PIP Case Update: Ruling Against Temporary Injunction



(Tallahassee, FL Wednesday, October 23, 2013)

Today the First District Court of Appeal, three judge appellate panel ruled in the appeal by the Office of Insurance Regulation (OIR) of Judge Lewis order of temporary injunction issued on March 18, 2013 in Myers v. McCarty.

The order reverses the March ruling by Leon County Circuit Judge Terry Lewis that said the law illegally prevented those injured in automobile accidents from using their PIP insurance coverage to pay for treatment by Acupuncture Physicians and Licensed Massage Therapists, and limited the services from Chiropractors.

In order to address fraud and abuse within Florida’s no-fault auto insurance system the Legislature chose to completely eliminate two licensed professions from providing services to those injured in automobile accidents, in effect punishing all law abiding practitioners in these professions for the crimes of a few. These professions were completely eliminated from providing treatment, all the while there were laws in place to deal with the issue of fraud.  In regards to therapy provided by Licensed Massage Therapists, there were existing requirements in place that did not permit treatment or billing for services without a valid prescription from a Medical Doctor with a diagnosis, statement indicating the treatment was medically necessary, and a directive on the length and duration of treatment.  The Legislatures did not pursue seeking out and punishing the entire M.D.’s profession for the fraud committed by a few.

In the future Senate Banking and Insurance Chairman David Simmons, R-Altamonte Springs, has stated that he’s moving forward with a proposal to scrap no-fault at the request of a number of insurance officials. Senator Simmons is moving forward on their behalf with little regard for the citizens of Florida and the impact such a law change will have on their ability to have their medical treatment cost covered without personal out of pocket financial impact, or the long delays that will be associated with the large number of cases that will then be required to go to court under such a system.  This potential change will have a negative impact on the injured public both in terms of their ability to afford to pay up front for necessary treatment, delays attorneys will experience in receiving their payment for handling the cases, and create a backlog in the courts to hear these cases as a result of the large number of drivers who experience accidents State wide 365 days a year.  These situations were faced by Legislators many years ago which is why the PIP system was put in place in the first place.  The reasons are even more valid today with even greater numbers of drivers on the roads in Florida.

Shifting to a Bodily Injury based system will not eliminate fraud, it will simply change the way those who chose to break the law go about doing so.  This approach is like believing that building more jails stops crime from occurring. Enforcement of the laws, arrest and prosecution is what helps to stop crime.

The FSMTA is not in favor of this approach to reduce insurance fraud in the medical community when there are laws in place to address the issue without eliminating massage therapy and an entire profession from providing services.  Massage Therapy is a valid and effective treatment for soft tissue injuries which helps to speed healing and recovery time, thereby saving both the consumer and the insurance company money.

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