PIP Reform Found Unconstitutional – Round 1 in the Books

In 2012, the Florida Legislature passed sweeping changes to Florida’s Personal Injury Protection (PIP) laws.  These changes went into effect on January 1, 2013.  For purposes of today’s blog, I would point out that part of the change included that persons involved in automobile accidents could no longer use PIP for massage therapists and acupuncturists.  Furthermore, it placed a cap on the amount that a chiropractor could receive under PIP.

To explore these highly fluid developments in PIP, I will break this down into a few questions.  A disclaimer first:  The following is meant as only a very brief summary, as an entire treatise could be written on PIP.

Screen Shot 2013-03-29 at 10.06.11 AM
PIP Coverage Pays for Portion of Auto Accident Victim’s Medical Treatment

What is PIP?

Personal Injury Protection, or PIP, is a type of “no-fault” benefit that was adopted by the Florida legislature in the early 1970s.  Basically, when passed, the premise was that regardless of fault, the holder of an automobile insurance policy would have $10,000.00 in coverage for medical bills reasonably related to the accident.  At the time, it was very controversial because it denied access to the Courts for these covered expenses.  The Florida Supreme Court held PIP to be a “reasonable alternative” to the common law,  and to the Constitutional Rights of Florida citizens.

What Were The Dramatic Changes to PIP in 2013 that has Everyone in an Uproar?

I have attended seminars on the new law, and have dissected it several times.  There are MANY changes.  However, the most controversial would be the following:

  1. A Florida resident can no longer use PIP for a massage therapist or acupuncturist;
  2. A Florida resident can no longer use the full $10,000 in coverage for chiropractic treatment; and
  3. Although $10,000 in coverage is still mandatory, the new law limits the amount actually available to $2,500.00 unless the injuries constitute an “Emergency Medical Condition,” or EMC.  EMC is defined in a manner that injuries have to be extremely serious to qualify for the full PIP coverage.  In other words, it is no longer enough that a person is injured, even to the point of severe pain, to qualify for the $10,000.00 in coverage he or she has purchased in mandatory PIP. (This is like purchasing a $10,000.00 life insurance policy, paying the premium for that amount of coverage, and then upon death your survivors are entitled to receive only $2,500.00 in actual benefits.  Confused yet?)

What is the Present Status of the 2013 PIP Law Changes

In a word:  Confusion.

First, we have the confusion over the language of the changes (these changes are poorly written, and there are several ambiguities).  On top of that, at issue is whether these statutory changes are legal in the first place.  Which leads to the next point.

Did A Florida Judge Just Rule that the Changes to PIP were Illegal?

Yes, in a sense.  I have obtained a copy of Judge Terry Lewis’s “ORDER GRANTING IN PART MOTION FOR TEMPORARY INJUNCTION.”  Judge Lewis is a Circuit Court Judge in Florida’s 2d Circuit, Tallahassee.  The Plaintiffs in this case are chiropractors, massage therapists, and acupuncturists (in other words, the medical professionals mentioned above that were most harmed by the changes to PIP).  They argued that there are four (4) legal grounds that would justify an injunction.  The Judge granted the Motion based on only ONE of these grounds:  That the requirement of an “Emergency Medical Condition” for a Florida Motorist to receive his or her full $10,000 in purchased PIP coverage, or that it disallowed services by chiropractors, acupuncturists and massage therapists to be UNCONSTITUTIONAL on the grounds that it denied access to Court.

Where does Judge Lewis’s Injunction Leave PIP?  Do I Now Have $10,000 in PIP Coverage that I can Actually Use?

I hesitate to even try to answer this question, because this could change from week to week.  Since Judge Lewis entered the ORDER granting the injunction, there have been a flurry of Motions.  The Defendant (Florida Office of Insurance Regulation) filed a Motion for an Automatic Stay.  The Plaintiffs responded with an Emergency Motion for an Order to Vacate the Stay.  All of this is legalize, and just means that the Insurance Commissioner asked the Court to “hold off” on enforcement of the ruling until it could be legally decided up the chain of appellate courts.  The Plaintiffs, on the other hand, argued that such a step was unjustified, and that the injunction should take effect immediately.

I will be closely monitoring the status of the Motions, Counter Motions, and Appeals closely so that I can best represent my clients, and procure all rights they are entitled to under the PIP statute.  Until I hear differently, I will argue that the current statute has been found unconstitutional, and that as long as my clients’ treatment is necessary and reasonably related to the car accident, he or she should have a choice of whom they treat with, and receive the full $10,000 of PIP coverage.

Summary – What Will Happen to the 2013 PIP Law Changes

In my opinion, the Florida Supreme Court will likely accept the case as a matter of great public importance, and will decide the issue of constitutionality.  It is also my opinion that the changes to the 2013 PIP laws are patently unconstitutional, but I do not sit on the Court.  We will have to wait and see how this plays out.  I will say that regardless of the eventual appellate decisions made on this subject, we can expect there to be many more challenges to the 2013 PIP changes.