Senator Calls For Car Insurance System Overhaul As PIP Reforms Now Enforceable

Oct 25, 2013

Chiropractors oppose a 2012 PIP reform requiring a medical doctor to diagnose an emergency condition before insurance companies can reimburse them.
Credit Jessica Palombo / WFSU News

A Florida state senator is on a mission to replace the state’s no-fault auto insurance system with one he says will lower drivers’ premiums and pay more in compensation when they’re injured. The call for insurance reform comes just as a court has allowed the state insurance regulator to start enforcing some controversial insurance changes the Legislature made last year.

Because of the changes, it’s now illegal for insurance companies to reimburse massage therapists and acupuncturists when they treat car accident victims.

Carrie Damaska, a Tampa massage therapist, was one of the people suing to block that part of the new law. 

“I’ve been doing massage for 14 years, so I’ve seen a lot of reactions from people and seen a lot of people get better,” she says. She says, as insurance companies stopped reimbursing her this year, one by one, she has lost about half of her revenue and is considering leaving the profession altogether.

But this week an appeals court ruled her group didn’t have legal standing and dismissed the challenge.

Damaska says,“There’s like a list of certain places they have to go to get treated, and I don’t think that’s fair to the people. They should be able to go where they want to use that $10,000.”

Also because of the 2012 changes, Florida drivers injured in a car accident must get a diagnosis within two weeks for insurance to cover treatment. If they have an injury that a doctor certifies is an emergency, they can recoup up to $10,000. For lesser injuries, maximum coverage drops to $2,500.

Tallahassee chiropractor Dennis Fiorini isn’t a party to the ongoing suit, but he says he hopes a court strikes down the changes—especially one that says chiropractors can only get reimbursed for treatment after an emergency physician says someone has an injury.

“I think that it might even encourage more fraud because now you’re going to get medical doctors saying this guy is referring me a patient—I have to say this is an emergency medical condition so I can get paid,” Fiorini says.

But the new rules have the support of auto insurers. Personal Insurance Federation of Florida Director Michael Carlson represents auto insurance companies that insure almost half of Florida drivers.

He says, “Limiting these kinds of services was valuable and would not harm the consumers, who can still benefit from emergency room care, can still benefit from going to their general practice, their family physician.”

He says the appeals court’s ruling tells auto insurers once and for all they should stop taking claims for certain treatments—which he says allows the reforms to achieve their intended purpose.

“All of the companies writing auto in Florida will be able to implement them fully and consumers will see cost savings, which is what we hope will happen, what we want to happen, so this state can be a less costly state to insure a motor vehicle in,” he says.

Carlson says the reforms were necessary to root out the estimated $1 billion in auto injury fraud committed in the state each year.

State Sen. David Simmons (R-Altamonte Springs) says, “I think what was done in 2012 by the Legislature was a valiant attempt to fix what was unfortunately the unfixable.”

He agrees the fraud needs to stop, but it won’t as long as Florida keeps using an outdated kind of auto insurance coverage.

“Many people would end up getting a reduction in their insurance if we were to simply go with a straight bodily injury program in the state of Florida,” he says.

Simmons says 70 percent of Florida drivers already have this kind of coverage. He says under the system that 45 states already use, injured drivers would be able to recoup up to $25,000 for treatment from the company that insures whoever caused the accident. He’s holding a hearing next month in the Senate Banking and Insurance Commission exploring what the switch would mean for drivers.

Treatment providers say they’ll continue to fight last year’s reforms.