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Auto insurance fraud leads to finger-pointing, reform bill

By Lynn Hatter


Tallahassee, FL – A new state report shows the number of claims made under the state's mandatory personal injury protection or PIP laws have increased, even though the number of auto crashes hasn't. It's an issue that lawmakers are looking at closely at two bills dealing directly with cracking down on PIP fraud are making their way through the legislature. But as Lynn Hatter reports, lawmakers are split on whether it will actually help solve the problem, or add to it.

Florida is a national leader when it comes to faked auto crashes and insurance fraud. Three years ago lawmakers attempted to re-write the rules to make it harder for people to fake accidents and collect money under the mandatory payouts of Personal Injury Protection or PIP. The state's law requires a driver to carry no less than 10-thousand dollars for medical care on their insurance premiums. But when the legislature went to fix PIP's fraud problem, Senator Ellyn Bogdanoff says they accidentally made it worse.

Sound- "I feel responsible for the proliferation of lawsuits since 2007 simply because we attempted to fix PIP and just made it worse. This system was created so that we could get people medical treatment quickly and efficiently and not get bogged down in the legal system and what we ended up doing was creating a huge boutique industry that has become a multi-billion dollar industry."

Now Bogdanoff is trying once again to crack down on auto insurance fraud. And Bogdanoff is sponsoring a bill to do that. Her proposal outlines new policies in the way doctors treat people involved in accidents, how and when those providers get paid. Bogandoff's bill pits attorneys, insurers and doctors against each other. Kim Driggers with the Florida Chiropractic Association says the bill swings too far the other way making it harder for people to get treatment and doctors to get paid for legitimate claims. Driggers says the proposal is an anti-payment, anti-provider bill.

"This bill allows 21 additional ways for insurance companies not to pay bills outside the PIP statute. If there's a mistake on the bill, if there's a mistake on the patient log, if there's mistakes on the patient disclosure form "

Insurance groups say the bill is needed to crack down on fraud cases. William Standar with Property and Casualty Insurers of America says there's an epidemic of fraud, not of mishandled claims.

"You want the companies to pay claims fairly and quickly, but at the same time we have a duty to properly pay claims. Senator Bogdanoff's bill is a bundle of tools to bring down the costs of auto insurance."

Attorney's see things differently. Rutledge Bradford is a board certified trial lawyer from Orlando. She says the proposal is problematic to legitimate claimants, especially a provision that deals with those claimants having to take medical claims exams under oath- something called an EUO. Bogdanoff's bill would extend that requirement to doctors, but changes how much they can get paid for their time. And Bradford says doctors would be turned off from taking auto accident victims because they don't want to deal with the headache.

Sound- "These EUO's are very common, they're lengthy, they're combative. And the law as proposed by Senator Bogdanoff says these doctors are not to be paid an expert fee, they're supposed to be compensated, and it takes them from a reasonable hourly rate, down to a witness fee of 7-10 dollars an hour."

The whole point of PIP is to pay out claims quickly and avoid litigation. But some insurers have refused to pay doctors because they say the claims are fraudulent. The issue over those fees is something that Republican Senator Alan Hays of Umatilla has a problem with.

"We've got to clean the whole mess up. As a healthcare practitioner myself, I am insulted and resent very much the imposition on my time and no one is willing to compensate me on that and Im not willing to do that to my fellow practitioners."
Bogdanoff says she's trying hard to solve the fraud problem. And she expressed frustration at all the opposition her bill garnered.

"Bottom line is, we've got a lot of fraud. And I will tell you there have been a lot of really articulate speakers on the issues but none of them have come to me. And I got to tell you it's really getting annoying. I have asked and begged for information I am trying to improve this, I am trying to cut out fraud with all the members here. And if I don't have information, I can't make it work. Bottom line, if we're going to work together, let's work together. But you can't just stand in the back and throw bombs because I almost believe there's no sincere effort to fix this."

Several committee members expressed concerns over the bill, and said they'd vote for it now, but if it remains in its current form, that support would go away. The proposal cleared on a 7-to-4 vote. A separate bill limiting how much money attorney's can collect under PIP cases also passed the committee. They now heads to the Senate's criminal justice committee, where more changes are sure to follow.