The cities of Gulfport and St. Petersburg appear poised to follow in the footsteps of Tampa, which is expected to approve a domestic partnership registry for unmarried couples in a few days. Gulfport City Council members are scheduled to discuss a similar ordinance during an April 19 workshop. The ordinance would give same-sex and unmarried heterosexual couples the right to make medical decisions for each other if either one had been incapacitated, and to be contacted as a family member if a partner were in an accident.
Absent a "domestic partnership registry" or allowing gay marriage in the state, there is another easy way to achieve the same goals. Good estate planning by domestic partners can go a long way toward providing several essential legal benefits.
First and foremost domestic partners can enter into a domestic partnership agreement, a legal contarct that spells out the legal aspects of their relationship as it relates to ownership or real property and personal property, as well as responsibility for car loans, leases, and other obligations.
Second, a "health care power of attorney" will provide domestic partners with assurance that they may be designated to make important health care decisions for each other, and to be present in a hospital and not told by family members to leave.
Third, a "durable power of attorney" allows domestic partners to make financial decisions for each other in the event that one is unable to act on their own behalf.
Fourth, a "living will" spells out each partners desires regarding being kept on life support in the event of a terminal condition for which recovery is unlikely.
With these documents, most domestic partners will have legal rights that would not otherwise have been available to them, even with a domestic partner registry.
For more information on domestic partnership agreements and estate planning for domestic partners, contact: Scott and Fenderson PLLC, at 727-321-0099. Free consultations available. http://www.scottandfenderson.com
For over 25 years, I've helped hundreds of patients recover from injuries resulting from auto accidents. My heart goes out to those who suffer from long-term pain and weakness of soft-tissue injuries. Mandatory Florida Personal Injury Protection (PIP) insurance is required to assist all victims of accidents up to $10,000 of medical benefit for diagnosis and treatment of such injuries.
That is, until December 31, 2012.
No-Thanks to the recent legislative session passing of HB119, your 'required' benefits will now be significantly limited, and you may be left paying for medical care due to the negligence of others.
On the guise of preventing insurance fraud (which has been the subject of recent insurance company led media hype of "staged accidents." Their answer to "staged accidents" is to upend the current benefits which will result in ANTI-Consumer, ANTI-State Budget, and PRO-insurance company ramifications.
(It seems the only thing this will reduce, is legitimate insurance company payments for legitimate injuries, in exchange for you paying full premiums for reduced coverage)
Here how things will change (with the signature of Governor Scott) to become Florida Law.
Medical benefits for "soft tissue" or non-emergent care are limited to $2,500 at 80% coverage.
Care for emergent conditions will be paid at the $10,000 benefit.
EFFECTIVE DATE:
After Governor Scott signs the bill, the primary provisions in the new law concerning PIP reimbursements go into effect January 1, 2013.
TIME LIMITS
There is a time limit for a patient to receive benefits. Patients must first present for treatment within 14 days of the car accident, to an emergency room or upon referral to a MD, DC or DO and obtain a diagnosis during this time. If ANY condition is not INITIALLY diagnosed within 14 days, it is NOT Covered.
(Including late-onset symptom of conditions (such as headaches, radiation of arm/leg pain, or conditions you "thought may go away"). Just today I had a patient complain of jaw pain of her TMJ, which was evaluated for ligamentous injury (as confirmed on an imaging study) and related to an accident 45 days ago.
EMERGENCY MEDICAL CONDITION (EMC)
As of now, we don't know what the diagnostic codes the PIP law defines as an EMC, but the law refers to an EMC as:
A medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:
(a) Serious jeopardy to patient health.
(b) Serious impairment to bodily functions.
(c) Serious dysfunction of any bodily organ or part.
NON-EMC Benefits are limited to $2500.00,
Q. If a patient is diagnosed with a non-EMC, the patient's benefit is $2500.
After reaching that benefit, can my health insurance company be billed?
YES. (They can be billed, but Who Pays?)
After receiving a denial of claim from the PIP carrier, Secondary (Health Insurance) may be billed. The patient is responsible for contractual deductibles, copays or co-insurance. (With more claims for auto-related medical benefits, the health insurance companies may raise premiums for care).
Other possible scenarios:
If the patient is under Medicare. Medicare pays.
If the patient is under Medicaid. The taxpayers pay (Medicaid is already a financial burden for the state).
If the patient is un-insured. The patient pays.
