Personal Injury Frequently Asked Questions of South Florida Serious Injury Attorneys at Rosenberg & Rosenberg, P.A.
The following information includes frequently asked personal injury questions. The answers stated are general in nature and are not intended to apply to every personal injury situation. Each case is different and carries its own set of circumstances which must be taken into consideration by competent legal counsel. By contacting Florida personal injury Lawyer Rosenberg & Rosenberg, P.A., you can receive a personal consultation regarding your specific legal claim.
What is Personal Injury?
What financial compensation can I recover in a personal injury claim?
What are Negligence Defenses?
What is Contributory Negligence?
What is Comparative Negligence?
How do I prove negligence?
What is premises liability?
Can a property owner use deadly force to defend their property?
What should I do if I've been injured in a slip & fall accident?
What should I do if I've been injured in an automobile accident?
What is Assumption of Risk?
What is Liability?
What is strict or absolute liability?
What is Intentional Misconduct?
What is the Statute of Limitations?
How long will it take to settle my claim?
What is a tort?
What are Toxic Torts?
What is Toxic Mold Litigation?
What are Aviation Accidents?
What is Nursing Home Neglect?
What is Wrongful Death?
Under what circumstances can a wrongful death occur?
What is medical malpractice?
Does someone who is simply not satisfied with the results of surgery have a malpractice case?
What is a Contingency Fee?
How do I know if I need an attorney?
What is Personal Injury?
Personal injury is any physical or mental injury to a person that results from another person’s negligence or harmful act. Personal Injury involves civil law cases as opposed to criminal law cases which involve a defendant and the State of Florida. Personal injury often refers to bodily injury and can occur in a wide variety of ways. The following are some of the most common accidents resulting in personal injury:
Auto Accidents
Other Vehicle Accidents (Aviation, Bicycle, Boat, Motorcycle, Railroad, Truck)
Burn Accidents
Construction/On the job Accidents
Dangerous or Defective Products
Dog/Animal Bites
Medical Malpractice (Birth Injuries, Misdiagnosis, Surgical Negligence)
Nursing home abuse and Neglect
Slip and Fall Accidents/Premise Liability
Spinal Cord Injury
Toxic Exposure
Traumatic Brain Injury
Wrongful Death
What financial compensation can I recover in a personal injury claim?
Personal injury accident victims are entitled to recover monetary damages for all losses and expenses sustained as the result of an accident. Depending upon the particular circumstances of your case, damages may include recovery for any of the following:
Medical bills
Lost income, including overtime wages
Pain & Suffering
Physical Disability
Disfigurement
Emotional Trauma
Mental Disability
Property Damage
What are Negligence Defenses?
In the case of negligence, damages awarded for a negligence claim may be reduced if there existed some type of contributory or comparative negligence. In some cases, if an assumption of risk was involved, the case may be dropped or the award reduced depending on the circumstances.
What is Conributory Negligence?
The term contributory negligence is used to describe the actions of an injured person that may have also caused that person's own injuries. For example, a person who ignores a "Wet Floor" sign and slips and falls in the supermarket may be found to have been careless and at fault for any injuries sustained. Contributory negligence can prevent a person from collecting any monies to compensate for injuries suffered, even if that person's carelessness was minor. Some states have done away with the concept of contributory negligence and instead use the concept of "comparative negligence."
What is Comparative Negligence?
Comparative negligence works on a percentage basis to assign a degree of fault for the injuries sustained. For example, a plaintiff in a products liability case cannot be found more than fifty percent at fault in order to be compensated for their injuries. If a plaintiff is found to be fifty-one percent at fault, he or she will not receive any damages for said injuries. Plaintiffs who are found to be less than fifty-percent at fault, however, are awarded compensation in accordance to their percentage of fault.
For example, a person slips and falls on a wet supermarket floor and is awarded $100,000. The supermarket is found to be eighty-percent responsible for the accident because of dangerous floor conditions. However, the injured plaintiff is found twenty percent responsible for not exercising caution, so the award is reduced to $80,000.
How do I prove negligence?
The burden of proof in a tort case, as in most civil law cases, is lower than the proof required in criminal law cases. In a criminal case, the state must prove a person's guilt beyond a reasonable doubt. To win a personal injury lawsuit based on tort law, the plaintiff need only prove that a majority of the evidence shows that an injury was caused by the defendant's negligent actions. This standard of proof is called "the preponderance of the evidence." The different burdens of proof mean that a company might be acquitted of criminal charges stemming from its actions, but be found liable in a civil lawsuit stemming from the same actions.
What is premises liability?
Premises liability generally refers to accidents that occur due to the negligent maintenance, or unsafe conditions upon property owned by someone other than the injured victim. The State of Florida requires landowners to maintain their property in a manner that does not cause injury to those that, for various reasons, visit the property. This law pertains to both business owners and homeowners. Crucial to a premises liability settlement is being able to show how long the defect or injury inflicting element was there, how visible it was, and how much notice the owner had of the dangerous condition before the accident.
Can a property owner use deadly force to defend their property?
No, a property owner may not use deadly force to defend their property. The life, health and safety of an individual, albeit an intruder, is considered to be more valuable to society than the material possessions in which that individual is trying to steal. However, a property owner is not prohibited from defending said property from another. For example, a property owner is entitled to use reasonable force to prevent someone, or something, from entering their property, or to remove someone from their property. Only the use of force calculated to do great bodily injury, or cause death, is not permitted.
However, there are legal loopholes to these guidelines. If an intruder threatens personal safety, or is committing a forcible felony, deadly force may be appropriate. For example, if a robber enters a home and, while stealing items, attempts to rape the property owner, the owner may be legally justified in shooting the robber.
What should I do if I've been injured in a slip & fall accident?
Most businesses and homeowners carry liability insurance to protect them in the event that someone is injured while on their property. The owner or possessor of a residence, land or place of business has the duty to exercise reasonable care for the protection of those individuals who are invited to come upon the premises; i.e. individuals visiting for business or pleasure. In such cases, the owner, company or person must inspect the premises to discover any dangerous conditions and warn the invitee of dangers upon said premises. Those injured by a negligent owner or possessor of a premise may recover damages for their injuries, including loss of income, medical expenses, pain and suffering, etc.
What should I do if I've been injured in an automobile accident?
When a motor vehicle is in an accident, it is important that certain action is taken. The name and address of the operator of each vehicle should be obtained. Additionally, the name and address of the owner of each vehicle involved should be obtained and license plate number of all vehicles should be recorded. Lastly, the name of the automobile insurance company for each vehicle should be obtained. If possible, obtain the names, addresses and telephone numbers of any witnesses to the accident.
If there has been any type of injury, the police should be called to investigate the accident. The police officer will write a report which includes the details of the accident and the nature and extent of any damages and injuries. Insurance companies will require that a report of the accident be obtained before providing any benefits. It is most important to immediately contact your own motor vehicle insurance company to report to them any property damage or personal injury. If you or a family member is injured in a motor vehicle accident, prompt medical attention should be obtained.
If you are seriously injured in an automobile accident as the result of someone else's negligence, please contact Florida personal injury Attorneys at Rosenberg & Rosenberg, P.A., today, for more information.
What is Assumption of Risk?
If you have knowingly and voluntarily assumed the risk inherent in a particular action that caused an accident, you cannot sue another person for negligence. For example, if you went to a friend’s house and they told you not to go out the backdoor because the deck was being repaired and after being told you still went out the backdoor, you assume the risk. If you become injured in most jurisdictions, under the doctrine of the assumption of risk, you would most likely not be able to collect damages.
Another example of assumption of risk is participation in a sport in which certain risks are inherent to the game. For example, if you are playing football and you get tackled and break an arm, you may not sue the person who tackled you. On the other hand, if you are playing tennis and a fight breaks out and you injured as a result of the altercation, you may be able to sue the person who injured you, since the assumption of risk does not cover any injury that was intentionally inflicted and not an inherent part of the game.
What is Liability?
The term liability generally means that an individual, company or some other entity may be obligated to pay damages or compensation to another. The negligent driver, manufacturer or seller of a product may be responsible or liable to pay for damages, including pain and suffering and financial losses, if they are caused by their carelessness.
What is strict or absolute liability?
Strict or absolute liability means that the defendant is responsible for injuring another person regardless of negligence or intent. It means that the manufacturer of a product is liable for selling any defective product that is considered "unreasonably dangerous" and results in injury either to the buyer or someone else who uses it. In strict product liability, it is unnecessary to prove that the manufacturer was negligent; all you have to do is show that the product was defective, that it was allowed to be sold, and that the injuries were caused by the defect in the product.
Some instances in which the law might apply strict liability are with regard to product liability, abnormally dangerous or ultra-hazardous activities, and animal owner's liability. For example, a plaintiff may be entitled to compensation after a defective product injures him or her regardless of whether the manufacturer was actually negligent.
What is Intentional Misconduct?
Intentional misconduct is a deliberate action resulting in an injury to another person or damage to another person's property. A plaintiff alleging intentional misconduct need not compare the defendant's actions to those of a reasonable person; he or she only must show that the defendant intended his or her actions. In a civil lawsuit in which the plaintiff alleges intentional misconduct, the plaintiff can recover punitive damages in addition to awards for injuries, pain and suffering.
What is the Statute of Limitations?
Every state has certain time limits, called "statutes of limitations," that govern the period during which you must file a personal injury lawsuit. In some states, for example, you may have as little as one year to file a lawsuit from an automobile accident. When the statute of limitations expires on your case, you simply don't have a case anymore.
