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State Regulators Working to Patch PIP Reform Loophole

May 20, 2012 - 6:00pm

Insurance regulators have been working for a couple of weeks to fix glitches in the states reformed auto insurance law the same glitches a Democratic lawmaker pointed out to the governor in a letter on Monday.

The state Agency for Health Care Administration, which oversees licensing medical providers to provide PIP coverage, released a three-page memo earlier this month that acknowledged the mistake and -- in the view of the agency -- has deemed the later date as the start date.

The changes on paper become law July 1.

However, an exemption in the law creating a list of medical providers eligible to treat PIP patients -- including hospitals, physicians and chiropractors -- isnt effective until Jan. 1, 2013.

The AHCA views the Jan. 1, 2013, date as the correct start date.

The agency believes that the act applies the same effective date of Jan. 1, 2013, to both the new licensure requirement and the 5(h) exemption, AHCAs general counsel Stuart Williams wrote on May 8.

Spokeswomen for Gov. Scott and the office of Chief Financial Officer Jeff Atwater both said ACHA and the Office of Insurance Regulation are handling the issue without the need to undertake legislative revisions.

Yet Rep. Rick Kriseman, D-St. Petersburg, stated in the letter to Gov. Rick Scott that its not up to agencies to fix conflicts within a law.

The plain language of the statute is what controls in any dispute regarding interpretation, Kriseman wrote.

The law gives accident victims two weeks to seek medical help, allows chiropractors to treat patients, imposes a prohibition on allowing massage therapists and acupuncturists to be eligible for PIP claims, and caps less serious injury coverage at $2,500.

The $10,000 coverage would remain in place for emergency medical care.

Kriseman contends the PIP bill is rife with technical problems that could cause "needless new chaos and costs" in the industry that has seen premiums jacked up $1 billion in recent years.

Kriseman specifically pointed out that the six-month gap, during which time hospitals and other medical providers would be prohibited from legally submitting claims, gives insurance providers justification to reject claims.

While your intent in advocating for the passage of this bill was to combat auto fraud, the errors contained in this bill are of such significance that failure to fix them prior to implementation of the legislation will invite litigation, Kriseman wrote.

I am sure you recognize that the lack of clarity under which insurance carriers and medical providers will attempt to operate is bound to create needless new chaos and costs.

Kriseman added that constituents have started to receive letters from auto insurance carriers that rates will be going up because of the recent changes to PIP.

Reach Jim Turner at or at (772) 215-9889.

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