PIP Insurance, IME Cutoffs & the Role of Your Car Accident Lawyer in Tampa

In the Tampa area and throughout Florida, insurance companies are obligated to pay up to $10,000 PIP, or personal injury protection, for injuries and lost wages after an auto accident, regardless of who is at fault or whether the accident occurred in Clearwater, Town ‘n' Country, Brandon, Seminole Heights, or Lutz.

As you may already know from your car insurance bills, you pay premiums to your insurance company—sometimes for many years—in order to receive these benefits. But it is in your insurance company's best interests to pay out these benefits only when they absolutely have to and sometimes only when they are forced to.

According to the contract that you entered into when you purchased PIP insurance, your auto insurance company has the right to send you to something called an independent medical exam, or IME, if you are involved in a car accident and you've suffered injuries. However, these exams are not so ‘independent' since the examiner knows who is paying the bill (your insurance company) and knows the purpose for the exam as well (to save your insurance company money). This being the case, a car accident lawyer in Tampa usually likes to call them compulsory medical exams, or CMEs.

These medical exams can take place in whatever specialty you receive treatment for your auto accident. So, if you are receiving chiropractic care, you can be sent to a chiropractic CME, or if you've been seeing a neurologist, you can be sent to a neurology CME. It's possible that as a result of your car accident, you are seeing both a chiropractor and a neurologist. In that case, your insurance company could send you for both a chiropractic and neurological CME.

If the CME examiner says that any injuries or symptoms you are complaining about are not the result of the motor vehicle accident, then your insurance benefits can be cut off. Oftentimes CME doctors will make the life-changing decision to cut off your benefits after only completing a brief physical examination and asking you a few questions. The examiner's decisions can be final, regardless of the opinion of the doctors who have treated you for perhaps months after your car accident—doctors who obviously have significantly more information about you and your medical condition.

When a CME causes your insurance benefits to be stopped, your choices for continued treatment are limited whether you live in Tampa, St Petersburg, Sun City Center, Riverview, Carrollwood, Dade City, or Seffner. They include your own personal health insurance or a letter of protection. Or, if you are cut off from receiving any additional PIP benefits, you or often your treating doctor can hire an attorney who can eventually reinstate your benefits. But sometimes, that process can take years.

And because of changes in Florida law affecting how much PIP attorneys can be paid, as well as other recent procedural requirements, it can be very difficult to find any Tampa car accident lawyer who is willing to pursue a PIP case. It is very important, therefore, that your law firm has the experience and concern for you to recommend suitable medical treatment and ensure appropriate documentation of that treatment. By doing this, your law firm can make it:

• Less likely that a CME is requested by an insurance company in the first place, or,
• Less likely that you are cut off from benefits if you are called in for a CME

If your law firm is not able to prevent either of the above possibilities, at least you will have an attorney in place to help ensure that the medical bills are taken care of by either pursuing a settlement with the insurance companies involved or if necessary, filing a lawsuit and obtaining a jury verdict.

At the Tampa personal injury law firm of Dale Appell, P.A., we utilized all of our experience and resources to allow our clients to seek the medical care they need and deserve. Please call or e-mail us today to receive a free assessment of your case.