Statutes of limitations differ not only from state to state, but also in regard to the kinds of lawsuits involved. In some states the statute of limitations for medical malpractice, suits against governmental agencies, and wrongful death actions is shorter than that for other types of personal injury cases. In general, however, the statute of limitations for personal injury cases is from one to three years, and the time begins from the time of the accident. For more information regarding the limitations for your specific case, please contact Florida personal injury Lawyer Rosenberg & Rosenberg, P.A..
How long will it take to settle my claim?
The time it takes to settle a personal injury case depends on the circumstances surrounding the case. The more complex the case the longer it may take to settle. Many cases can take anywhere from 3 to 18 months to settle depending on its complexity.
What is a tort?
A tort is a civil wrong recognized by law as grounds for a lawsuit. Torts fall into three general categories: intentional torts (e.g., intentionally hitting a person); negligent torts (e.g., causing an accident by failing to obey traffic rules); and strict liability torts (e.g., liability for making and selling defective products). These wrongs result in an injury or harm constituting the basis for a claim by the injured party (tort litigation).
What are Toxic Torts?
Toxic torts are caused by exposure to toxic or dangerous substances, chemicals, dangerous forms of energy, and medical products or devices. Toxic tort cases are usually brought as class action lawsuits, because usually the same toxin affects large numbers of people.
Plaintiffs who win toxic tort lawsuits can recover monetary damages for past and future medical expenses, past and future pain and suffering, lost wages, loss of future earning capacity, loss of enjoyment of life, emotional distress and sometimes punitive damages.
Because the effects of toxic substance exposure may take years to manifest, it may be months or years before the toxic tort case is actually litigated. Examples of toxic tort cases include, but are not limited to:
Asbestos
Chemicals
Pharmaceuticals
Cosmetics
Pesticides
Radiation or Electromagnetic Energy
Medical Products and/or Devices
Well Water Contamination Caused by Oil, Gas or Other Toxins
There are many different ways to establish liability in a toxic tort case including negligence, premises liability, breach of warranty, misrepresentation and products liability. In litigating a toxic tort case, the plaintiff must prove that:
He or she was exposed to the toxic substance, energy, product or device
The defendant(s) caused his or her injuries
He or she suffered damages from exposure to the toxic substance, energy, product or device
What is Toxic Mold Litigation?
A related practice area is toxic mold litigation, where the exposure is to toxic molds rather than toxic substances, energy, products or devices. Molds are microscopic fungi that need plant and animal matter in order to grow. Molds are found in almost every environment outdoors, and in homes and buildings. Household molds exist in colors such as red, green, blue-green, brown and black. Most molds pose little or no health risks to people, but exposure to some molds (including two household varieties) can cause severe health complications and even death for infants and sensitive individuals. A few examples of toxic molds include:
Aspergillus
Fusarium
Memnoniella (toxic household mold)
Paecilomyces
Penicillium
Stachybotrys (toxic household mold)
What are Aviation Accidents?
Aviation accidents occur in a variety of different situations. While the most common aviation accidents are those involving commercial airlines, many accidents occur with private airplanes, as well as commercial and private helicopters. The leading causes of commercial airline accidents include engine failures, controlled flight into terrain, approach and landing, loss of control, runway incursions and weather (including turbulence). Private or "general" aviation accidents can include controlled flight into terrain, weather, loss of control, and runway incursions.
Depending on the circumstances surrounding the accident, the investigation is conducted by one or more of the following agencies: National Transportation Safety Board (NTSB), Federal Aviation Administration (FAA), Transportation Security Administration (TSA) and Federal Bureau of Investigations (FBI). But, accident investigations may also involve foreign or local authorities, or the Departments of Justice, State and/or Defense. Agencies such as the American Red Cross, Department of Health and Human Services, and the Federal Emergency Management Agency may also be involved in providing services to victims and their families.
What is Nursing Home Neglect?
The State of Florida has special laws enacted for the specific purpose of protecting the elderly population (over 65) and dependent adults. These laws were designed to encourage victims and their attorneys to pursue legal cases against all persons or entities that abuse or neglect this vulnerable segment of society. Elder, disabled and dependent adults depend on nursing homes to provide most if not all of their daily care, which includes food, water, medicine, toileting, grooming, social and physical stimulation, as well as regularly being turned in their beds. However, because nursing homes are not sufficiently staffed, and the staff there is generally underpaid, millions of elder and dependent adults are currently being neglected and abused. Signs of nursing home abuse and neglect include:
Bed sores (pressure sores, decubitus ulcers)
Burns
Rapid weight loss
Unexplained bruises
Emotional withdrawal
Malnutrition or dehydration
Heavy sedation
Inability of caretakers to explain patient’s condition
Whether it is a single incident that causes injury or recurrent neglect or abuse, the victim or his/her next of kin has a right to bring claims against the nursing home under the nursing home neglect laws. If the nursing home is found to be negligent or abusive, the victim and/or next of kin will generally be awarded monetary compensation and the nursing home could potentially lose its certification for failing to supply the expected care (leading to a loss of federal funding).
The best prevention of neglect and abuse is attentive family members, who, on an ongoing basis, are aware of the general health of their vulnerable relatives. If you suspect that you or a loved one is or was subject to an abuse or neglect, it is important to report that abuse or neglect right away. Florida nursing home abuse Attorneys at Rosenberg & Rosenberg, P.A. has prosecuted many cases involving the abuse or neglect of the elderly and dependent and provides free consultation to any individuals who believe that abuse or neglect may have been committed.
What is Wrongful Death?
Wrongful death occurs when a person's death was caused by the negligent, willful, or wrongful act, neglect, omission, or default of another, such as careless driving or a deliberate murder. In addition to injuring the person who died, people who depended upon the deceased for financial or emotional support may be entitled to compensation for the wrongful death. The State of Florida has enacted a statute permitting a lawsuit to be brought by the relatives of a person who died as a result of a wrongful act.
Under what circumstances can a wrongful death occur?
Wrongful Death Law provides financial compensation to the family of a person whose death was caused by the negligent, willful or wrongful act of another. Wrongful death cases are filed as a result of a variety of situations, including:
Medical malpractice resulting in decedent's death
Neglect or abuse on the part of a nursing home that results in decedent's death
Automobile, bus, train, airplane or other common carrier fatality accident
Occupational exposure to hazardous conditions or substances (exposure to asbestos, etc.)
Death during a supervised activity (sports tournament, field trip, etc.)
What is medical malpractice?
Medical malpractice is negligence committed by a professional health care provider-a doctor, nurse, dentist, technician, hospital, or hospital worker-whose performance of duties deviates from a standard of practice of those with similar training and experience, resulting in harm to a patient or patients. Most medical malpractice cases are based on the concept of negligence-that is, the patient was harmed because the health care provider failed to meet the required standards of skill and care, in accordance with generally accepted standards. Instances of malpractice might include cutting off the oxygen supply during surgery, misdiagnosing an injury because routine tests and procedures were not followed, or prescribing an illegal drug or one not approved for the patient’s condition.
Does someone who is simply not satisfied with the results of surgery have a malpractice case?
No. In general, there are no guarantees of medical results, and unexpected or unsuccessful results do not necessarily mean that negligence occurred. To succeed in a medical malpractice case, a plaintiff has to prove that a medical injury or related damages resulted from the doctor's deviation from the standard of care pertaining to the procedure, not that the results from a standardized medical treatment were unsatisfactory.
What is a Contingency Fee?
A contingency fee is an industry standard fee that is applied to personal injury cases and is dependent upon the successful resolution of your case. A contingency fee is a percentage of the monetary recovery obtained by counsel on a client's behalf and is only paid if and when counsel is successful in obtaining monetary recovery, whether through settlement or litigation. The industry-standard contingency fee is about one third of the awarded settlement. A contingency fee is the form of payment earned by a lawyer when he or she states that "there is no fee unless we win your case." Florida personal injury Attorneys at Rosenberg & Rosenberg, P.A. uses contingency fees for his personal injury cases and will not charge you for services rendered unless you are awarded monetary recovery.
How do I know if I need an attorney?
If you have been seriously injured in South Florida, or within the surrounding areas of Florida, and are unsure about the outcome of your injury, consult with an experienced personal injury attorney as soon as possible. Make sure this is done before you give any official statements or sign papers of any kind. Florida laws require filing a lawsuit within a specific period of time. Depending upon the circumstances of your case, you may be prohibited from filing a lawsuit and obtaining any compensation for your injuries. Serious injury Attorneys at Rosenberg & Rosenberg, P.A. can advise you on the applicable statute of limitations for your injury case.
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Wednesday, November 28, 2007
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Florida Automobile Insurance Coverage
Florida Automobile Insurance Coverage
Automobile insurance laws in Florida require the owner of a vehicle to have a certain amount of personal injury protection. Fla. Sta § 627.736. http://www.leg.state.fl.us/Statutes/index.cfm?mode=View%20Statutes&SubMenu=1&App_mode=Display_Statute&Search_String=&URL=CH0627/SEC736.HTM.
Automobile insurance laws in Florida require the owner of a vehicle to have a certain amount of personal injury protection. Fla. Sta § 627.736. http://www.leg.state.fl.us/Statutes/index.cfm?mode=View%20Statutes&SubMenu=1&App_mode=Display_Statute&Search_String=&URL=CH0627/SEC736.HTM.
