Last month, Allstate filed a brief with the Florida Supreme Court seeking the high court to overturn an August ruling by the 4th District Court of Appeal. In the underlying appellate action, Allstate was in a dispute regarding No-Fault or Personal Injury Protection benefits. The case involved 32 consolidated cases and dealt with the question of whether the Allstate policies would reimburse the physicians under a fee schedule based on the Medicare reimbursement rates. The medical providers argued that the Allstate policies were “ambiguous”. The 4th District Court of Appeal agreed and ruled in favor of the medical providers. In Allstate’s brief filed with the Florida Supreme Court, Allstate points to a ruling out of the 1st District Court of Appeal (our district in the panhandle) that they believe entitles them to use the Medicare fee schedule as a basis for reimbursement.
If you do not know what No-Fault Benefits or Personal Injury Protection benefits, often referred to as PIP benefits, check out our other blogs. But, in short, the No-Fault Act requires residents of Florida that own and operate a motor vehicle within the state to maintain minimum levels of medical insurance in the event that an accident occurs. The minimum coverage is $10,000.00 in PIP coverage. PIP benefits can pay 80% of your medical bills, 60% of your lost wages, or a combination of both until your maximum limit of $10,000.00 is exhausted. “Given that every Florida driver must carry PIP insurance, and the vast numbers of claims processed under such coverage, this conflict (between appeals courts) creates confusion and instability in the lower courts and impacts thousands of insureds and many other citizens and businesses in Florida”.