If the patient is not 'at fault' - The patient hires an attorney to collect payment (if the other party has adequate coverage). With less PIP benefit for treatment, settlements or judgments will be used to pay off outstanding balances from letters of protection with your treating physician (ie. less money in your pocket, more money for the insurance company).
DIAGNOSTIC TESTING
Unfortunately, diagnostic testing is included in the $2500 limit. A trip to the hospital with diagnostic testing may exhaust your benefits by the time you leave the emergency room.
EXAMINATIONS UNDER OATH
Because of the anti-fraud measure, the insurance company has the power to hold claim payments until you, the patient, respond to an Examination under Oath (EUO). Your medical bills will be put on hold.
MASSAGE AND ACUPUNCTURE EXCLUDED
PIP insurers are not required to reimburse massage "as defined in s. 480.033 or acupuncture as defined in s. 457.102, regardless of the person, entity, or licensee providing massage or acupuncture."
PIP PREMIUM REDUCTION?
Although there is language to suggest the carriers to reduce premiums, the carrier may challenge the requirement by justifying why it could not reduce the premiums.
UNINSURED MOTORIST (UM) and MEDICAL PAYMENTS (Med Pay)
From my understanding, Medical Payments policies do NOT follow PIP statutes or limitations.
The problem is that many insurance companies do not offer or suggest these policies in order to be competitive with other insurance companies for your business.
If PIP premiums are eventually reduced, you will still need to purchase additional Med Pay or UM coverage to protect yourself and your family for financial liability. (ie. More money/profit for the insurance companies)
DEATH BENEFIT INCREASED:
The death benefit has been increased to $5,000 in addition to $10,000 in medical and disability benefits used. Previously the death benefit was the lesser of any unused PIP benefit up to $5,000. So, if the medical benefit is unused, the death benefit remains at $5,000. Why don't they just increase the death benefit to $15,000 if medical/disability benefits are unused? Do they not consider death a "serious" medical condition or a disability for gainful employment?
So, WHAT DOES THIS LAW DO?
Takes away conservative treatment of most legitimate auto related injuries (ie. soft-tissue).
Increases (false) perception that "Soft-Tissue" injuries are fraudulent in nature.
Increases (false) perception that those who treat "soft-tissue injuries" are fraudulent (ie. Massage therapists, chiropractors, acupuncturists).
Increases (false) perception that "soft tissue injuries" are not ‘serious' or cause lasting impairment worthy for medical benefits.
Shifts care to the most expensive ER Hospital Diagnostic and MD specialists.
Less treatment available for injured (absorbed by high ER and Ambulance costs)
Limited (non-emergent) chiropractic care increases exposure and dependency (addictions) to pain medications
Increases non-covered costs to consumers and Medicaid (taxpayers)
Increases injured responsibility for care of conditions which present after 14 days (or for the injured who did not get a diagnosis within 14 days.
Benefits insurance companies and stockholders (Less payout) (increased sales of Med Pay or UM for benefits not paid by PIP).
Helps to raise funds for Governor Rick Scott, who accepted a $100,000 political committee contribution from an affiliate of United Auto Insurance 2 days before the voting to pass this bill.
For more information or a free consultation on your legal issue contact Scott and Fenderson PLLC, your injury law and family law attorneys, at 727-321-0099. http://www.scottandfenderson.com
We had a great turn out this past Saturday at the Pinellas Park Chamber in the Park event. Approximately 20,000 people turned out to meet and mingle with other businesses at this annual event. Our "Dont Text and Drive" campaign was a big hit and we gave out hundreds of bumper stickers. If you didn't get your free public service "Dont Text and Drive" bumper sticker, give us a call we still have them. We made lots of new friends and enjoyed meeting everyone that came out.
Did the Florida Legislature loose sight of the reason we have PIP?
The personal injury protection (PIP) law was adopted in 1972 to make sure anyone injured in an auto accident would quickly get money to treat their injuries. The legislation provided that a driver’s insurance company pay up to $10,000 to cover medical bills and lost wages after an accident, no matter who is at fault.