Personal injury protection provides compensation to you in the event you are in an accident. The minimum amount of personal injury coverage required by law is $10,000.00 according to Fla Sta. §627.736, but you can purchase higher amounts of insurance that covers medical, surgical, funeral, and disability benefits regardless of fault. This is known as no-fault insurance. Please feel free to contact Cory T. Knight at 954-652-0733 at CTK INVESTIGATIONS, LLC to ask any questions. Mr. Knight has over 20 years experience dealing with accident investigations and has a comprehensive understanding of PIP cases and investigation.
Here is some more direct information on Florida's PIP or NO-Fault Law:
1627.736 Required personal injury protection benefits; exclusions; priority; claims.--
(1) REQUIRED BENEFITS.--Every insurance policy complying with the security requirements of s. 627.733 shall provide personal injury protection to the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in such motor vehicle, and other persons struck by such motor vehicle and suffering bodily injury while not an occupant of a self-propelled vehicle, subject to the provisions of subsection (2) and paragraph (4)(d), to a limit of $10,000 for loss sustained by any such person as a result of 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. Such benefits shall also include necessary remedial treatment and services recognized and permitted under the laws of the state for an injured person who relies upon spiritual means through prayer alone for healing, in accordance with his or her religious beliefs; however, this sentence does not affect the determination of what other services or procedures are medically necessary.
(b) Disability benefits.--Sixty percent of any loss of gross income and loss of earning capacity per individual from inability to work proximately caused by the injury sustained by the injured person, plus all expenses reasonably incurred in obtaining from others ordinary and necessary services in lieu of those that, but for the injury, the injured person would have performed without income for the benefit of his or her household. All disability benefits payable under this provision shall be paid not less than every 2 weeks.
(c) Death benefits.--Death benefits of $5,000 per individual. The insurer may pay such benefits to the executor or administrator of the deceased, to any of the deceased's relatives by blood or legal adoption or connection by marriage, or to any person appearing to the insurer to be equitably entitled thereto. Only insurers writing motor vehicle liability insurance in this state may provide the required benefits of this section, and no such insurer shall require the purchase of any other motor vehicle coverage other than the purchase of property damage liability coverage as required by s. 627.7275 as a condition for providing such required benefits. Insurers may not require that property damage liability insurance in an amount greater than $10,000 be purchased in conjunction with personal injury protection. Such insurers shall make benefits and required property damage liability insurance coverage available through normal marketing channels. Any insurer writing motor vehicle liability insurance in this state who fails to comply with such availability requirement as a general business practice shall be deemed to have violated part IX of chapter 626, and such violation shall constitute an unfair method of competition or an unfair or deceptive act or practice involving the business of insurance; and any such insurer committing such violation shall be subject to the penalties afforded in such part, as well as those which may be afforded elsewhere in the insurance code.
(2) AUTHORIZED EXCLUSIONS.--Any insurer may exclude benefits:
(a) For injury sustained by the named insured and relatives residing in the same household while occupying another motor vehicle owned by the named insured and not insured under the policy or for injury sustained by any person operating the insured motor vehicle without the express or implied consent of the insured.
(b) To any injured person, if such person's conduct contributed to his or her injury under any of the following circumstances:
1. Causing injury to himself or herself intentionally; or
2. Being injured while committing a felony. Whenever an insured is charged with conduct as set forth in subparagraph 2., the 30-day payment provision of paragraph (4)(b) shall be held in abeyance, and the insurer shall withhold payment of any personal injury protection benefits pending the outcome of the case at the trial level. If the charge is nolle prossed or dismissed or the insured is acquitted, the 30-day payment provision shall run from the date the insurer is notified of such action.
(3) INSURED'S RIGHTS TO RECOVERY OF SPECIAL DAMAGES IN TORT CLAIMS.--No insurer shall have a lien on any recovery in tort by judgment, settlement, or otherwise for personal injury protection benefits, whether suit has been filed or settlement has been reached without suit. An injured party who is entitled to bring suit under the provisions of ss. 627.730-627.7405, or his or her legal representative, shall have no right to recover any damages for which personal injury protection benefits are paid or payable. The plaintiff may prove all of his or her special damages notwithstanding this limitation, but if special damages are introduced in evidence, the trier of facts, whether judge or jury, shall not award damages for personal injury protection benefits paid or payable. In all cases in which a jury is required to fix damages, the court shall instruct the jury that the plaintiff shall not recover such special damages for personal injury protection benefits paid or payable.
(4) BENEFITS; WHEN DUE.--Benefits due from an insurer under ss. 627.730-627.7405 shall be primary, except that benefits received under any workers' compensation law shall be credited against the benefits provided by subsection (1) and shall be due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered by the policy issued under ss. 627.730-627.7405. When the Agency for Health Care Administration provides, pays, or becomes liable for medical assistance under the Medicaid program related to injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle, benefits under ss. 627.730-627.7405 shall be subject to the provisions of the Medicaid program.
(a) An insurer may require written notice to be given as soon as practicable after an accident involving a motor vehicle with respect to which the policy affords the security required by ss. 627.730-627.7405.
(b) Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same. If such written notice is not furnished to the insurer as to the entire claim, any partial amount supported by written notice is overdue if not paid within 30 days after such written notice is furnished to the insurer. Any part or all of the remainder of the claim that is subsequently supported by written notice is overdue if not paid within 30 days after such written notice is furnished to the insurer. When an insurer pays only a portion of a claim or rejects a claim, the insurer shall provide at the time of the partial payment or rejection an itemized specification of each item that the insurer had reduced, omitted, or declined to pay and any information that the insurer desires the claimant to consider related to the medical necessity of the denied treatment or to explain the reasonableness of the reduced charge, provided that this shall not limit the introduction of evidence at trial; and the insurer shall include the name and address of the person to whom the claimant should respond and a claim number to be referenced in future correspondence. However, notwithstanding the fact that written notice has been furnished to the insurer, any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment. For the purpose of calculating the extent to which any benefits are overdue, payment shall be treated as being made on the date a draft or other valid instrument which is equivalent to payment was placed in the United States mail in a properly addressed, postpaid envelope or, if not so posted, on the date of delivery. This paragraph does not preclude or limit the ability of the insurer to assert that the claim was unrelated, was not medically necessary, or was unreasonable or that the amount of the charge was in excess of that permitted under, or in violation of, subsection (5). Such assertion by the insurer may be made at any time, including after payment of the claim or after the 30-day time period for payment set forth in this paragraph.
(c) All overdue payments shall bear simple interest at the rate established under s. 55.03 or the rate established in the insurance contract, whichever is greater, for the year in which the payment became overdue, calculated from the date the insurer was furnished with written notice of the amount of covered loss. Interest shall be due at the time payment of the overdue claim is made.
(d) The insurer of the owner of a motor vehicle shall pay personal injury protection benefits for:
1. Accidental bodily injury sustained in this state by the owner while occupying a motor vehicle, or while not an occupant of a self-propelled vehicle if the injury is caused by physical contact with a motor vehicle.
2. Accidental bodily injury sustained outside this state, but within the United States of America or its territories or possessions or Canada, by the owner while occupying the owner's motor vehicle.
3. Accidental bodily injury sustained by a relative of the owner residing in the same household, under the circumstances described in subparagraph 1. or subparagraph 2., provided the relative at the time of the accident is domiciled in the owner's household and is not himself or herself the owner of a motor vehicle with respect to which security is required under ss. 627.730-627.7405.
4. Accidental bodily injury sustained in this state by any other person while occupying the owner's motor vehicle or, if a resident of this state, while not an occupant of a self-propelled vehicle, if the injury is caused by physical contact with such motor vehicle, provided the injured person is not himself or herself:
a. The owner of a motor vehicle with respect to which security is required under ss. 627.730-627.7405; or
b. Entitled to personal injury benefits from the insurer of the owner or owners of such a motor vehicle.
(e) If two or more insurers are liable to pay personal injury protection benefits for the same injury to any one person, the maximum payable shall be as specified in subsection (1), and any insurer paying the benefits shall be entitled to recover from each of the other insurers an equitable pro rata share of the benefits paid and expenses incurred in processing the claim.
(f) It is a violation of the insurance code for an insurer to fail to timely provide benefits as required by this section with such frequency as to constitute a general business practice.
(g) Benefits shall not be due or payable to or on the behalf of an insured person if that person has committed, by a material act or omission, any insurance fraud relating to personal injury protection coverage under his or her policy, if the fraud is admitted to in a sworn statement by the insured or if it is established in a court of competent jurisdiction. Any insurance fraud shall void all coverage arising from the claim related to such fraud under the personal injury protection coverage of the insured person who committed the fraud, irrespective of whether a portion of the insured person's claim may be legitimate, and any benefits paid prior to the discovery of the insured person's insurance fraud shall be recoverable by the insurer from the person who committed insurance fraud in their entirety. The prevailing party is entitled to its costs and attorney's fees in any action in which it prevails in an insurer's action to enforce its right of recovery under this paragraph.
(5) CHARGES FOR TREATMENT OF INJURED PERSONS.--
(a) Any physician, hospital, clinic, or other person or institution lawfully rendering treatment to an injured person for a bodily injury covered by personal injury protection insurance may charge the insurer and injured party only a reasonable amount pursuant to this section for the services and supplies rendered, and the insurer providing such coverage may pay for such charges directly to such person or institution lawfully rendering such treatment, if the insured receiving such treatment or his or her guardian has countersigned the properly completed invoice, bill, or claim form approved by the office upon which such charges are to be paid for as having actually been rendered, to the best knowledge of the insured or his or her guardian. In no event, however, may such a charge be in excess of the amount the person or institution customarily charges for like services or supplies. With respect to a determination of whether a charge for a particular service, treatment, or otherwise is reasonable, consideration may be given to evidence of usual and customary charges and payments accepted by the provider involved in the dispute, and reimbursement levels in the community and various federal and state medical fee schedules applicable to automobile and other insurance coverages, and other information relevant to the reasonableness of the reimbursement for the service, treatment, or supply.
