Florida’s Supreme Court Weighs in on Florida’s Personal Injury Protection (No-Fault Law)

It is not every day that the Florida Supreme Court rules on an issue that involves Florida’s Personal Injury Protection insurance laws, which are also known as Florida Motor Vehicle No-Fault Laws (No-Fault Laws).  These are the laws that govern the payment of medical bills and lost wages for individuals involved in car, truck, motorcycle, and pedestrian traffic accidents.  This week the Supreme Court issued an opinion regarding what discovery is permissible by insurance companies looking to evade payments even before they even sued for non-compliance. The case arose from a conflict between Florida’s PIP statute and opinions issued by Florida’s First and Fourth District Courts of Appeal over what charges were appropriately paid out of a PIP and what discovery would be available by an insurance company even before it was sued for non-compliance under the policy.  The facts of the case involve medical treatment rendered by Shands Jacksonville Medical Center (Shands) to twenty-nine people who carried State Farm PIP Insurance and were injured in motor vehicle accidents. After paying Shands, State Farm requested documentation relating to the “reasonableness of the charges,” pursuant to section 627.736(6)(b) of Florida’s PIP statutes. This section requires healthcare providers to provided PIP insurance companies like State Farm, upon request, specific documents and information relating to the treatment of injured persons and the associated costs. In other words, insurance companies use discovery like this as a basis for refusing to make payments even before a lawsuit is filed. In response, Shands provided State Farm with the medical records documenting the treatments and charges for the services rendered, its most recent Medicare Cost Report,...

Florida Car Accidents: Florida’s Supreme Court Severely Limits PIP Benefits

Florida’s mandatory Personal Injury Protection insurance, or PIP, which is the minimum required auto insurance, has probably generated more civil litigation than any other in body of law I have seen in my 26 years of practicing law. The reason it is so often at the center of hotly contested battles in both trial and appellate courts may be the fact that so many people are affected by what, when, and how much PIP insurance pays to whom after a car, truck, motorcycle, or pedestrian accident in Florida, not to mention payments to doctors, hospitals, and others who provided them medical care. This week a PIP case wiggled itself all the way to Florida’s Supreme Court, where the justices were asked to decide if Allstate could limit the amount it paid for medical expenses (related to a Florida car crash) to Medicare’s current fee schedule. Several Florida appellate courts have recognized the disparity between payment under the “fee-schedule method” that pays much lower benefits (commensurate with meager Medicare rates) than would be payable under the “fact-based payment method.” Florida’s Supreme Court has the jurisdiction to resolve conflicting opinions between district appellate courts.1See art. V, § 3(b)(4), Fla. Const. The case stemmed from an appeal, from Florida’s Fourth District Court of Appeal, called Orthopedic Specialists v. Allstate Insurance Co.2177 So. 3d 19 (Fla. 4th DCA 2015).In that case the court held that Allstate’s PIP policy language was not legally sufficient to authorize Allstate to apply the Medicare fee schedules when paying for their insured’s medical expenses. This opinion conflicted with an opinion from Florida’s First District Court of Appeal, Allstate...

Hit By a Drunk Driver: Local Bar Sued for Over Serving Alcohol

Dear Miami PI Lawyer,   What happens when a bar or restaurant in Florida serves a customer too much alcohol and that person then gets behind the wheel and causes a car accident? I work at a local pizza joint, and I have seen a lot of folks get pretty drunk at the bar while waiting for their pizzas to take home. Just wondering, Wolfgang G. Miami, Florida   Dear Wolfgang, That’s a very good question. A partial answer is that Florida’s legislature is quick to find ways to protect businesses from being held responsible for just about everything.  Statute 768.125 protects businesses from being sued for over-serving unless the customer is underage or a known and habitual drunk.1768.125 Liability for injury or damage resulting from intoxication.—A person who sells or furnishes alcoholic beverages to a person of lawful drinking age shall not thereby become liable for injury or damage caused by or resulting from the intoxication of such person, except that a person who willfully and unlawfully sells or furnishes alcoholic beverages to a person who is not of lawful drinking age or who knowingly serves a person habitually addicted to the use of any or all alcoholic beverages may become liable for injury or damage caused by or resulting from the intoxication of such minor or person.    Recently, however, in a case in Broward County, Florida, a Flanigan’s restaurant was sued after one of its intoxicated patrons got behind the wheel and caused a very serious traffic accident. The injured plaintiffs tried to get around the protection of Statute 768.125 by claiming that Flanigan’s has an internal...