The public policy in support of having PIP is expressed in Florida Statute Section 627.737 Tort exemption; limitation on right to damages. The intent was to limit injury lawsuits in Florida to the extent of personal injury protection benefits paid. The statute reads as follows:
627.737 Tort exemption: "Every owner, registrant, operator, or occupant of a motor vehicle with respect to which security has been provided as required by ss. 627.730-627.7405, and every person or organization legally responsible for her or his acts or omissions, is hereby exempted from tort liability for damages because of bodily injury, sickness, or disease arising out of the ownership, operation, maintenance, or use of such motor vehicle in this state to the extent that the benefits described in s. 627.736(1) are payable for such injury, or would be payable but for any exclusion authorized by ss. 627.730-627.7405, under any insurance policy or other method of security complying with the requirements of s. 627.733, or by an owner personally liable under s. 627.733 for the payment of such benefits, unless a person is entitled to maintain an action for pain, suffering, mental anguish, and inconvenience for such injury under the provisions of subsection (2)."
The need for this exemption, and the PIP statute is based upon the fact that Florida does not require mandatory bodily injury liability insurance. Florida is a No Fault State. Everyone with auto insurance (not including motorcycle policies) is required to carry PIP (Personal Injury Protection). It typically covers 80% of your medical bills and 60% of your lost wages up to $10,000.00. You can buy medical payments coverage to fill in the 20% gap and you can also buy extended PIP coverage. If you want to save money, you can get wage exclusions on the PIP or a PIP deductible.
What most people aren't aware of is that BI (bodily injury) coverage is not mandatory in Florida so someone can hit you with "full coverage" and be without BI coverage. Mandatory BI coverage is required in many states, but not in Florida. So "full coverage" equals PIP and Property Damage.
A much needed amendment to the new 2012 PIP bill was proposed during this session that would have added mandatory BI (bodily injury coverage) in Florida, however that amendment was shot down. The insurance company lobby prevailed again, as they would prefer not to have mandatory BI coverage in this state, and now have successfully limited PIP coverage with the new bill passed last Friday evening. Perhaps the legislature has lost sight of the needs of the people of Florida, as well as the intent of the PIP staute, and corresponding limitation of liability, and handed the insurance industry a nice gift for 2012 at the expense of the citizens of this state.
For more information or for a free consultation, contact Scott and Fenderson, PA Injury and Family Law Attorneys, by calling 727-321-0099 or view our web site http://www.scottandfenderson.com
Everything you wanted to know about the new pip bill in Florida but were afraid to ask.
Gov. Rick Scott got the legislation he wanted to reform Florida’s mandatory motor vehicle no-fault law and crack down on the abuses in personal injury protection cases that have led to skyrocketing increases for coverage. Whether the new measure will be effective remains to be seen.
The personal injury protection (PIP) law was adopted in 1972 to make sure anyone injured in an auto accident would quickly get money to treat their injuries. The legislation provided that a driver’s insurance company pay up to $10,000 to cover medical bills and lost wages after an accident, no matter who is at fault.
Recently the legislature under the urging of Rick Scott and the insurance industry pushed for changes to the PIP law. Here are some highlights of the new law:
"Emergency medical condition" means a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:
(a) Serious jeopardy to patient health.
(b) Serious impairment to bodily functions.
(c) Serious dysfunction of any bodily organ or part.
"Entity wholly owned" means a proprietorship, group practice, partnership, or corporation that provides health care services rendered by licensed health care practitioners and in which licensed health care practitioners are the business owners of all aspects of the business entity, including, but not limited to, being reflected as the business owners on the title or lease of the physical facility, filing taxes as the business owners, being account holders on the entity's bank account, being listed as the principals on all incorporation documents required by this state, and having ultimate authority over all personnel and compensation decisions relating to the entity. However, this definition does not apply to an entity that is wholly owned, directly or indirectly, by a hospital licensed under chapter 395.
REQUIRED BENEFITS. An insurance policy complying with the security requirements of s. 627.733 must provide personal injury protection to the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in the motor vehicle, and other persons struck by the motor vehicle and suffering bodily injury while not an occupant of a self-propelled vehicle, subject to subsection (2) and paragraph (4)(e), to a limit of $10,000 in medical and disability benefits and $5,000 in death benefits resulting from bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle as follows:
(a) Medical benefits.—Eighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices, and medically necessary ambulance, hospital, and nursing services if the individual receives initial services and care pursuant to subparagraph 1. within 14 days after the motor vehicle accident. The medical benefits provide reimbursement only for:
1. Initial services and care that are lawfully provided, supervised, ordered, or prescribed by a physician licensed under chapter 458 or chapter 459, a dentist licensed under chapter 466, or a chiropractic physician licensed under chapter 460 or that are provided in a hospital or in a facility that owns, or is wholly owned by, a hospital. Initial services and care may also be provided by a person or entity licensed under part III of chapter 401 which provides emergency transportation and treatment.