(b)1. An insurer or insured is not required to pay a claim or charges:
a. Made by a broker or by a person making a claim on behalf of a broker;
b. For any service or treatment that was not lawful at the time rendered;
c. To any person who knowingly submits a false or misleading statement relating to the claim or charges;
d. With respect to a bill or statement that does not substantially meet the applicable requirements of paragraph (d);
e. For any treatment or service that is upcoded, or that is unbundled when such treatment or services should be bundled, in accordance with paragraph (d). To facilitate prompt payment of lawful services, an insurer may change codes that it determines to have been improperly or incorrectly upcoded or unbundled, and may make payment based on the changed codes, without affecting the right of the provider to dispute the change by the insurer, provided that before doing so, the insurer must contact the health care provider and discuss the reasons for the insurer's change and the health care provider's reason for the coding, or make a reasonable good faith effort to do so, as documented in the insurer's file; and
f. For medical services or treatment billed by a physician and not provided in a hospital unless such services are rendered by the physician or are incident to his or her professional services and are included on the physician's bill, including documentation verifying that the physician is responsible for the medical services that were rendered and billed.
2. Charges for medically necessary cephalic thermograms, peripheral thermograms, spinal ultrasounds, extremity ultrasounds, video fluoroscopy, and surface electromyography shall not exceed the maximum reimbursement allowance for such procedures as set forth in the applicable fee schedule or other payment methodology established pursuant to s. 440.13.
3. Allowable amounts that may be charged to a personal injury protection insurance insurer and insured for medically necessary nerve conduction testing when done in conjunction with a needle electromyography procedure and both are performed and billed solely by a physician licensed under chapter 458, chapter 459, chapter 460, or chapter 461 who is also certified by the American Board of Electrodiagnostic Medicine or by a board recognized by the American Board of Medical Specialties or the American Osteopathic Association or who holds diplomate status with the American Chiropractic Neurology Board or its predecessors shall not exceed 200 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year's changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor.
4. Allowable amounts that may be charged to a personal injury protection insurance insurer and insured for medically necessary nerve conduction testing that does not meet the requirements of subparagraph 3. shall not exceed the applicable fee schedule or other payment methodology established pursuant to s. 440.13.
5. Allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services shall not exceed 175 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year's changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor for the 12-month period ending June 30 of that year, except that allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services provided in facilities accredited by the Accreditation Association for Ambulatory Health Care, the American College of Radiology, or the Joint Commission on Accreditation of Healthcare Organizations shall not exceed 200 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year's changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor for the 12-month period ending June 30 of that year. This paragraph does not apply to charges for magnetic resonance imaging services and nerve conduction testing for inpatients and emergency services and care as defined in chapter 395 rendered by facilities licensed under chapter 395.
6. The Department of Health, in consultation with the appropriate professional licensing boards, shall adopt, by rule, a list of diagnostic tests deemed not to be medically necessary for use in the treatment of persons sustaining bodily injury covered by personal injury protection benefits under this section. The initial list shall be adopted by January 1, 2004, and shall be revised from time to time as determined by the Department of Health, in consultation with the respective professional licensing boards. Inclusion of a test on the list of invalid diagnostic tests shall be based on lack of demonstrated medical value and a level of general acceptance by the relevant provider community and shall not be dependent for results entirely upon subjective patient response. Notwithstanding its inclusion on a fee schedule in this subsection, an insurer or insured is not required to pay any charges or reimburse claims for any invalid diagnostic test as determined by the Department of Health.
(c)1. With respect to any treatment or service, other than medical services billed by a hospital or other provider for emergency services as defined in s. 395.002 or inpatient services rendered at a hospital-owned facility, the statement of charges must be furnished to the insurer by the provider and may not include, and the insurer is not required to pay, charges for treatment or services rendered more than 35 days before the postmark date of the statement, except for past due amounts previously billed on a timely basis under this paragraph, and except that, if the provider submits to the insurer a notice of initiation of treatment within 21 days after its first examination or treatment of the claimant, the statement may include charges for treatment or services rendered up to, but not more than, 75 days before the postmark date of the statement. The injured party is not liable for, and the provider shall not bill the injured party for, charges that are unpaid because of the provider's failure to comply with this paragraph. Any agreement requiring the injured person or insured to pay for such charges is unenforceable.
2. If, however, the insured fails to furnish the provider with the correct name and address of the insured's personal injury protection insurer, the provider has 35 days from the date the provider obtains the correct information to furnish the insurer with a statement of the charges. The insurer is not required to pay for such charges unless the provider includes with the statement documentary evidence that was provided by the insured during the 35-day period demonstrating that the provider reasonably relied on erroneous information from the insured and either:
a. A denial letter from the incorrect insurer; or
b. Proof of mailing, which may include an affidavit under penalty of perjury, reflecting timely mailing to the incorrect address or insurer.
3. For emergency services and care as defined in s. 395.002 rendered in a hospital emergency department or for transport and treatment rendered by an ambulance provider licensed pursuant to part III of chapter 401, the provider is not required to furnish the statement of charges within the time periods established by this paragraph; and the insurer shall not be considered to have been furnished with notice of the amount of covered loss for purposes of paragraph (4)(b) until it receives a statement complying with paragraph (d), or copy thereof, which specifically identifies the place of service to be a hospital emergency department or an ambulance in accordance with billing standards recognized by the Health Care Finance Administration.
4. Each notice of insured's rights under s. 627.7401 must include the following statement in type no smaller than 12 points:
BILLING REQUIREMENTS.--Florida Statutes provide that with respect to any treatment or services, other than certain hospital and emergency services, the statement of charges furnished to the insurer by the provider may not include, and the insurer and the injured party are not required to pay, charges for treatment or services rendered more than 35 days before the postmark date of the statement, except for past due amounts previously billed on a timely basis, and except that, if the provider submits to the insurer a notice of initiation of treatment within 21 days after its first examination or treatment of the claimant, the statement may include charges for treatment or services rendered up to, but not more than, 75 days before the postmark date of the statement.
(d) All statements and bills for medical services rendered by any physician, hospital, clinic, or other person or institution shall be submitted to the insurer on a properly completed Centers for Medicare and Medicaid Services (CMS) 1500 form, UB 92 forms, or any other standard form approved by the office or adopted by the commission for purposes of this paragraph. All billings for such services rendered by providers shall, to the extent applicable, follow the Physicians' Current Procedural Terminology (CPT) or Healthcare Correct Procedural Coding System (HCPCS), or ICD-9 in effect for the year in which services are rendered and comply with the Centers for Medicare and Medicaid Services (CMS) 1500 form instructions and the American Medical Association Current Procedural Terminology (CPT) Editorial Panel and Healthcare Correct Procedural Coding System (HCPCS). All providers other than hospitals shall include on the applicable claim form the professional license number of the provider in the line or space provided for "Signature of Physician or Supplier, Including Degrees or Credentials." In determining compliance with applicable CPT and HCPCS coding, guidance shall be provided by the Physicians' Current Procedural Terminology (CPT) or the Healthcare Correct Procedural Coding System (HCPCS) in effect for the year in which services were rendered, the Office of the Inspector General (OIG), Physicians Compliance Guidelines, and other authoritative treatises designated by rule by the Agency for Health Care Administration. No statement of medical services may include charges for medical services of a person or entity that performed such services without possessing the valid licenses required to perform such services. For purposes of paragraph (4)(b), an insurer shall not be considered to have been furnished with notice of the amount of covered loss or medical bills due unless the statements or bills comply with this paragraph, and unless the statements or bills are properly completed in their entirety as to all material provisions, with all relevant information being provided therein.
(e)1. At the initial treatment or service provided, each physician, other licensed professional, clinic, or other medical institution providing medical services upon which a claim for personal injury protection benefits is based shall require an insured person, or his or her guardian, to execute a disclosure and acknowledgment form, which reflects at a minimum that:
a. The insured, or his or her guardian, must countersign the form attesting to the fact that the services set forth therein were actually rendered;
b. The insured, or his or her guardian, has both the right and affirmative duty to confirm that the services were actually rendered;
c. The insured, or his or her guardian, was not solicited by any person to seek any services from the medical provider;
d. That the physician, other licensed professional, clinic, or other medical institution rendering services for which payment is being claimed explained the services to the insured or his or her guardian; and
e. If the insured notifies the insurer in writing of a billing error, the insured may be entitled to a certain percentage of a reduction in the amounts paid by the insured's motor vehicle insurer.
2. The physician, other licensed professional, clinic, or other medical institution rendering services for which payment is being claimed has the affirmative duty to explain the services rendered to the insured, or his or her guardian, so that the insured, or his or her guardian, countersigns the form with informed consent.
3. Countersignature by the insured, or his or her guardian, is not required for the reading of diagnostic tests or other services that are of such a nature that they are not required to be performed in the presence of the insured.
4. The licensed medical professional rendering treatment for which payment is being claimed must sign, by his or her own hand, the form complying with this paragraph.
5. The original completed disclosure and acknowledgment form shall be furnished to the insurer pursuant to paragraph (4)(b) and may not be electronically furnished.
6. This disclosure and acknowledgment form is not required for services billed by a provider for emergency services as defined in s. 395.002, for emergency services and care as defined in s. 395.002 rendered in a hospital emergency department, or for transport and treatment rendered by an ambulance provider licensed pursuant to part III of chapter 401.
