Florida’s PIP Insurance Fraud: What Does it Mean for the Good Guys?

Auto Insurance, PIPPersonal injury protection insurance (PIP) is important to anyone looking for full auto coverage; if you get in an accident, this policy is the best way that you can assure any medical bills you incur are covered by your insurance. According to CoverHound, PIP insurance promises maximum benefits regardless of fault; while designed primarily to cover medical expenses, it can also cover lost wages, transportation and follow-up medical appointments related to the accident.

Florida’s Reputation with PIP Insurance

PIP insurance is required in 13 states, the most prominent of which is Florida. Unfortunately, Florida’s reputation with PIP insurance is more infamous than famous thanks to a staggeringly high rate of insurance fraud within the state. The reason for this is that PIP insurance is a “no fault” policy, meant to help keep auto insurance claims out of court as much as possible, and it works well enough to a degree. Since everyone gets the money to cover their medical bills regardless of who is to blame for the accident, it’s significantly more rare in these states to see accident victims taking those at fault to court in order to get coverage for medical expenses—one of the most important aspects of full covered insurance to begin with. This way even if someone gets hurt, everyone can be treated by a medical professional.

Heartland reports that Florida’s law requires that insurers pay as much as $10,000 in medical claims, and the average PIP claim is over $8,000, with a surge in the number of claims in 2010 of over 46 percent. In the same year, “questionable” claims increased by 77 percent. These are the work of unscrupulous characters suffering from minimal or even nonexistent injuries, verified with the cooperation of corrupt physicians, clinics, and more, allowing fraudulent claims to clear with insurance companies and pay out to the scamming parties.

Undue Hardship

Any attempt to “crack down” on these issues, however, can hurt the good guy more than it hurts the bad guy. By adding to the requirements needed to get a claim accepted and paid out, or limiting the physicians and clinics that are accepted by the company, insurance companies can cause undue hardship to perfectly honest, upright customers, while frauds can still slip through the cracks and make thousands on a stubbed toe.

There’s no single way to be sure that you’ll get all the coverage you need when it comes to injury protection, particularly in areas with a high rate of fraud. The best way to be sure that your claim will be approved is to report any and all injuries as soon as the accident occurs, visit your physician as soon as possible afterward, and insist on as many labs and procedures as necessary to prove your injury is valid. This could include costly X-rays, splits, braces and more, but as long as your insurance covers the claim there’s nothing to worry about—and as long as you start the ball rolling fast, and don’t demand more money than you really need, the likelihood of getting denied is slim to none.

PIP insurance fraud hurts everyone, but there are ways to keep its impacts from making your life after an accident more difficult. Play it safe and smart, and you’ll be covered every time.

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Posted in Auto, Personal Insurance

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