2. Upon referral by a provider described in subparagraph 1., followup services and care consistent with the underlying medical diagnosis rendered pursuant to subparagraph 1. which may be provided, supervised, ordered, or prescribed only by a physician licensed under chapter 458 or chapter 459, a chiropractic physician licensed under chapter 460, a dentist licensed under chapter 466, or, to the extent permitted by applicable law and under the supervision of such physician, osteopathic physician, chiropractic physician, or dentist, by a physician assistant licensed under chapter 458 or chapter 459 or an advanced registered nurse practitioner licensed under chapter 464. Followup services and care may also be provided by any of the following persons or entities:
a. A hospital or ambulatory surgical center licensed under chapter 395.
b. An entity wholly owned by one or more physicians licensed under chapter 458 or chapter 459, chiropractic physicians licensed under chapter 460, or dentists licensed under chapter 466 or by such practitioners and the spouse, parent, child, or sibling of such practitioners.
c. An entity that owns or is wholly owned, directly or indirectly, by a hospital or hospitals.
d. A physical therapist licensed under chapter 486, based upon a referral by a provider described in subparagraph 2.
e. A health care clinic licensed under part X of chapter 400 which is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the American Osteopathic Association, the Commission on Accreditation of Rehabilitation Facilities, or the Accreditation Association for Ambulatory Health Care, Inc., or (I) Has a medical director licensed under chapter 458, chapter 459, or chapter 460; (II) Has been continuously licensed for more than 3 years or is a publicly traded corporation that issues securities traded on an exchange registered with the United States Securities and Exchange Commission as a national securities exchange; and
(III) Provides at least four of the following medical specialties:
(A) General medicine.
(B) Radiography.
(C) Orthopedic medicine.
(D) Physical medicine.
(E) Physical therapy.
(F) Physical rehabilitation.
(G) Prescribing or dispensing outpatient prescription medication.
(H) Laboratory services.
3. Reimbursement for services and care provided in subparagraph 1. or subparagraph 2. up to $10,000 if a physician licensed under chapter 458 or chapter 459, a dentist licensed under chapter 466, a physician assistant licensed under chapter 458 or chapter 459, or an advanced registered nurse practitioner licensed under chapter 464 has determined that the injured person had an emergency medical condition.
4. Reimbursement for services and care provided in subparagraph 1. or subparagraph 2. is limited to $2,500 if any provider listed in subparagraph 1. or subparagraph 2. determines that the injured person did not have an emergency medical condition.
5. Medical benefits do not include massage as defined in s. 480.033 or acupuncture as defined in s. 457.102, regardless of the person, entity, or licensee providing massage or acupuncture, and a licensed massage therapist or licensed acupuncturist may not be reimbursed for medical benefits under this section.
The new legislation shall take effect July 1, 2012.
For more information or a free consultation on your legal issue contact Scott and Fenderson PLLC, your injury law and family law attorneys, at 727-321-0099. http://www.scottandfenderson.com
HOW AND WHY SHOULD YOU INCORPORATE YOUR SMALL BUSINESS
by Charles D. Scott, Esquire
Why Incorporate?
Deciding how a business is structured is one of the most important decisions you will make for your new or existing business. Incorporation may be essential, however for some, it may be an unnecessary decision, and so each business should carefully assess the benefits of incorporation before filing corporation papers.
A businesses, whether large, small, new, or existing, can benefit from incorporating. Corporations and LLCs are both separate legal entities (business structures) that enjoy certain protections under the law and important benefits. Most people form a legal business structure to safeguard their personal assets. There are several advantages of forming a corporation or Limited Liability Company (LLC) which include:
•Perpetual Existence - Corporations and LLCs have perpetual existence, even if the owner dies or management changes, however a sole proprietorship or partnership ends if an owner dies or leaves the business. As a separate entity, the corporation exists independent from the shareholders/owners and its employees. Regardless of what happens to the shareholders, or the directors, or the employees, the corporation continues to exist in perpetuity until a time the directors and shareholders decide to dissolve the corporation. Incorporation also prevents the ability of a minority shareholder from dissolving a business without cause.
