Florida PIP Suit Attorney for Medical Providers

Posted by Daniel BottariSep 05, 20210 Comments

PIP SUITS

Are you a Florida medical provider that treats patients injured in car accidents? If so, many of your bills are getting denied or reduced by insurance carriers. At Bottari & Doyle, our attorneys work hard to get you paid. There is no upfront cost to you. We file PIP suits on behalf of medical providers throughout the state of Florida. We make this process as easy as possible for you, and we are able to audit your files to see which claims have been denied by the insurance carriers. We represent chiropractors, orthopedists, neurologists, and diagnostic facilities. Our goal is to get you paid every penny. Please call us at (561) 588-2781 for a free consultation. Even though our physical address is in South Florida, we are able to travel to you for a consultation. Please read below for more information about the PIP demand and PIP suit process. Our attorney's fees are paid by the insurance carriers, not you. 

Since the PIP Repeal Veto by Governor Desantis, we are seeing more denials on claims that had previously been paid by carriers. Contact Us for a free audit. 561-588-2781.

What is a PIP Suit? 

A pip suit is abbreviated for PIP lawsuit. If the insurance carrier, Allstate, Geico, State Farm, Progressive etc. chooses to not pay your bill, then we will file a lawsuit against the carrier. The statute of limitations for a PIP lawsuit in Florida is generally five years from the date of serviceyears from the date the claim is overdue.  This is because a PIP lawsuit is filed for breach of contract.  The insurance carriers owe you money for interest on any overdue bills.  Pursuant to 627.736 (4b), an insurance carrier has 30 days to pay the bill from the day of receipt.  After that day, the bill is overdue and you are owed interest. The interest rate is set by Florida's Chief Financial Officer.  As of the date of this article, September 12, 2021, the interest rate on overdue bills is 4.25% per annum. 

We will not waive interest at the request of pip defense attorneys. We try to obtain all of the money that is owed to you and that includes interest. 

What is a PIP Demand? 

After your bill gets denied, reduced or remains unpaid, we send a demand letter to the patient's insurance carrier. The demand letter gives the insurance carrier one last opportunity to pay your bill. If the carrier does not pay your bill within 30 days, then we will file a lawsuit against the insurance company. This is at no cost to you. We are able to get the majority of your bills paid through this demand process.

How long does it take a PIP lawyer to send me a check?

The majority of your payments will be sent to you within 30 to 45 days from when you send us your files. 

What are common PIP insurance denials?

Insurance carriers typically deny bills for the following reasons:

  1. The patient didn't receive medical treatment within 14 days after the accident. Florida's 14 day rule requires the patient to treat within 14 days after the accident to be entitled to benefits. Many times, insurance carriers are unaware that the patient received EMS treatment, or that the patient treated at the hospital.
  2. Material Misrepresentation: Carriers frequently denies claims alleging that the named insured failed to disclose all of their household members when submitting their policy application. If disclosed, the premium would have been higher. There are many issues with material misrepresentations. Please call us for more information.
  3. IME Cutoff: This occurs when the insurance company requests an “independent” medical examination for the patient. The insurance company's doctor then evaluates the patient and opines that the patient doesn't require any further medical treatment. Any bills submitted after the IME doctor's determination are denied. As you are well aware, insurance companies frequently use the IME defense to deny bills. We have been very successful in recovering benefits owed to medical providers after the IME cutoff.  
  4. No Emergency Medical Condition – Benefits Capped at $2500.00. Without an EMC, insurance carriers routinely deny bills after $2500 has been disbursed to the patient's medical providers. It is important for the patient to have a documented EMC.
  5. Missed CPT codes or downcoding: Adjusters are human beings. They make mistakes by missing CPT codes and incorrectly downcoding bills (i.e. Reimbursing you for 99203 when you bill 99204). We find these mistakes and put the insurance company on notice through the demand and pip suit process
  6. Benefits Exhausted:  An insurance company only has to pay $10,000 of pip benefits, unless the carrier has acted in bad faith.  Did you submit your bills timely? Did you provide a notice of initiation of treatment? Did the insurance carrier simply skip over your bill and pay another provider? Did the carrier make a gratuitous payment, or an extra payment to a different carrier at your expense? Call our office today at 561-588-2781 to discuss benefits exhausted issues. 
  7. Untimely Bill Submission:  Do you have proof of mailing your bill or the notice of initiation of treatment? We can get your office paid with proof of mailing. 

Why do you need a Florida PIP Lawyer?

A PIP lawyer is necessary to recover all of your money from the auto insurance carriers.  Even if you send your own demand letters, you are leaving money on the table if you do not have a pip attorney file lawsuits for your office. Insurance carriers will never fully compensate you without having a pip attorney file suit to recover all of your benefits. 

Where is the Florida Personal Injury Protection Law?

Florida PIP law is codified in Florida Statute Section 627.736.

What are the insurance carriers obligations to providers?

The insurance carrier must pay your bill within 30 days from receipt of the bill.  Additionally, the insurance carrier must supply you with an explanation of benefits if the carrier reduces or denies payment.

Who pays a PIP lawyer's attorney's fees?

Florida law states that if you win, Plaintiff's attorney's fees are paid by the insurance company, not you. The fact that attorney's fees are paid by the insurance company makes it possible for you to collect on benefits that would otherwise be cost prohibitive to you. Pursuant to Section 627.736, attorney's fees must comply with prevailing professional standards, represent necessary legal services and not overinflate the number of hours required to perform the work.  

What is a gratuitous payment?

A gratuitous payment is extra money paid to a provider by the insurance carrier. The provider is not entitled to the additional money. Gratuitous payments are relevant to claims where carriers pay out $10,000 in benefits. This is because a provider who receives a gratuitous payment does so at the expense of the provider who was paid last, and ultimately shorted money. We have been successful in recovering money for providers due to gratuitous payments.

What makes our firm different from other PIP firms? 

We are a small firm, which means we pay attention to your files. We understand how difficult it is to get patients to treat with you on car accident cases. Therefore, we recognize the value these cases provide to you and your business. We make sure you get every penny to help pay your overhead and advertising costs. 

Resources

Florida PIP Statute 627.736

Contact Us

These are just some of the issues that frequently arise in PIP cases. Please call us at (561)588-2781 to speak to a pip suit attorney about your PIP claims. There is no cost you, and we are able to travel to your location.