PIP Claims Consulting

PIP Claims Consulting

PIP Claims Consulting for Health Care Providers

To begin, health care providers that process PIP claims are either experienced or are aware of the complications of F.S. 627.736 and its varied pits and pratfalls. Therefore, the processing of a claim can be a headache.  At best, it's an absolute quagmire of delay.  Also, you face double talk by the PIP carriers and its corps of adjustors.

Failure to Pay Valid PIP Claims is an Unfair and Deceptive Practice

Also, Personal Injury Protection (PIP) insurance companies improperly reject claims every day.  In South Florida, some of the biggest insurance providers wrongfully deny claims, frequently.  If you are a medical practitioner, the Dawson Law Firm wants to help you be certain that you are not wrongfully underpaid for the PIP Claims that you submit to the insurers. We will help your practice to review your patient files and determine areas where you were wrongfully denied payments on PIP claims. After notifying the insurance company with a demand letter, they have 30 days to respond. If the PIP Insurer still denies payment for whatever reasons, we will move forward with filing a lawsuit.

The end goal is to collect on the monies that are owed to you from the insurance company.

To begin, Florida law requires the purchase of automobile insurance compliant with Florida Statute 627.736. So, simply stated, the goal of this statute is the efficient, expedited method of making payments to various medical providers.  However, the purpose of PIP (personal injury protection) is as follows.  The statute contemplates recovery of payment by medical providers directly from the PIP insurer, which in turn, guarantees injured parties quick payment of medical bills.

However, PIP can be a mine field of time sensitive requirements and barriers.

1. Providers: It is critical that office procedures follow the policy language and applicable Personal Injury Protection statutes.  Bills can be challenged for procedural and substantive grounds.  For instance, totally reasonable necessary and related medical treatment can be denied for simple office procedural mistakes.  Also, claims can also be denied substantively for failure to meet the RRN standard or Reasonable, Related and Necessary.

2. Claimants: It is critical to understand the stringent requirements imposed upon claimants or policyholders when navigating through the jungle of PIP claims.  Delay in the initiation of treatment can be a complete bar to PIP recovery.  Other impediments and requirements placed upon this class of individual.  The requirement to submit to Independent Medical Examinations (IME) are Examinations Under Oath (EUO).  In any event, the failure to cooperate with the company or its agent / exam vendor.

3. Counsel: (Referrals Accepted - Client relationship respected and observed)  Much like any other trial litigation involving insurance, the evaluation always includes who the lawyer is for the Plaintiff / Claimant / Assignee.  Simply stated, the law firms’ experience and familiarity with the battleground would enhance the value of any Bodily Injury or Personal Injury Protection claim.

Finally, the Dawson Law Firm is experienced with PIP cases and it would benefit you to utilize the experience of these trial lawyers to maximize your PIP Claim.  Reach out to us for a free case evaluation, today!

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