•Personal asset protection - corporation and LLC companies allow owners to separate and protect their personal assets. If the corporation is properly structured and managed, the owners should have limited liability for business debts and obligations. Incorporating or forming a Limited Liability Company (LLC) allows you to conduct your business without worrying that you might lose your home, car, or personal savings because of a business liability. Any debt or liability against a corporation does not open the doors of shareholders' assets to the creditor(s). The shareholder's liability in any corporate debt or liability is limited to what the shareholder invested (unless there is fraud). This is contrasted to a sole proprietorship or general partnership, in which the owner(s) and/or general partners remain completely liable for any debt or liability placed against the business. If a business is unable to pay a debt, the creditor can attack the assets of an owner or partner until the debt is satisfied. In a corporation, a creditor can only go after the share holder to the extent the shareholder invested into the corporation (unless there is fraud). This allows the corporation to make business decisions without the risk of endangering the personal assets of its shareholders beyond what was invested.
•Protects Your Business Name - once you have registered a corporation in the name of your business, others may not file the exact corporation name or LLC name in your state.
•Credibility - when your business has "Inc." or "LLC" at the end of your business name it adds credibility and tells others that they are doing business with an incorporated company and not just an individual.
•Tax Considerations - In a sole proprietorship or partnership, the taxable income of the business flows directly to the owner and/or partners and are taxed based upon the individual's income tax bracket. However, because a corporation is considered a separate entity, the taxable income of a corporation is taxed first under a corporate tax. If the corporation then distributes the remaining income to the shareholders, that income is taxed again at the individual's income tax bracket, hence, double-taxation. A small businesses can avoid double-taxation by incorporating as an S-corporation or filing as a Limited Liability Company (LLC). These options allow the taxable income to flow directly to the shareholders/members without being taxed twice, while at the same time, maintaining the benefits of incorporation. Because corporate returns tend to be more accurate than sole proprietors, the IRS has typically audited a much higher percentage of sole proprietor tax filings than corporate filings.
•Expense Deductions - Corporations and LLCs can deduct normal business expenses, including salaries, before profits are passed through to the owners.
• Liquidity - when an owner or partner needs to leave the business, incorporation allows the free transferability of interest from one person to another. In contrast to a partnership, a partner cannot transfer his/her interest in a business to another without the express consent of all other partners. If a partner still decides to leave the partnership against the will of the other partners, the partnership is automatically dissolved. Incorporation removes this limitation by allowing shareholders/owners to freely transfer his interest to another without the unanimous consent of all other shareholders.
How to Incorporate?
Once you decide to establish a corporation of LLC, in Florida the Division of Corporations serves as the state´s central location for business entity filings. The Division renders two broad functional services: (1) formalizes the legal standing of a business or activity by accepting and indexing the filing or registration, and (2) supplies information and certification regarding the filings and activities of record. Florida´s Division of Corporations is the most active corporate filing entity in the country.
If you elect a corporation, then you must first select a name and find out if your desired corporate name is available, then submit "articles of incorporation" or "articles of organization" if you want to set up an LLC company, to the Florida Department of State with the appropriate fee. The articles must follow a specific format, and contain certain minimum required elements, not limited to the name of the corporation or LLC, the address that will be the principal place of business, the name and address of the registered agent, the name and address of each manager or managing member (if an LLC), the purpose of the corporation, the number of shares of stock that the corporation is authorized to issue, the names and address of the officers and directors of the corporation, the name and address of the incorporator, and the effective date of the corporation or LLC company. You must also submit a cover letter and the required filing fee.
The State of Florida operates a web site that is very helpful in learning more about establishing a corporation or LLC company, and will allow you to check and see if a particular corporate name is available. That web site is www.sunbiz.org.
Charles Scott has been practicing law in St. Petersburg Florida since 1993 and is the managing partner of Scott and Fenderson, PLLC, a family owned and operated law firm since 1997.
