Government

Reforms Zero In on PIP Fraud

House, Senate serious about ending phony accident, medical claims
By: Kenric Ward and Nancy Smith | Posted: March 16, 2011 2:30 PM
Sen. Ellyn Bogdanoff, Rep. Jim Boyd, CFO Jeff Atwater and others discuss PIP insurance, no-fault fraud billFrom left, Sen. Ellyn Bogdanoff, Rep. Jim Boyd, CFO Jeff Atwater, others discuss PIP insurance, no-fault fraud bill | Photo: Lane Wright
A bill cracking down on staged-accident scams breezed through a House subcommittee Wednesday, and a fleet of similar reforms is revving up.

House Bill 967 cleared the Insurance and Banking Subcommittee on a 13-2 bipartisan vote after just 45 minutes of discussion. It now heads to the Civil Justice Subcommittee.

The measure, along with companion Senate Bill 1694, cracks down on what insurers call "rampant" fraud involving the state's Personal Insurance Protection (no-fault) program.

“Today's committee action shows that the Legislature has recognized the urgent need for PIP reform in our state and is committed to passing comprehensive legislation to provide insurers with the tools to combat PIP fraud statewide,” said William Stander, assistant vice president of the Property Casualty Insurers Association and regional manager for Florida.

The reform measure by Rep. Mike Horner, R-Kissimmee, would expand investigations, encourage arbitration and cap lawyers' fees. The Senate's companion bill is carried by Sen. Garrett Richter, R-Naples.

Two related bills --  SB 1930 and HB 1411 -- aim to implement additional legal reforms. Those bills are sponsored by Sen. Ellyn Bogdanoff, R-Fort Lauderdale, and Rep. Jim Boyd, R-Bradenton.

SB 1930 would increase penalties for medical providers who knowingly submit bogus applications for clinics that treat auto crash victims; require responding law enforcement to list names and addresses of all passengers involved in a crash; and provide insurers more time to investigate suspicious claims and vet honest claims for payment.

HB 1411 would forbid medical providers to seek payments from policyholders when an insurer denies the provider’s claim because of suspected fraud; provide discounts for consumers who use honest, insurer-recommended clinics; and create a state authority to fund auto-fraud investigations and prosecutions without raising taxes.

At a Wednesday afternoon press conference, Bogdanoff said, "Floridians are paying what amounts to a 'fraud tax' on top of their car insurance every year and will continue to do so unless we close the loopholes in the system. Floridians also deserve protections to prevent them from becoming victims in PIP fraud."

She said PIP was designed to keep the legal system out of vehicle accidents and give victims some compensation. "But we've created a boutique industry" for unscrupulous swindlers gaming the system.

Chief Financial Officer Jeff Atwater, also speaking at the press conference, said, "Florida is No. 1 in the nation in questionable auto accidents that lead to claims. ... I say that's No. 1 in accidents that are pure fraud."

While trial lawyers oppose many of the proposals, the insurance industry says Floridians are hurt by a spate of staged auto accidents and faked medical claims that drive up premium costs on law-abiding motorists.

The industry estimates that PIP fraud costs Floridians $1 billion a year in the form of higher insurance rates.

“House Bill 967 will ultimately help insurers crack down on criminals who continue to keep Florida at the top of the list for the highest number of questionable, or ‘staged,’ auto accidents of any other state in the country," Stander said.

Four of the 10 U.S. cities with the highest rates of questionable claims are Miami, Tampa, Orlando and Hialeah, Stander reported.

Comments (5)

Bella
6:47PM MAR 17TH 2011
"...provide discounts for consumers who use honest, insurer-recommended clinics" this makes me lol. Another ploy from insurance companies not to shell out money for injuries. I would not trust any insurer-recommended clinic that is just going to agree with the insurance company that you do not need the treatment. I mean, come on - you think we're that dumb. Staged-crashes have to stop yes but they are using them as an excuse for people to vote on these bills that are meant to fill up insurance companies' pockets.
Joan Cortez
10:00PM MAR 16TH 2011
My son was in an accident in high school. He rear ended a car that made a sudden complete stop in the road when leaving for lunch. It ended up being a 15 year old without a license that drove his uncle's car to school. My son's insurance had to pay to repair the car. This could be another area that requires some strict laws.
Stuart
3:21PM MAR 17TH 2011
Your son was not paying attention or following too close. Your son was at fault for the accident. His insurance company SHOULD have paid. the following car is almost always at fault for a rear end accident.
Joan Cortez
9:59PM MAR 16TH 2011
My son was in an accident in high school. He rear ended a car that made a sudden complete stop in the road when leaving for lunch. It ended up being a 15 year old without a license that drove his uncle's car to school. My son's insurance had to pay to repair the car. This could be another area that requires some strict laws.
Dr. Frank Lanzisera
4:25PM APR 4TH 2011
Regardless your son was at fault as he was probably following too close. Teach him to give at least 4 seconds travelling time from the rear of the vehicle in front of him.