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Emergency Medicine wins ruling for PIP

Thanks to Bradford Cederberg PA, emergency medicine has won two very significant rulings from the Circuit Court in Seminole County sitting in its appellate capacity. The appellate rulings are the first of their kind in the state of Florida. In affirming the trial court, the appellate court held that you cannot apply a provider of emergency services and care’s bill toward an elected deductible in a PIP matter. This is a monumental ruling in favor of Emergency Physicians whose bills are routinely applied toward patients’ deductibles in the PIP setting, despite a mandatory $5000.00 reserve for providers of emergency services and care for payment of these charges. Auto insurers have basically ignored Florida’s PIP laws promulgated for the benefit of Emergency Providers and have routinely ignored the mandatory $5000.00 reserve and applied ED physician invoices to PIP auto deductibles. Thousands of claims have been filed on behalf of ED physicians against auto insurance companies for the past several years and after initially setting the matter and paying the claim, carriers united and took a hard line stance on this issue against ED physicians, despite more than 20 rulings in a three county area in favor of ED physicians on this issue.

Emergency Physicians must submit their bills within 30 days of a MVA (date insurer knew of the claim) to avoid having the deductible applied to their bill. If the Emergency Physician bills after that initial 30 day period, then the ED physician loses the protection of the statute and stands in line like all other providers. The PIP deductible in those instances can be applied toward their bill. These appellate decisions are being circulated around the state to others fighting on behalf of ED physicians in the PIP arena.

Rutledge M. Bradford
Board Certified Civil Trial Lawyer more


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