Lets start here, this is from the Miami Herald (see link below). United Group Underwriters, an affiliate of United Automobile Insurance Company, gave $100,000 to Scott’s Let’s Get to Work political committee. At the same time, Scott was preparing to bash the Senate’s PIP bill it passed Wednesday, which mandated rate reductions and wasn’t as strict as a House measure. Scott said the Senate bill didn’t do enough to reduce fraud – words echoed by the dozens of lobbyists representing the industry. Said Scott: "The Senate bill seems like it’s been written by special interests." At the same time, the other special interests were writing Scott his big check. It accounts for about a third of the $317,000 Scott has raised since the beginning of the year. Since January 2011, Scott has pulled in a total of $774,751. Some of the biggest contributions came from some of the biggest players in the just-ended legislative session: Miguel B Fernandez ($125,000), Florida Optometric CCE ($100,000), Florida Retail Federation ($100,000), and Florida Association of Insurance Agent ($50,000). Scott’s supporters, like any politician collecting big checks, says his contributors aren’t buying him – instead, they’re buying his agenda. Scott set out early this year to overhaul PIP, which the auto-insurance industry has sought for years. In the waning days, Scott, his staff and Lt. Gov. Jennifer Carroll worked the Senate and got just enough votes to back a compromise bill that passed Friday out of the Legislature. "This is a triumphant moment for the residents of Florida," Scott said in a written statement after the bill passed. "Members of the legislature heard our call to put Floridians ahead of special interests and combat the fraud that has become a billion dollar tax on drivers. Read more here: http://miamiherald.typepad.com/nakedpolitics/2012/03/auto-insurer-strokes-100k-check-to-rick-scott-as-he-pushes-pip-bashes-special-interests.html#storylink=cpy. Lets look at the last sentence, a billion dollar tax on drivers. I took a look at my own auto insurance policy and my annual premium is $1,600 for full coverage. Of this premium my charge for mandatory PIP was about $320, or about 22% of the total premium. My bill for PIP coverage has not changed at all in the past several years. Based upon my own auto policy bill, I don't see charges for PIP coverage "skyrocketing". If the proposed savings of 10% that the insurance companies are supposed to roll back PIP premiums does happen, my bill will change by a whopping $32. In exchange for this $32 savings, I will loose significant benefits previously available to me under my PIP policy coverage. Instead of $10,000 in chiropractic treatment, I can only get $2500 in chiropractic treatment, and then only if I am referred by an MD or DO. Having been a personal injury attorney for fifteen years, I have found that medical doctors have no idea how to treat a whiplash type injury or car accident related injury. They will typically order x-rays, and if you don't have a broken bone, you get sent home with muscle relaxants and some Motrin. Further if you go to an emergency room, your one visit can easily be in excess of $10,000.00, and you will probably get x-rays, and some Motrin for your $10,000.00. It seems that instead of going after the fraudulent PIP mills and so called "accident clinics" of which there are a handful in Florida, the legislature in their wisdom has elected to put the axe to every chiropractor in this state. As a citizen of this state I don't gain any benefits from this new law, instead I have lost most of the benefits previously available to me under PIP. No, the only ones that benefit are the insurance companies operating in Florida. They must be laughing all the way to the bank. Just my opinion, if you disagree, review the new law and come to your own conclusions.
For more information or a free consultation on your legal issue contact Scott and Fenderson PLLC, your injury law and family law attorneys, at 727-321-0099. http://www.scottandfenderson.com
The Floirida legislature has finally come to an agreement on personal injury protection law in Florida, also known as PIP. Under the compromise hammered out Thursday and Friday, the House agreed to allow up to $10,000 for emergency service coverage as determined by a physician, osteopath, dentist, physician's assistant or registered nurse practitioner. Visits to chiropractors would be covered up to $2,500 for certain types of injuries, but would require a referral from one of the other health care providers for others. Acupuncturists and massage therapists would no longer be covered by PIP. That was a concession for the House, which originally wanted initial care to take place only at a hospital or emergency room and later amended its plan to allow private physician visits with a coverage limit of $2,500.
The compromise bill also would require patients to seek care within two weeks of a crash, a concession from the House's original seven-day requirement. The compromise also does not include a cap on attorneys fees as the House originally wanted.
Further the deal would require insurers to roll back rates 10 percent by October and 25 percent by Jan. 1., 2014, or else give a "detailed explanation" to insurance regulators for why the rates were not reduced. The Senate had sought an immediate 25 percent rate reduction.
The bill also would require insurance companies to notify claimants within 30 days if they suspect fraud, and gives the companies another 60 days to investigate. One of the more controversial parts of the deal would require those whose claims are being investigated to submit to examinations under oath if their insurance companies ask. So can we expect insurance companies to "roll back rates"? I seriously doubt it because pip is not a significant part of most policy premiums anyway. My rates for pip are about $300 which is only 22% of my $1600 annual premium. I am not sure where the citizens of Florida will benefit from lower rates on PIP, and it appears that the only ones that will benefit are the insurance companies. The benefits under PIP for the citizens of Florida just got reduced significantly and I would not expect any reduction in pip premiums. The insurance industry lobby was behind this pip bill and apparently sitting in the gallery anxiously awaiting the passage of the bill. Good luck citizens of Florida.
