Houston Casualty Co. and National Specialty Insurance Co. asked the Eleventh Circuit to sustain U.S. District Judge Marcia G. Cooke ruling that they have no duty to defend or protect Direct General, arguing that she correctly held that some pre-policy claims against Direct General regarding PIP benefits were claims for wrongful acts, and that the pre-policy claims came from the same conduct as post-policy lawsuits such that they all constituted a single claim and were omitted from coverage.
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.
In order to register your Florida automobile, you must meet minimal insurance requirements. The requirements are as follows: (1) $10,000.00 of Personal Injury Protection ("PIP") and (2) $10,000 of property damage liability.
A Federal Court has agreed to hear a case where several plaintiffs allege a chain of hospitals, HCA Holdings Inc., overcharged patients' personal insurance protection (PIP) at several HCA-run Florida hospitals by charging up to 65 times what Medicare pays. In the appeal, the plaintiffs challenge a Judge's decision which took away the class action and allowed only one of the plaintiffs to go forward with her claims against a single hospital.
Since the laws governing personal-injury protection were reformed, the number of car accidents staged in Florida so an insurance claim could be filed has fallen by more than half, according to the statistics. The nonprofit National Insurance Crime Bureau stated they completed a study which reports that PIP claims involving accidents that appear to have been intentionally caused fell from 712 in 2012 to 328 last year. Overall, questionable PIP claims filed in Florida dropped by nearly 8 percent in a year, reported the bureau. Joe Wehrle, the bureau's president told the Sun-Sentinel that his company was encouraged by the decline in questionable claims but they still had a long way to go to stop the staged claims. According to Mr. Wehrle, Florida remains a hotbed for fraudulent activity. The 2012 law requires those involved in vehicle crashes to seek treatment within 14 days and limits non-emergency medical claims to $2,500. The law also established stronger penalties for medical providers who commit PIP fraud, including a five-year license suspension and a 10-year restriction from PIP reimbursement. Two insurance groups here in Florida thinks the study shows the law is helping cut abuse that they claim drive up premium costs. Two insurance groups said Monday that the study shows the law is helping cut abuse that drives up premium costs. Premiums for PIP coverage are projected to drop by an average of 13.2 percent, based upon on a review of 20 insurers that provide coverage for more than 75 percent of the Florida market, the Florida Office of Insurance Regulation said in January.