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PIP Fraud: The Insurance Fraud that affects all Florida drivers

Personal injury protection insurance (PIP) fraud has a direct impact on all motorists in Florida. It also places a huge burden on the viability of the insurance industry, which is forced to counterbalance by increasing premiums. A few bad apples ruin the experience for everyone by lodging fake medical claims under PIP law.

A typical scheme benefits a crooked attorney, a runner and a doctor. The runner offers to help the accident victim receive treatment. Once the insurance company releases payment, the victim may be offered little or no money from the payout. Personal injury lawyers who file a fraudulent claim against the victim’s insurance provider often obtain a sizable share from the cash payment.

Impact on drivers

Auto insurance providers in Florida have been forced to raise rates for a number of years as they grapple with the impact of the scourge. The Florida Office of Insurance Regulation reported that this type of crime cost insurers nearly $1 billion between 2010 and 2012. This figure translates to an increase of almost $250 in automobile insurance per household.

The impact of PIP fraud is also felt by Florida drivers in the form of stricter regulation. The accident reporting and compensation claims process comes with stringent requirements that place a huge burden on bona fide claimants. The law requires accident victims to report any injuries within two weeks.

Treatments must be administered in a medical emergency setting. A referral is needed for all follow-ups related to the treatment. The follow-ups should be consistent with the initial diagnosis. In the event that a victim is not diagnosed with an emergency medical condition, the PIP is reduced to $2,500 from $10,000.

Questionable claims

According to actuarial studies, the stringent PIP claims requirements have contributed to a significant decrease in fraud cases. Medical practitioners found guilty of taking part in fraudulent claims are stripped of their medical license for a period of five years. In addition, they are prohibited from reimbursing a PIP claim for up to 10 years.

Despite efforts to minimize the impact on legitimate claimants, the crackdown still hurts more Florida drivers than criminals. Motorists are urged to make an appointment with a physician and report injuries immediately after the accident. Requesting a comprehensive evaluation that covers a wide variety of relevant procedures makes it easier to prove that the claim is valid. Some of the relevant tests include X-Rays, MRIs and bone scans.

For more detailed information on automobile insurance please contact us at The Marcus Group. We can be found online at www.myflainsurance.com or reached directly at (954) 721-1180.