For more information or a free consultation on your legal issue contact Scott and Fenderson PLLC, your injury law and family law attorneys, at 727-321-0099. http://www.scottandfenderson.com
There are occasions when a personal injury claim is pending and the injured party files for bankruptcy during the course of representation. It is essential that a bankruptcy filing be brought to the attention of your injury lawyer immediately, as it will have a significant impact on the handling of your injury claim.
The client should not file a Chapter 7 bankruptcy unless they are willing to give up the claim entirely, including any entitlement to payment of future medical expenses, which is explained in more detail below.
Failure to disclose a pending personal injury claim in your bankruptcy filing is a criminal offense known as bankruptcy fraud.
There are two "Chapters of the Bankruptcy Code (Title ii U.S.C.) under which individuals usually seek relief. Below a summary of their impact on personal injury claims.
CHAPTER7
If there is not a surplus beyond all debt, the injured party has no standing to participate in the settlement process, nor to object to the amount of the settlement. The trustees have very little incentive to push for maximum recovery, they are only liquidators. An additional complication when a Chapter 7 bankruptcy case is filed is that the medical expenses incurred after the filing of the bankruptcy are not dischargeable in the bankruptcy case. Bankruptcy only discharges debts in existence when the case is commenced. While those medical expenses will be an administrative expense of the bankruptcy estate to be paid out of any settlement as necessary to support and prove the claim, the bankruptcy trustee will be attempting to minimize payment to all medical providers in order to maximize payment to pre-petition creditors who are the beneficiaries of the bankruptcy estate. He has no incentive to negotiate a release of personal liability to the injured - just to settle claims against his estate as cheaply as possible. Insurance defense attorneys are trained to do bankruptcy checks because if the injured party filed bankruptcy and didn't disclose the cause of action, the defense attorney can move for dismissal on the day of trial for improper party plaintiff often after the statute has run for refiling. Since it is too late for the bankruptcy trustee to refile, his only recourse is to sue the debtor for non-disclosure, move to revoke has discharge, and possibly refer the case to the F.B.I. for criminal charges for bankruptcy fraud.
CHAPTER 13
Chapter 13 is considered the "wage earner's reorganization" and is available only to individuals, not corporations. (There are three other reorganizations: generally Chapter 9 is for government units: Chapter II is for corporations or individuals with extraordinarily large debts, usually engaged In business; Chapter 12 is for family farmers or family fishermen with regular annual income.)
If a client has an actionable personal injury claim but they are in collection or being sued by creditors, a Chapter 13 bankruptcy case is ordinarily the best solution. The client is protected by the "automatic stay" of bankruptcy from all collection actions.
Instead of the cause or action being turned over to a trustee, as it is in Chapter 7, the Chapter 13 debtor chooses and retains counsel and through the bankruptcy attorney, that counsel is approved by the bankruptcy court to represent both the interests of the debtor and of the bankruptcy estate/Chapter 13 trustee. Once personal injury counsel has been approved by the bankruptcy court the case proceeds normally, with day to day litigation decisions generally being made by the client and personal injury counsel. Day-to-day litigation decisions should be made by the debtor and litigation counsel and it does not normally require that a motion for court approval of litigation actions be made until a proposed settlement has been reached.
When the client and personal injury counsel agree that a binding offer should be accepted, that acceptance must be expressly subject to bankruptcy court approval. (a motion for approval of the settlement). Normally at the same time a motion to approve the fees of personal injury counsel is also filed. It is very unusual for the judge to deny either motion. Bankruptcy judges do not want to discourage personal injury counsel from representing debtors in bankruptcy and generally approve the contingency contract and costs as agreed and incurred unless the bankruptcy judge finds those to be unfair under the factual circumstances. At the time personal injury counsel is authorized by the bankruptcy judge to represent the debtor and the bankruptcy estate, the order normally says that personal injury counsel's fees and costs shall be such as the bankruptcy court shall determine. Fees and costs awarded are always within the discretion of the bankruptcy judge. Upon separate motion the Bankruptcy Court will determine distribution of the rest of the proceeds between the debtor and the bankruptcy estate.