Investigating Florida Auto Insurance Bad Faith Claims

In Florida, Insurance Bad Faith typically occurs–and often results in a lawsuit–when an insurance company does not pay a claim when it is supposed to¹. Florida’s Insurance bad-faith law is both complicated and evolving, as insurance companies are influential and instrumental in making sure that Tallahassee keeps Florida insurance bad-faith lawyers in business by finding ways to keep their victims from holding them accountable. When determining whether or not an insurance company has acted in bad faith, the courts must look at the evidence in the light most favorable to the person who bought the insurance, or whom the insurance was meant to protect, known as “the insured”–and not the insurance company, known as “the insurer.”    The recently decided Florida Bad Faith claims case of Geico v. James Harvey helps illustrate this². This bad-faith case stems from the tragic incident in which Mr. Harvey caused a car accident that killed John Potts, resulting in a Florida wrongful death car accident claim. The accident was reported to GEICO, which had insured Mr. Harvey with a $100,000 policy.  GEICO assigned as the claims adjuster Ms. Fran Korkus, who advised Mr. Harvey in writing that the wrongful death claim brought by Mr. Potts’s Estate would exceed his $100,000 policy limits, thereby exposing him to a judgment beyond the policy’s limit. This is called excess exposure, which means that the insurance policy is not enough to cover the amount of damage, in this case the wrongful death that was caused in the accident, and that Mr. Harvey’s personal assets are exposed and at risk by the wrongful death claim. The adjuster also...

Miami Car Accident: Accidents caused by Distracted Drivers Using Snapchat and FaceTime

Accidents caused by distracted drivers who are busy texting, Snapping, taking selfies, searching for Pokémon Go, or scrolling through their Tinder accounts are sadly becoming more common. The National Highway Traffic Safety Administration’s latest data reports that the percentage of highway fatalities increased more in 2015 than in any of the past 50 years. And the numbers are getting worse. In 2015, 3,477 people were killed in distracted driving accidents, many of them teens (15-19). Based solely upon the number of cases our Florida personal injury law firm investigates weekly, distracted driver accidents are starting to look like a potential epidemic. I believe, however, that there is a simple and elegant solution. Unfortunately, none of those capable of implementing it seem particularly interested–for now.    Mobile email, texting and other forms of smartphone communication have one thing in common–a smartphone–and simple ways of preventing these types of applications from operating over certain vehicular speeds, in specific situations, already exist. For example, the technology already exists in IPhones, and Apple has a protocol it calls CoreMotion that allows programmers to measure an IPhone’s movement, with an “automotive” property that can predict whether an IPhone is being used in a moving vehicle.   Most cars today have the ability to host smartphones and to connect them to a vehicle’s entertainment and navigation system via bluetooth. This allows a user’s phone calls, texts, and music to be routed through the car’s dashboard–rather than potentially diverting the driver’s attention to a cellphone’s tiny screen. I believe these features can be “upgraded” to lock the homescreen once attached and in use; doing so would...

How Do You Collect Money When Hit By a DUI Driver in a Florida Car Accident ?

DEAR FLORIDA CAR ACCIDENT LAWYER, I WAS HIT BY A DUI DRIVER WHO HAS NO AUTO INSURANCE HOW DO I GET MONEY? SOL in Miami DEAR SOL in MIAMI, THANK YOU FOR YOUR EMAIL. MAYBE WE CAN HELP. I have been a Florida personal injury lawyer since 1991, and having personally investigated thousands of car, truck, motorcycle, bicycle, and pedestrian accidents, the best advice I can give you is that if you own a vehicle in Florida, the best way to protect yourself and your family is to make sure you have purchased uninsured/underinsured motorist coverage. This is a type of insurance that will pay you money for lost wages, medical expenses, and pain and suffering in the event that the person or persons who hit you don’t have insurance or not enough of it. Moreover, it costs just a few dollars a day more to have it. Take for instance the recent case of Thomas Dixon. Mr. Dixon was hit head-on by Gerardo Alcebo, who was driving under the influence of alcohol and without any auto insurance. Mr. Alcebo was convicted of drunk driving causing a bodily injury. Fortunately, Mr. Dixon had purchased uninsured/underinsured coverage from GEICO of $20,000 per person. Now, just because you have the coverage does not mean that the insurance company will pay without a fight. Of course, GEICO refused to pay the coverage, and Mr. Dixon sued his insurer, claiming that it breached the insurance contract for failure to pay the amount of the uninsured motorist coverage. He also sued Mr. Alcebo as a co-defendant, seeking both compensatory and punitive damages against him for...
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