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PIP Repeal and Hospital Liens. RENEE JORDAN, ESQ. BACEN & JORDAN, P.A. 4801 S. University Drive, Suite 2000 Davie, FL 33328 (954) 961-5544 RJORDAN@BACENJORDAN.COM. PIP = No Fault !!.
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PIP Repeal and Hospital Liens RENEE JORDAN, ESQ. BACEN & JORDAN, P.A. 4801 S. University Drive, Suite 2000 Davie, FL 33328 (954) 961-5544 RJORDAN@BACENJORDAN.COM
PIP = No Fault !! No Fault are first party benefits that pay regardless of fault. No Fault claims are paid quicker than Fault claims which must apportion fault. There are 12 States that have No Fault insurance. • Florida, Michigan, New Jersey*, New York, Pennsylvania*, Hawaii, Kansas, Kentucky*, Massachusetts, Minnesota, North Dakota, Utah. • * Choice No Fault
PIP Coverage • No fault benefits (PIP) covers the following persons: • Named Insured or any relative living with them while operating or occupying a motor vehicle or as a pedestrian. • (Relative residing in the same household means a relative of any degree by blood or by marriage who usually makes her or his home in the same family unit, whether or not temporarily living elsewhere). • Any other person while operating the insured’s vehicle or as a passenger, or as a pedestrian struck by the insured’s vehicle. • $10,000 per person
PIP Repeal?? • Why – PIP Fraud, Trial Attorneys want a Tort State, Save consumers money. • Some argue that HB 19 will save consumers approximately $81.00 per year on premium. • Critics argue that SB 150 will increase premiums $8 to $12 per year. Others say the increase is likely to be 60%-70%. • Florida is only 1 of 2 states not requiring Bodily Injury Coverage.
PIP Repeal Bills • House Bill 19 – Rep. Erin Grall (R) Vero Beach • 1/1/2019 Effective Date • Requires BI $25k / $50k
PIP Repeal Bills • Senate Bill 150 – Sen. Tom Lee (R) Thonotosassa • Effective 1/1/2019 • Requires Med Pay $5k (has all the same PIP requirements) • Requires BI • 2019-2020 = $20k / $40k • 2021-2022 = $25k / $50k • 2023- = $30k / $60k
The financial Impact • In 2010, total PIP payments in FL were almost $2.5 Billion. • Report on Review of the 2011 Personal Injury Protection Data Call, April 11, 2011, Florida Office of Insurance Regulation
Financial Impact • Total Payments by Region in 2010: • South Florida $1.1 Billion • Central Florida $300 Million • Tampa/St. Pete $200 Million • Southwest Florida $100+ Million • Northeast Florida $100 Million • Report on Review of the 2011 Personal Injury Protection Data Call, April 11, 2011, Florida Office of Insurance Regulation
Financial Impact • Private Commercial Healthcare = 42% or $1.047 Billion • Medicaid = 17% or $417 Million • Medicare = 11% or $277 Million • Self Pay = 30% or $757 Million • Date supplied by Accelerated Claim, Inc.
AVAILABLE SOURCES FOR HEALTHCARE REIMBURSEMENT • Unlike PIP, other liability benefits require some degree of fault or negligence: • Bodily Injury and Uninsured / Underinsured Motorist • Product liability – Equipment malfunction • Slip and fall – Need to report the incident • Homeowner liability – Dog bite is strict liability • Commercial liability – Gun shot, Businesses • Victims Compensation – Police report within 72 hours • Worker’s Compensation – Independent Contractor
Lien Ordinance • The lien law creates a secured priority right for the hospital on any settlement or judgment proceeds for the patient. • The lien laws provide remedies for impairment of the Hospital lien, including the right to bring a lien impairment lawsuit, attorneys’ fees and court cost. • It allows for intervention.
CASE LAW Dade County v. Bodie, Dade County v. Perez – The court can not reduce the lien based on equitable distribution. Dade County v. Pavon – Lien attaches to UM benefits. Public Health Trust v. O’Neal, Crowder v. Dade County, Lee Memorial v McCray – Lien can not be reduced by the amount of PI attorney’s fees. Fernandez v. South Carolina Ins. – Lien has priority over claims for lost wages and funeral benefits.
ENFORCING THE HOSPTIAL LIEN • Monitor the patient’s personal injury case at all stages. • Average PI case takes 12-18 months to settle. • Legal Intervention may be necessary: • Probate • Intervention • Lien Impairment • Interpleader • Motion for Equitable Distribution • Negotiate settlement with PI attorney - settlement disclosure required.