7. The Financial Services Commission shall adopt, by rule, a standard disclosure and acknowledgment form that shall be used to fulfill the requirements of this paragraph, effective 90 days after such form is adopted and becomes final. The commission shall adopt a proposed rule by October 1, 2003. Until the rule is final, the provider may use a form of its own which otherwise complies with the requirements of this paragraph.
8. As used in this paragraph, "countersigned" means a second or verifying signature, as on a previously signed document, and is not satisfied by the statement "signature on file" or any similar statement.
9. The requirements of this paragraph apply only with respect to the initial treatment or service of the insured by a provider. For subsequent treatments or service, the provider must maintain a patient log signed by the patient, in chronological order by date of service, that is consistent with the services being rendered to the patient as claimed. The requirements of this subparagraph for maintaining a patient log signed by the patient may be met by a hospital that maintains medical records as required by s. 395.3025 and applicable rules and makes such records available to the insurer upon request.
(f) Upon written notification by any person, an insurer shall investigate any claim of improper billing by a physician or other medical provider. The insurer shall determine if the insured was properly billed for only those services and treatments that the insured actually received. If the insurer determines that the insured has been improperly billed, the insurer shall notify the insured, the person making the written notification and the provider of its findings and shall reduce the amount of payment to the provider by the amount determined to be improperly billed. If a reduction is made due to such written notification by any person, the insurer shall pay to the person 20 percent of the amount of the reduction, up to $500. If the provider is arrested due to the improper billing, then the insurer shall pay to the person 40 percent of the amount of the reduction, up to $500.
(g) An insurer may not systematically downcode with the intent to deny reimbursement otherwise due. Such action constitutes a material misrepresentation under s. 626.9541(1)(i)2.
(6) DISCOVERY OF FACTS ABOUT AN INJURED PERSON; DISPUTES.--
(a) Every employer shall, if a request is made by an insurer providing personal injury protection benefits under ss. 627.730-627.7405 against whom a claim has been made, furnish forthwith, in a form approved by the office, a sworn statement of the earnings, since the time of the bodily injury and for a reasonable period before the injury, of the person upon whose injury the claim is based.
(b) Every physician, hospital, clinic, or other medical institution providing, before or after bodily injury upon which a claim for personal injury protection insurance benefits is based, any products, services, or accommodations in relation to that or any other injury, or in relation to a condition claimed to be connected with that or any other injury, shall, if requested to do so by the insurer against whom the claim has been made, furnish forthwith a written report of the history, condition, treatment, dates, and costs of such treatment of the injured person and why the items identified by the insurer were reasonable in amount and medically necessary, together with a sworn statement that the treatment or services rendered were reasonable and necessary with respect to the bodily injury sustained and identifying which portion of the expenses for such treatment or services was incurred as a result of such bodily injury, and produce forthwith, and permit the inspection and copying of, his or her or its records regarding such history, condition, treatment, dates, and costs of treatment; provided that this shall not limit the introduction of evidence at trial. Such sworn statement shall read as follows: "Under penalty of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief." No cause of action for violation of the physician-patient privilege or invasion of the right of privacy shall be permitted against any physician, hospital, clinic, or other medical institution complying with the provisions of this section. The person requesting such records and such sworn statement shall pay all reasonable costs connected therewith. If an insurer makes a written request for documentation or information under this paragraph within 30 days after having received notice of the amount of a covered loss under paragraph (4)(a), the amount or the partial amount which is the subject of the insurer's inquiry shall become overdue if the insurer does not pay in accordance with paragraph (4)(b) or within 10 days after the insurer's receipt of the requested documentation or information, whichever occurs later. For purposes of this paragraph, the term "receipt" includes, but is not limited to, inspection and copying pursuant to this paragraph. Any insurer that requests documentation or information pertaining to reasonableness of charges or medical necessity under this paragraph without a reasonable basis for such requests as a general business practice is engaging in an unfair trade practice under the insurance code.
(c) In the event of any dispute regarding an insurer's right to discovery of facts under this section, the insurer may petition a court of competent jurisdiction to enter an order permitting such discovery. The order may be made only on motion for good cause shown and upon notice to all persons having an interest, and it shall specify the time, place, manner, conditions, and scope of the discovery. Such court may, in order to protect against annoyance, embarrassment, or oppression, as justice requires, enter an order refusing discovery or specifying conditions of discovery and may order payments of costs and expenses of the proceeding, including reasonable fees for the appearance of attorneys at the proceedings, as justice requires.
(d) The injured person shall be furnished, upon request, a copy of all information obtained by the insurer under the provisions of this section, and shall pay a reasonable charge, if required by the insurer.
(e) Notice to an insurer of the existence of a claim shall not be unreasonably withheld by an insured.
(7) MENTAL AND PHYSICAL EXAMINATION OF INJURED PERSON; REPORTS.--
(a) Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury protection insurance benefits, such person shall, upon the request of an insurer, submit to mental or physical examination by a physician or physicians. The costs of any examinations requested by an insurer shall be borne entirely by the insurer. Such examination shall be conducted within the municipality where the insured is receiving treatment, or in a location reasonably accessible to the insured, which, for purposes of this paragraph, means any location within the municipality in which the insured resides, or any location within 10 miles by road of the insured's residence, provided such location is within the county in which the insured resides. If the examination is to be conducted in a location reasonably accessible to the insured, and if there is no qualified physician to conduct the examination in a location reasonably accessible to the insured, then such examination shall be conducted in an area of the closest proximity to the insured's residence. Personal protection insurers are authorized to include reasonable provisions in personal injury protection insurance policies for mental and physical examination of those claiming personal injury protection insurance benefits. An insurer may not withdraw payment of a treating physician without the consent of the injured person covered by the personal injury protection, unless the insurer first obtains a valid report by a Florida physician licensed under the same chapter as the treating physician whose treatment authorization is sought to be withdrawn, stating that treatment was not reasonable, related, or necessary. A valid report is one that is prepared and signed by the physician examining the injured person or reviewing the treatment records of the injured person and is factually supported by the examination and treatment records if reviewed and that has not been modified by anyone other than the physician. The physician preparing the report must be in active practice, unless the physician is physically disabled. Active practice means that during the 3 years immediately preceding the date of the physical examination or review of the treatment records the physician must have devoted professional time to the active clinical practice of evaluation, diagnosis, or treatment of medical conditions or to the instruction of students in an accredited health professional school or accredited residency program or a clinical research program that is affiliated with an accredited health professional school or teaching hospital or accredited residency program. The physician preparing a report at the request of an insurer and physicians rendering expert opinions on behalf of persons claiming medical benefits for personal injury protection, or on behalf of an insured through an attorney or another entity, shall maintain, for at least 3 years, copies of all examination reports as medical records and shall maintain, for at least 3 years, records of all payments for the examinations and reports. Neither an insurer nor any person acting at the direction of or on behalf of an insurer may materially change an opinion in a report prepared under this paragraph or direct the physician preparing the report to change such opinion. The denial of a payment as the result of such a changed opinion constitutes a material misrepresentation under s. 626.9541(1)(i)2.; however, this provision does not preclude the insurer from calling to the attention of the physician errors of fact in the report based upon information in the claim file.
(b) If requested by the person examined, a party causing an examination to be made shall deliver to him or her a copy of every written report concerning the examination rendered by an examining physician, at least one of which reports must set out the examining physician's findings and conclusions in detail. After such request and delivery, the party causing the examination to be made is entitled, upon request, to receive from the person examined every written report available to him or her or his or her representative concerning any examination, previously or thereafter made, of the same mental or physical condition. By requesting and obtaining a report of the examination so ordered, or by taking the deposition of the examiner, the person examined waives any privilege he or she may have, in relation to the claim for benefits, regarding the testimony of every other person who has examined, or may thereafter examine, him or her in respect to the same mental or physical condition. If a person unreasonably refuses to submit to an examination, the personal injury protection carrier is no longer liable for subsequent personal injury protection benefits.
(8) APPLICABILITY OF PROVISION REGULATING ATTORNEY'S FEES.--With respect to any dispute under the provisions of ss. 627.730-627.7405 between the insured and the insurer, or between an assignee of an insured's rights and the insurer, the provisions of s. 627.428 shall apply, except as provided in subsection (11).
(9)(a) Each insurer which has issued a policy providing personal injury protection benefits shall report the renewal, cancellation, or nonrenewal thereof to the Department of Highway Safety and Motor Vehicles within 45 days from the effective date of the renewal, cancellation, or nonrenewal. Upon the issuance of a policy providing personal injury protection benefits to a named insured not previously insured by the insurer thereof during that calendar year, the insurer shall report the issuance of the new policy to the Department of Highway Safety and Motor Vehicles within 30 days. The report shall be in such form and format and contain such information as may be required by the Department of Highway Safety and Motor Vehicles which shall include a format compatible with the data processing capabilities of said department, and the Department of Highway Safety and Motor Vehicles is authorized to adopt rules necessary with respect thereto. Failure by an insurer to file proper reports with the Department of Highway Safety and Motor Vehicles as required by this subsection or rules adopted with respect to the requirements of this subsection constitutes a violation of the Florida Insurance Code. Reports of cancellations and policy renewals and reports of the issuance of new policies received by the Department of Highway Safety and Motor Vehicles are confidential and exempt from the provisions of s. 119.07(1). These records are to be used for enforcement and regulatory purposes only, including the generation by the department of data regarding compliance by owners of motor vehicles with financial responsibility coverage requirements. In addition, the Department of Highway Safety and Motor Vehicles shall release, upon a written request by a person involved in a motor vehicle accident, by the person's attorney, or by a representative of the person's motor vehicle insurer, the name of the insurance company and the policy number for the policy covering the vehicle named by the requesting party. The written request must include a copy of the appropriate accident form as provided in s. 316.065, s. 316.066, or s. 316.068.
