Legislators continue to review Florida’s Personal Injury Protection (PIP) no-fault insurance, which some believe is at the root of the state posting the nation’s second highest number of questionable—and possibly fraudulent—insurance claims.

Mandatory for all registered motorists, PIP coverage requires insurance carriers to pay policyholders injured in an accident up to $10,000 for medical costs and lost wages, regardless of who was responsible for the crash. A number of politicians, including Gov. Rick Scott, have called for reform of the no-fault system to stem rising claims’ costs, which lead to higher premiums for all insurance buyers.

Reform Must Protect Legitimate Claims

While reducing the number of bogus claims is a positive step toward holding down consumer costs, Ormond Beach car accident attorneys at Johnson & Gilbert note that any reform must ensure accident victims with legitimate claims are not denied recovery for their injuries and losses.

The Florida Senate’s Committee on Banking and Insurance considering reform was told replacing PIP with bodily injury (BI) coverage will produce a reduction in car insurance premiums across the state. Sandra Starnes, director of property and casualty product review at the Florida Office of Insurance Regulation (FOIR), said reductions would be the greatest in those regions were the number of questionable PIP claims are the largest.

Speaking at a statewide insurance fraud management conference, Joe Wehrle, president of National Insurance Crime Bureau (NICB), said the number of questionable no-fault coverage claims filed in Florida jumped 22.5 percent from 2010 to last year.

Three south Florida counties registered the most questionable claims. They are:

  • Miami-Dade County, at more than 3,500
  • Broward County, topping 900
  • Palm Beach County, with more than 700

NICB set up a special task force looking into south Florida claims’ fraud in 2002, followed by a second task force for central Florida nearly three years ago. The bureau says the task forces are charged with stemming auto policy medical fraud, which has thrived in the state.

Most Questionable Claims Come from Florida Auto Crashes

While NICB looks at all types of policies, personal auto insurance coverage accounted for more than 90 percent of the questionable claims, with medical issues the most prevalent, according to the bureau. Faked or exaggerated injuries led the count. Other suspicious claims involved medical providers, excessive treatment, and billing for services not performed.

Citing bureau reports on illicit schemers faking car crashes and injuries and medical forgeries that negatively impact resources for legitimate claims, Johnson & Gilbert’s Florida car accident attorneys support the ongoing efforts to diminish fraud. NICB has identified Florida as the nation’s capital of organized insurance fraud rings.

For more than 15 years the Ormond Beach car accident attorneys at Johnson & Gilbert, P.A., have worked with clients to recover losses suffered as a result of crashes. They invite calls at 386.673.4412 or toll free at 800.556.8890 for a free consultation.