Insurance Law

March 14, 2010

“IME,” “Independent Medical Examination,” & “Peer Review” – Says Who? (Florida Law)

Florida Statues may allow PIP carriers to conduct medical examinations and perform paper reviews, but no authority, including the statute itself, grants PIP carriers license to reference those procedures as an “IME,” “Independent Medical Examination,” or a “Peer Review.” In short, PIP carriers have created the terms out of whole cloth to mislead juries.

The doctors are not independent or conducting peer reviews. (Merriam-Webster Dictionary’s only definition of “peer review” is: a process by which something proposed (as for research or publication) is evaluated by a group of experts in the appropriate field.) They are hired by the defense and paid by the defense. If the jury hears that doctors are “independent” or a “Peer Review,” the jury may be confused into believing or thinking the doctors were appointed by the court, a governing body, or with the approval of the Plaintiff or the Plaintiff’s attorney.

When preparing for trial, the Plaintiff’s attorney should consider moving the court for an In Limine order preventing the insurance company from perpetuating the falsehood.
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February 14, 2010

Bad Faith Insurance Law Protects Floridians

by Jeffrey P. Gale, P.A.

Thanks to thoughtful and well-reasoned legislation and court decisions, Floridians can have a reasonable expectation that their own liability insurance companies will act in their best interests. That may soon be changing.

When handling claims, Insurance companies have a duty to act in the best interests of their insureds. This is especially so when insureds are at risk on claims in which the value of the claim (i.e., exposure) exceeds the limits of coverage under the policy of insurance. In those instances, insurance companies are required to do everything within reason to resolve claims within coverage limits. Failing to do so may expose insureds to judgments in excess of policy coverage limits. When this is the result of insurance company indifference or neglect, the carrier may be responsible for paying the excess judgment. This is known as bad faith law and it has been the driving force for more than 30 years in Florida behind insurance companies honoring their duty to handle claims in good faith.
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February 8, 2010

“Full Coverage” Motor Vehicle Accident Insurance in Florida

by Jeffrey P. Gale, P.A.

Almost daily people tell us that they or the at-fault driver in an accident have “Full Coverage” vehicle insurance. The subject comes up while trying to determine if insurance is available to provide compensation for non-economic damages such as pain & suffering arising from personal injuries sustained in a motor vehicle crash. Most people believe that such coverage is available as part of the basic insurance coverage required by the state of florida to lawfully operate a vehicle in Florida. It isn’t.

Florida law requires every owner of a vehicle registered in Florida to maintain nothing more than Personal Injury Protection (“PIP”) and Property Damage Liability insurance. Many people are suprised to learn that neither of these coverages compensates anyone for pain & suffering damages. PIP covers 80% of medical expenses and/or 60% of wage losses up to a total of $10,000 subject to deductibles, while Property Damage Liability pays for damage to other vehicle caused by the at-fault pary. (The minimum level for this type of coverage is $10,000.)

When someone is injured in a Florida motor vehicle accident, only Bodily Injury Liability (“BI”) and Uninsured/Underinsured Motorist (“UM/UIM”) insurance will compensate the victim for his non-economic (pain & suffering) damages. Neither of these coverages is mandatory and to have either requires a premium payment over that required for the minimum mandatory PIP and PD Liability insurance.
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