(b) Every insurer with respect to each insurance policy providing personal injury protection benefits shall notify the named insured or in the case of a commercial fleet policy, the first named insured in writing that any cancellation or nonrenewal of the policy will be reported by the insurer to the Department of Highway Safety and Motor Vehicles. The notice shall also inform the named insured that failure to maintain personal injury protection and property damage liability insurance on a motor vehicle when required by law may result in the loss of registration and driving privileges in this state, and the notice shall inform the named insured of the amount of the reinstatement fees required by s. 627.733(7). This notice is for informational purposes only, and no civil liability shall attach to an insurer due to failure to provide this notice.
(10) An insurer may negotiate and enter into contracts with licensed health care providers for the benefits described in this section, referred to in this section as "preferred providers," which shall include health care providers licensed under chapters 458, 459, 460, 461, and 463. The insurer may provide an option to an insured to use a preferred provider at the time of purchase of the policy for personal injury protection benefits, if the requirements of this subsection are met. If the insured elects to use a provider who is not a preferred provider, whether the insured purchased a preferred provider policy or a nonpreferred provider policy, the medical benefits provided by the insurer shall be as required by this section. If the insured elects to use a provider who is a preferred provider, the insurer may pay medical benefits in excess of the benefits required by this section and may waive or lower the amount of any deductible that applies to such medical benefits. If the insurer offers a preferred provider policy to a policyholder or applicant, it must also offer a nonpreferred provider policy. The insurer shall provide each policyholder with a current roster of preferred providers in the county in which the insured resides at the time of purchase of such policy, and shall make such list available for public inspection during regular business hours at the principal office of the insurer within the state.
(11) DEMAND LETTER.--
(a) As a condition precedent to filing any action for benefits under this section, the insurer must be provided with written notice of an intent to initiate litigation. Such notice may not be sent until the claim is overdue, including any additional time the insurer has to pay the claim pursuant to paragraph (4)(b).
(b) The notice required shall state that it is a "demand letter under s. 627.736(11)" and shall state with specificity:
1. The name of the insured upon which such benefits are being sought, including a copy of the assignment giving rights to the claimant if the claimant is not the insured.
2. The claim number or policy number upon which such claim was originally submitted to the insurer.
3. To the extent applicable, the name of any medical provider who rendered to an insured the treatment, services, accommodations, or supplies that form the basis of such claim; and an itemized statement specifying each exact amount, the date of treatment, service, or accommodation, and the type of benefit claimed to be due. A completed form satisfying the requirements of paragraph (5)(d) or the lost-wage statement previously submitted may be used as the itemized statement. To the extent that the demand involves an insurer's withdrawal of payment under paragraph (7)(a) for future treatment not yet rendered, the claimant shall attach a copy of the insurer's notice withdrawing such payment and an itemized statement of the type, frequency, and duration of future treatment claimed to be reasonable and medically necessary.
(c) Each notice required by this subsection must be delivered to the insurer by United States certified or registered mail, return receipt requested. Such postal costs shall be reimbursed by the insurer if so requested by the claimant in the notice, when the insurer pays the claim. Such notice must be sent to the person and address specified by the insurer for the purposes of receiving notices under this subsection. Each licensed insurer, whether domestic, foreign, or alien, shall file with the office designation of the name and address of the person to whom notices pursuant to this subsection shall be sent which the office shall make available on its Internet website. The name and address on file with the office pursuant to s. 624.422 shall be deemed the authorized representative to accept notice pursuant to this subsection in the event no other designation has been made.
(d) If, within 15 days after receipt of notice by the insurer, the overdue claim specified in the notice is paid by the insurer together with applicable interest and a penalty of 10 percent of the overdue amount paid by the insurer, subject to a maximum penalty of $250, no action may be brought against the insurer. If the demand involves an insurer's withdrawal of payment under paragraph (7)(a) for future treatment not yet rendered, no action may be brought against the insurer if, within 15 days after its receipt of the notice, the insurer mails to the person filing the notice a written statement of the insurer's agreement to pay for such treatment in accordance with the notice and to pay a penalty of 10 percent, subject to a maximum penalty of $250, when it pays for such future treatment in accordance with the requirements of this section. To the extent the insurer determines not to pay any amount demanded, the penalty shall not be payable in any subsequent action. For purposes of this subsection, payment or the insurer's agreement shall be treated as being made on the date a draft or other valid instrument that is equivalent to payment, or the insurer's written statement of agreement, is placed in the United States mail in a properly addressed, postpaid envelope, or if not so posted, on the date of delivery. The insurer shall not be obligated to pay any attorney's fees if the insurer pays the claim or mails its agreement to pay for future treatment within the time prescribed by this subsection.
(e) The applicable statute of limitation for an action under this section shall be tolled for a period of 15 business days by the mailing of the notice required by this subsection.
(f) Any insurer making a general business practice of not paying valid claims until receipt of the notice required by this subsection is engaging in an unfair trade practice under the insurance code.
(12) CIVIL ACTION FOR INSURANCE FRAUD.--An insurer shall have a cause of action against any person convicted of, or who, regardless of adjudication of guilt, pleads guilty or nolo contendere to insurance fraud under s. 817.234, patient brokering under s. 817.505, or kickbacks under s. 456.054, associated with a claim for personal injury protection benefits in accordance with this section. An insurer prevailing in an action brought under this subsection may recover compensatory, consequential, and punitive damages subject to the requirements and limitations of part II of chapter 768, and attorney's fees and costs incurred in litigating a cause of action against any person convicted of, or who, regardless of adjudication of guilt, pleads guilty or nolo contendere to insurance fraud under s. 817.234, patient brokering under s. 817.505, or kickbacks under s. 456.054, associated with a claim for personal injury protection benefits in accordance with this section.
(13) MINIMUM BENEFIT COVERAGE.--If the Financial Services Commission determines that the cost savings under personal injury protection insurance benefits paid by insurers have been realized due to the provisions of this act, prior legislative reforms, or other factors, the commission may increase the minimum $10,000 benefit coverage requirement. In establishing the amount of such increase, the commission must determine that the additional premium for such coverage is approximately equal to the premium cost savings that have been realized for the personal injury protection coverage with limits of $10,000.
(14) FRAUD ADVISORY NOTICE.--Upon receiving notice of a claim under this section, an insurer shall provide a notice to the insured or to a person for whom a claim for reimbursement for diagnosis or treatment of injuries has been filed, advising that:
(a) Pursuant to s. 626.9892, the Department of Financial Services may pay rewards of up to $25,000 to persons providing information leading to the arrest and conviction of persons committing crimes investigated by the Division of Insurance Fraud arising from violations of s. 440.105, s. 624.15, s. 626.9541, s. 626.989, or s. 817.234.
(b) Solicitation of a person injured in a motor vehicle crash for purposes of filing personal injury protection or tort claims could be a violation of s. 817.234, s. 817.505, or the rules regulating The Florida Bar and should be immediately reported to the Division of Insurance Fraud if such conduct has taken place.
History.--s. 7, ch. 71-252; s. 3, ch. 76-168; s. 4, ch. 76-266; s. 1, ch. 77-457; s. 33, ch. 77-468; s. 3, ch. 78-374; s. 114, ch. 79-40; s. 165, ch. 79-164; s. 239, ch. 79-400; s. 3, ch. 80-206; s. 430, ch. 81-259; ss. 2, 3, ch. 81-318; ss. 554, 563, ch. 82-243; s. 31, ch. 87-226; s. 1, ch. 87-282; ss. 19, 20, 21, 22, ch. 88-370; s. 2, ch. 89-243; s. 1, ch. 89-313; s. 40, ch. 90-119; s. 7, ch. 90-232; s. 11, ch. 90-248; s. 36, ch. 90-295; s. 7, ch. 91-106; s. 66, ch. 91-282; s. 84, ch. 92-318; s. 7, ch. 93-289; s. 1, ch. 94-123; s. 8, ch. 95-202; s. 83, ch. 95-211; s. 381, ch. 96-406; s. 1738, ch. 97-102; s. 2, ch. 98-270; s. 262, ch. 99-8; s. 62, ch. 2001-63; s. 6, ch. 2001-271; s. 1195, ch. 2003-261; ss. 8, 19, ch. 2003-411; s. 124, ch. 2004-5; s. 121, ch. 2005-2; s. 13, ch. 2006-305.
1Note.--Section 19, ch. 2003-411, provides that:
"(1) Effective October 1, 2007, sections 627.730, 627.731, 627.732, 627.733, 627.734, 627.736, 627.737, 627.739, 627.7401, 627.7403, and 627.7405, Florida Statutes, constituting the Florida Motor Vehicle No-Fault Law, are repealed, unless reenacted by the Legislature during the 2006 Regular Session and such reenactment becomes law to take effect for policies issued or renewed on or after October 1, 2006.
"(2) Insurers are authorized to provide, in all policies issued or renewed after October 1, 2006, that such policies may terminate on or after October 1, 2007, as provided in subsection (1)."
