious jeopardy to patient health; B. Serious impairment to bodily functions; C. Serious dysfunction of any bodily organ or part. A chiropractic physician cannot make the determination that a person has an “Emerg ency Medical Condition.” Category #2: If a person does not have an “Emergency Medical Condition,” the injured person is on ly entitled to $2,500.00 in PIP medical coverage. 3. Follow up care must be Consistent with the Initial Diagnosis

If an injured person is in Category #2 such that PIP coverage is limited to $2,5 00.00, any follow up care must be “consistent with the initial diagnosis” in order t o be covered by PIP. This means that if you are diagnosed with low back pain – an d no other problems – during your initial office, any complaints of headaches, sho ulder pain or something other than “low back pain” at a follow up visit will not be

covered by PIP since it is not “consistent with the initial diagnosis.” 4. PIP Death Benefit is $5,000.00

The new PIP law offers $5,000.00 in death benefits. 5. Miscellaneous

The new PIP law changes the rules about insurance company investigations of PIP claims. In short, under the new law, insurance companies have been given more ti me to investigate any claim they reasonably believe may involve fraud. The insur ance company can also require the injured person to submit to an examination und er oath before any benefits are owed. Another change to the PIP law involves regulation of the billing procedures of d octor’s offices. That is, the “fee schedule” sets forth more clearly the amount of mon ey that a doctor can charge for a particular type of treatment. In addition, bil ling and communications can be made electronically if they are transmitted by se cure electronic data transfer. The new PIP law also regulates the amount that attorney’s can be awarded if they w in a PIP case against an insurance company. Contingency fee risk multipliers ar e not allowed. Also, upon request, a Judge can be required to make written find ings to support the amount of attorney’s fees that is awarded. 6. Legal Thoughts

There is considerable debate in the legal community on whether some of the chang es to the PIP law are constitutional. In particular, the old PIP law contained a limitation as it concerns an injured person’s “right to sue” an at-fault party for pa in and suffering damages. This limitation on the right to sue was generally tho ught to be constitutional given that $10,000.00 in PIP insurance benefits was br oadly available regardless of who was at fault for the accident. The new law is not nearly as broad. It contains a 14 day time restriction to qua lify for benefits. It also reduces the available benefits by 75% in that the be nefits are reduced from $10,000.00 to $2,500.00 in many cases. It may be uncons titutional to limit the “right to sue” when the PIP benefit is only $2,500.00 in PI P coverage. Many lawyers believe this amount of money is insufficient to suppla nt the right to sue, particularly when a single visit to the emergency room afte r an accident can easily absorb most or all of the $2,500.00. The constitutiona lity of the new PIP law will be decided in the Florida Courts. For now, the law has been signed by the governor and it most of its provisions will be in effect on January 1, 2013. Jeffrey D. Starker, Esq., has been an insurance and injury lawyer in Orlando, Fl orida, for over 15 years. Mr. Starker formerly represented insurance companies, and he currently represents people that have been injured in car accidents, mot orcycle accidents, trucking accidents, and many other accidents.