Emergency Medical Conditions Under The New Florida PIP Law

An ‘Emergency Medical Condition’ under the new Florida PIP law that became effective on January 1, 2013 is a medical condition that demonstrates itself by severe acute symptoms including severe pain that in the lack of medical assistance could result in:

  • Serious jeopardy to patient health, and or
  • Serious impairment to bodily functions, and/or
  • Serious dysfunction of any bodily organ or part.

What are acute symptoms of sufficient severity?  Does it mean a broken back or neck? Does it impair the individual’s range of motion? Does it limit motor skills?  Can the person walk?  The definition presented under the law is very vague. Since there is no clear definition, then it will be left to the jury to decide if the injured person’s injuries are serious enough to meet the requirement of an “emergency medical condition.”

Another important aspect of this new PIP law is that the “emergency medical condition” must be treated within fourteen (14) days of the injury. Also note that if the incident is not labeled an “emergency medical condition” there is a cap of $2,500.00 for the PIP medical benefit treatment. So, be sure that your medical services provider is aware of this fact before he or she orders expensive medical testing and you have to foot the bill. Also be advised that the full $10,000.00 PIP medical benefit is available only if a physician, osteopathic physician, dentist or a supervised physicians’ assistant or advanced registered nurse practitioner determines that the insured has an “emergency medical condition.”

There are also numerous other changes in the new PIP law effective January 1, 2013. Many of these changes pertain to clinics, which must become licensed and other types of medical services that will no longer be covered such as massage. Only time will tell if the new changes reduce the number of insurance fraud cases and control the spiraling auto insurance rates. One thing is certain though, insurers will likely be paying out $2,500.00 instead of $10,000.00 in PIP benefits to injured parties.

If you have a personal injury claim then you should immediately contact an attorney familiar with the new PIP law to learn about your legal rights.

The Ward Law Group, P.L. has represented countless injured persons with regard to their personal injury claims, quite possibly even someone you know. Most people do not have the experience of resolving a personal injury claim with the at-fault insurance company and are at a decided disadvantage via said insurance company. Our years of experience in assisting personal injury victims allow us to thoroughly investigate your injuries in an expedient and professional manner and document same for presentation to the insurance company. Our goal is to maximize the valuation of your personal injury claim as expeditiously as possible.