(1) REQUIRED BENEFITS.--Every insurance policy complying with the security requirements of s. 627.733 shall provide personal injury protection to the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in such motor vehicle, and other persons struck by such motor vehicle and suffering bodily injury while not an occupant of a self-propelled vehicle, subject to the provisions of subsection (2) and paragraph (4)(d), to a limit of $10,000 for loss sustained by any such person as a result of 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. Such benefits shall also include necessary remedial treatment and services recognized and permitted under the laws of the state for an injured person who relies upon spiritual means through prayer alone for healing, in accordance with his or her religious beliefs; however, this sentence does not affect the determination of what other services or procedures are medically necessary.
(b) Disability benefits.--Sixty percent of any loss of gross income and loss of earning capacity per individual from inability to work proximately caused by the injury sustained by the injured person, plus all expenses reasonably incurred in obtaining from others ordinary and necessary services in lieu of those that, but for the injury, the injured person would have performed without income for the benefit of his or her household. All disability benefits payable under this provision shall be paid not less than every 2 weeks.
(c) Death benefits.--Death benefits of $5,000 per individual. The insurer may pay such benefits to the executor or administrator of the deceased, to any of the deceased's relatives by blood or legal adoption or connection by marriage, or to any person appearing to the insurer to be equitably entitled thereto. Only insurers writing motor vehicle liability insurance in this state may provide the required benefits of this section, and no such insurer shall require the purchase of any other motor vehicle coverage other than the purchase of property damage liability coverage as required by s. 627.7275 as a condition for providing such required benefits. Insurers may not require that property damage liability insurance in an amount greater than $10,000 be purchased in conjunction with personal injury protection. Such insurers shall make benefits and required property damage liability insurance coverage available through normal marketing channels. Any insurer writing motor vehicle liability insurance in this state who fails to comply with such availability requirement as a general business practice shall be deemed to have violated part IX of chapter 626, and such violation shall constitute an unfair method of competition or an unfair or deceptive act or practice involving the business of insurance; and any such insurer committing such violation shall be subject to the penalties afforded in such part, as well as those which may be afforded elsewhere in the insurance code.
(2) AUTHORIZED EXCLUSIONS.--Any insurer may exclude benefits:
(a) For injury sustained by the named insured and relatives residing in the same household while occupying another motor vehicle owned by the named insured and not insured under the policy or for injury sustained by any person operating the insured motor vehicle without the express or implied consent of the insured.
(b) To any injured person, if such person's conduct contributed to his or her injury under any of the following circumstances:
1. Causing injury to himself or herself intentionally; or
2. Being injured while committing a felony. Whenever an insured is charged with conduct as set forth in subparagraph 2., the 30-day payment provision of paragraph (4)(b) shall be held in abeyance, and the insurer shall withhold payment of any personal injury protection benefits pending the outcome of the case at the trial level. If the charge is nolle prossed or dismissed or the insured is acquitted, the 30-day payment provision shall run from the date the insurer is notified of such action.
(3) INSURED'S RIGHTS TO RECOVERY OF SPECIAL DAMAGES IN TORT CLAIMS.--No insurer shall have a lien on any recovery in tort by judgment, settlement, or otherwise for personal injury protection benefits, whether suit has been filed or settlement has been reached without suit. An injured party who is entitled to bring suit under the provisions of ss. 627.730-627.7405, or his or her legal representative, shall have no right to recover any damages for which personal injury protection benefits are paid or payable. The plaintiff may prove all of his or her special damages notwithstanding this limitation, but if special damages are introduced in evidence, the trier of facts, whether judge or jury, shall not award damages for personal injury protection benefits paid or payable. In all cases in which a jury is required to fix damages, the court shall instruct the jury that the plaintiff shall not recover such special damages for personal injury protection benefits paid or payable.
(4) BENEFITS; WHEN DUE.--Benefits due from an insurer under ss. 627.730-627.7405 shall be primary, except that benefits received under any workers' compensation law shall be credited against the benefits provided by subsection (1) and shall be due and payable as loss accrues, upon receipt of reasonable proof of such loss and the amount of expenses and loss incurred which are covered by the policy issued under ss. 627.730-627.7405. When the Agency for Health Care Administration provides, pays, or becomes liable for medical assistance under the Medicaid program related to injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle, benefits under ss. 627.730-627.7405 shall be subject to the provisions of the Medicaid program.
(a) An insurer may require written notice to be given as soon as practicable after an accident involving a motor vehicle with respect to which the policy affords the security required by ss. 627.730-627.7405.
(b) Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same. If such written notice is not furnished to the insurer as to the entire claim, any partial amount supported by written notice is overdue if not paid within 30 days after such written notice is furnished to the insurer. Any part or all of the remainder of the claim that is subsequently supported by written notice is overdue if not paid within 30 days after such written notice is furnished to the insurer. When an insurer pays only a portion of a claim or rejects a claim, the insurer shall provide at the time of the partial payment or rejection an itemized specification of each item that the insurer had reduced, omitted, or declined to pay and any information that the insurer desires the claimant to consider related to the medical necessity of the denied treatment or to explain the reasonableness of the reduced charge, provided that this shall not limit the introduction of evidence at trial; and the insurer shall include the name and address of the person to whom the claimant should respond and a claim number to be referenced in future correspondence. However, notwithstanding the fact that written notice has been furnished to the insurer, any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment. For the purpose of calculating the extent to which any benefits are overdue, payment shall be treated as being made on the date a draft or other valid instrument which is equivalent to payment was placed in the United States mail in a properly addressed, postpaid envelope or, if not so posted, on the date of delivery. This paragraph does not preclude or limit the ability of the insurer to assert that the claim was unrelated, was not medically necessary, or was unreasonable or that the amount of the charge was in excess of that permitted under, or in violation of, subsection (5). Such assertion by the insurer may be made at any time, including after payment of the claim or after the 30-day time period for payment set forth in this paragraph.
(c) All overdue payments shall bear simple interest at the rate established under s. 55.03 or the rate established in the insurance contract, whichever is greater, for the year in which the payment became overdue, calculated from the date the insurer was furnished with written notice of the amount of covered loss. Interest shall be due at the time payment of the overdue claim is made.
(d) The insurer of the owner of a motor vehicle shall pay personal injury protection benefits for:
1. Accidental bodily injury sustained in this state by the owner while occupying a motor vehicle, or while not an occupant of a self-propelled vehicle if the injury is caused by physical contact with a motor vehicle.
2. Accidental bodily injury sustained outside this state, but within the United States of America or its territories or possessions or Canada, by the owner while occupying the owner's motor vehicle.
3. Accidental bodily injury sustained by a relative of the owner residing in the same household, under the circumstances described in subparagraph 1. or subparagraph 2., provided the relative at the time of the accident is domiciled in the owner's household and is not himself or herself the owner of a motor vehicle with respect to which security is required under ss. 627.730-627.7405.
4. Accidental bodily injury sustained in this state by any other person while occupying the owner's motor vehicle or, if a resident of this state, while not an occupant of a self-propelled vehicle, if the injury is caused by physical contact with such motor vehicle, provided the injured person is not himself or herself:
a. The owner of a motor vehicle with respect to which security is required under ss. 627.730-627.7405; or
b. Entitled to personal injury benefits from the insurer of the owner or owners of such a motor vehicle.
(e) If two or more insurers are liable to pay personal injury protection benefits for the same injury to any one person, the maximum payable shall be as specified in subsection (1), and any insurer paying the benefits shall be entitled to recover from each of the other insurers an equitable pro rata share of the benefits paid and expenses incurred in processing the claim.
(f) It is a violation of the insurance code for an insurer to fail to timely provide benefits as required by this section with such frequency as to constitute a general business practice.
(g) Benefits shall not be due or payable to or on the behalf of an insured person if that person has committed, by a material act or omission, any insurance fraud relating to personal injury protection coverage under his or her policy, if the fraud is admitted to in a sworn statement by the insured or if it is established in a court of competent jurisdiction. Any insurance fraud shall void all coverage arising from the claim related to such fraud under the personal injury protection coverage of the insured person who committed the fraud, irrespective of whether a portion of the insured person's claim may be legitimate, and any benefits paid prior to the discovery of the insured person's insurance fraud shall be recoverable by the insurer from the person who committed insurance fraud in their entirety. The prevailing party is entitled to its costs and attorney's fees in any action in which it prevails in an insurer's action to enforce its right of recovery under this paragraph.
(5) CHARGES FOR TREATMENT OF INJURED PERSONS.--
(a) Any physician, hospital, clinic, or other person or institution lawfully rendering treatment to an injured person for a bodily injury covered by personal injury protection insurance may charge the insurer and injured party only a reasonable amount pursuant to this section for the services and supplies rendered, and the insurer providing such coverage may pay for such charges directly to such person or institution lawfully rendering such treatment, if the insured receiving such treatment or his or her guardian has countersigned the properly completed invoice, bill, or claim form approved by the office upon which such charges are to be paid for as having actually been rendered, to the best knowledge of the insured or his or her guardian. In no event, however, may such a charge be in excess of the amount the person or institution customarily charges for like services or supplies. With respect to a determination of whether a charge for a particular service, treatment, or otherwise is reasonable, consideration may be given to evidence of usual and customary charges and payments accepted by the provider involved in the dispute, and reimbursement levels in the community and various federal and state medical fee schedules applicable to automobile and other insurance coverages, and other information relevant to the reasonableness of the reimbursement for the service, treatment, or supply.