In Chapter 7 bankruptcy cases, unless the cause of action is exempt under law such as a Worker's Compensation claim, upon commencement of the case the cause of action is given over to the bankruptcy trustee as the representative of the creditors. The injured plaintiff may remain injured, but he or she is no longer the proper party plaintiff. The real party in interest is the bankruptcy trustee acting on behalf of the "bankruptcy estate", who has complete authority to pursue the litigation and negotiate settlements. Any settlement is subject to the bankruptcy judges approval, which is rarely withheld. The original injured plaintiff has no standing to object to any settlement unless they can convince the judge that there should be sufficient recovery to pay all creditors in full, with some surplus repayable to the injured original plaintiff (a difficult burden to prove). This means all creditors must get paid in full, including such unusual debts as deficiencies on foreclosed real estate.
For more information or for a free consultation, contact Scott and Fenderson, PLLC Injury and Family Law Attorneys, by calling 727-321-0099 or view our web site http://www.scottandfenderson.com
What Most People Don’t understand about UM insurance.
There are two common misconceptions about UM, also known as un-insured or under-insured motorist insurance coverage.
First Many insurance agents discourage people from purchasing UM coverage and tell their customers that UM is not necessary or they can save a little money by not purchasing this coverage. For the most part UM is not an expensive addition to your policy premium compared to liability coverage or collision coverage, neither of which cover your injury in the event of an accident with an uninsured or underinsured motorist. The real reason agents discourage buying UM is that it is a very affordable coverage and a great bargain for the client, but not a good deal for the insurance company.
Second Many people who do have UM coverage don’t want to pursue a claim against their own insurance carrier, or don’t understand how or why they would have a claim under their UM coverage.
In Florida the only insurance that is mandatory is PIP (Personal Injury Protection which covers 80% of your medical bills and 60% of your lost wages after an accident regardless of fault up to $10,000.00. Right now PIP is being overhauled in the Florida Legislature and may change drastically after this week, unless our law makers in Tallahassee are unable to reach some agreement.
If you are involved in an accident in which the at fault driver either has no liability insurance coverage or is under-insured with regard to bodily injury liability, you may find that there is no coverage for your injury, or insufficient coverage for your injury, other than the minimum PIP coverage as required by law.
If your injury is serious, your medical bills may well exceed $10,000.00, and if you have a serious or permanent injury you may be entitled to compensation for those injuries from the at fault driver that caused the accident. You would expect the at fault driver to have liability insurance to cover your loss, but in Florida there is no requirement that any driver carry bodily injury liability insurance. In the current economy, many drivers elect the minimum required insurance coverage of PIP and property damage, and forego purchasing liability coverage.
To add insult to injury, if the at fault driver is in such a financial condition that he or she cannot afford liability insurance coverage, then they probably don’t have any assets to speak of, which means that filing a lawsuit against them would not be of any benefit either, as any judgement you might achieve in court would likely be uncollectible.
Uninsured motorist coverage then takes the place of the bodily injury coverage the at fault driver failed to carry, or supplements the inadequate or under-insured coverage of the at-fault driver.
The injured person can pursue a claim against their UM coverage in the same manner that they would have pursued their claim against the un-insured or under-insured driver.
In the case of an under-insured driver, for example, the at fault driver carried $10,000 in liability, but your loss is in excess of this amount, you would first pursue a claim against the at fault driver for the limits of their liability coverage, then pursue a claim under your own UM coverage for the remaining value of your injury claim. In the case of an un-insured driver, your claim is under your own UM from the outset once it is determined that the at fault driver has no liability insurance.
Clients are often hesitant to pursue a claim against their own insurance company when the accident is not their fault, however this would defeat the whole purpose of having UM coverage. It is like having homeowners insurance and not wanting to file a claim after your house burns down. It makes no sense not to utilize a coverage that you paid for, which will cover your loss.
Making a claim under your uninsured motorist coverage is not any easier, or simpler than making a claim against the at fault driver. Most insurance companies do not simply pay out the benefit available under your UM coverage and require that you prove your claim, normally with the assistance of a lawyer, in the same manner as you would against the at fault driver. Clients normally find their own insurance company fighting them for the UM benefits they paid for, and offering settlements under the UM coverage that are far less than the value of the claim.
If you want more information about pursuing a UM claim, call Scott and Fenderson PLLC for a free consultation 727-321-0099 or visit http://www.scottandfenderson.com