(b)1. An insurer or insured is not required to pay a claim or charges:
a. Made by a broker or by a person making a claim on behalf of a broker;
b. For any service or treatment that was not lawful at the time rendered;
c. To any person who knowingly submits a false or misleading statement relating to the claim or charges;
d. With respect to a bill or statement that does not substantially meet the applicable requirements of paragraph (d);
e. For any treatment or service that is upcoded, or that is unbundled when such treatment or services should be bundled, in accordance with paragraph (d). To facilitate prompt payment of lawful services, an insurer may change codes that it determines to have been improperly or incorrectly upcoded or unbundled, and may make payment based on the changed codes, without affecting the right of the provider to dispute the change by the insurer, provided that before doing so, the insurer must contact the health care provider and discuss the reasons for the insurer's change and the health care provider's reason for the coding, or make a reasonable good faith effort to do so, as documented in the insurer's file; and
f. For medical services or treatment billed by a physician and not provided in a hospital unless such services are rendered by the physician or are incident to his or her professional services and are included on the physician's bill, including documentation verifying that the physician is responsible for the medical services that were rendered and billed.
2. Charges for medically necessary cephalic thermograms, peripheral thermograms, spinal ultrasounds, extremity ultrasounds, video fluoroscopy, and surface electromyography shall not exceed the maximum reimbursement allowance for such procedures as set forth in the applicable fee schedule or other payment methodology established pursuant to s. 440.13.
3. Allowable amounts that may be charged to a personal injury protection insurance insurer and insured for medically necessary nerve conduction testing when done in conjunction with a needle electromyography procedure and both are performed and billed solely by a physician licensed under chapter 458, chapter 459, chapter 460, or chapter 461 who is also certified by the American Board of Electrodiagnostic Medicine or by a board recognized by the American Board of Medical Specialties or the American Osteopathic Association or who holds diplomate status with the American Chiropractic Neurology Board or its predecessors shall not exceed 200 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year's changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor.
4. Allowable amounts that may be charged to a personal injury protection insurance insurer and insured for medically necessary nerve conduction testing that does not meet the requirements of subparagraph 3. shall not exceed the applicable fee schedule or other payment methodology established pursuant to s. 440.13.
5. Allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services shall not exceed 175 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year's changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor for the 12-month period ending June 30 of that year, except that allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services provided in facilities accredited by the Accreditation Association for Ambulatory Health Care, the American College of Radiology, or the Joint Commission on Accreditation of Healthcare Organizations shall not exceed 200 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year's changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor for the 12-month period ending June 30 of that year. This paragraph does not apply to charges for magnetic resonance imaging services and nerve conduction testing for inpatients and emergency services and care as defined in chapter 395 rendered by facilities licensed under chapter 395.
6. The Department of Health, in consultation with the appropriate professional licensing boards, shall adopt, by rule, a list of diagnostic tests deemed not to be medically necessary for use in the treatment of persons sustaining bodily injury covered by personal injury protection benefits under this section. The initial list shall be adopted by January 1, 2004, and shall be revised from time to time as determined by the Department of Health, in consultation with the respective professional licensing boards. Inclusion of a test on the list of invalid diagnostic tests shall be based on lack of demonstrated medical value and a level of general acceptance by the relevant provider community and shall not be dependent for results entirely upon subjective patient response. Notwithstanding its inclusion on a fee schedule in this subsection, an insurer or insured is not required to pay any charges or reimburse claims for any invalid diagnostic test as determined by the Department of Health.
(c)1. With respect to any treatment or service, other than medical services billed by a hospital or other provider for emergency services as defined in s. 395.002 or inpatient services rendered at a hospital-owned facility, the statement of charges must be furnished to the insurer by the provider and may not include, and the insurer is not required to pay, charges for treatment or services rendered more than 35 days before the postmark date of the statement, except for past due amounts previously billed on a timely basis under this paragraph, and except that, if the provider submits to the insurer a notice of initiation of treatment within 21 days after its first examination or treatment of the claimant, the statement may include charges for treatment or services rendered up to, but not more than, 75 days before the postmark date of the statement. The injured party is not liable for, and the provider shall not bill the injured party for, charges that are unpaid because of the provider's failure to comply with this paragraph. Any agreement requiring the injured person or insured to pay for such charges is unenforceable.
2. If, however, the insured fails to furnish the provider with the correct name and address of the insured's personal injury protection insurer, the provider has 35 days from the date the provider obtains the correct information to furnish the insurer with a statement of the charges. The insurer is not required to pay for such charges unless the provider includes with the statement documentary evidence that was provided by the insured during the 35-day period demonstrating that the provider reasonably relied on erroneous information from the insured and either:
a. A denial letter from the incorrect insurer; or
b. Proof of mailing, which may include an affidavit under penalty of perjury, reflecting timely mailing to the incorrect address or insurer.
3. For emergency services and care as defined in s. 395.002 rendered in a hospital emergency department or for transport and treatment rendered by an ambulance provider licensed pursuant to part III of chapter 401, the provider is not required to furnish the statement of charges within the time periods established by this paragraph; and the insurer shall not be considered to have been furnished with notice of the amount of covered loss for purposes of paragraph (4)(b) until it receives a statement complying with paragraph (d), or copy thereof, which specifically identifies the place of service to be a hospital emergency department or an ambulance in accordance with billing standards recognized by the Health Care Finance Administration.
4. Each notice of insured's rights under s. 627.7401 must include the following statement in type no smaller than 12 points:
BILLING REQUIREMENTS.--Florida Statutes provide that with respect to any treatment or services, other than certain hospital and emergency services, the statement of charges furnished to the insurer by the provider may not include, and the insurer and the injured party are not required to pay, charges for treatment or services rendered more than 35 days before the postmark date of the statement, except for past due amounts previously billed on a timely basis, and except that, if the provider submits to the insurer a notice of initiation of treatment within 21 days after its first examination or treatment of the claimant, the statement may include charges for treatment or services rendered up to, but not more than, 75 days before the postmark date of the statement.
(d) All statements and bills for medical services rendered by any physician, hospital, clinic, or other person or institution shall be submitted to the insurer on a properly completed Centers for Medicare and Medicaid Services (CMS) 1500 form, UB 92 forms, or any other standard form approved by the office or adopted by the commission for purposes of this paragraph. All billings for such services rendered by providers shall, to the extent applicable, follow the Physicians' Current Procedural Terminology (CPT) or Healthcare Correct Procedural Coding System (HCPCS), or ICD-9 in effect for the year in which services are rendered and comply with the Centers for Medicare and Medicaid Services (CMS) 1500 form instructions and the American Medical Association Current Procedural Terminology (CPT) Editorial Panel and Healthcare Correct Procedural Coding System (HCPCS). All providers other than hospitals shall include on the applicable claim form the professional license number of the provider in the line or space provided for "Signature of Physician or Supplier, Including Degrees or Credentials." In determining compliance with applicable CPT and HCPCS coding, guidance shall be provided by the Physicians' Current Procedural Terminology (CPT) or the Healthcare Correct Procedural Coding System (HCPCS) in effect for the year in which services were rendered, the Office of the Inspector General (OIG), Physicians Compliance Guidelines, and other authoritative treatises designated by rule by the Agency for Health Care Administration. No statement of medical services may include charges for medical services of a person or entity that performed such services without possessing the valid licenses required to perform such services. For purposes of paragraph (4)(b), an insurer shall not be considered to have been furnished with notice of the amount of covered loss or medical bills due unless the statements or bills comply with this paragraph, and unless the statements or bills are properly completed in their entirety as to all material provisions, with all relevant information being provided therein.
(e)1. At the initial treatment or service provided, each physician, other licensed professional, clinic, or other medical institution providing medical services upon which a claim for personal injury protection benefits is based shall require an insured person, or his or her guardian, to execute a disclosure and acknowledgment form, which reflects at a minimum that:
a. The insured, or his or her guardian, must countersign the form attesting to the fact that the services set forth therein were actually rendered;
b. The insured, or his or her guardian, has both the right and affirmative duty to confirm that the services were actually rendered;
c. The insured, or his or her guardian, was not solicited by any person to seek any services from the medical provider;
d. That the physician, other licensed professional, clinic, or other medical institution rendering services for which payment is being claimed explained the services to the insured or his or her guardian; and
e. If the insured notifies the insurer in writing of a billing error, the insured may be entitled to a certain percentage of a reduction in the amounts paid by the insured's motor vehicle insurer.
2. The physician, other licensed professional, clinic, or other medical institution rendering services for which payment is being claimed has the affirmative duty to explain the services rendered to the insured, or his or her guardian, so that the insured, or his or her guardian, countersigns the form with informed consent.
3. Countersignature by the insured, or his or her guardian, is not required for the reading of diagnostic tests or other services that are of such a nature that they are not required to be performed in the presence of the insured.
4. The licensed medical professional rendering treatment for which payment is being claimed must sign, by his or her own hand, the form complying with this paragraph.
5. The original completed disclosure and acknowledgment form shall be furnished to the insurer pursuant to paragraph (4)(b) and may not be electronically furnished.
6. This disclosure and acknowledgment form is not required for services billed by a provider for emergency services as defined in s. 395.002, for emergency services and care as defined in s. 395.002 rendered in a hospital emergency department, or for transport and treatment rendered by an ambulance provider licensed pursuant to part III of chapter 401.
7. The Financial Services Commission shall adopt, by rule, a standard disclosure and acknowledgment form that shall be used to fulfill the requirements of this paragraph, effective 90 days after such form is adopted and becomes final. The commission shall adopt a proposed rule by October 1, 2003. Until the rule is final, the provider may use a form of its own which otherwise complies with the requirements of this paragraph.
8. As used in this paragraph, "countersigned" means a second or verifying signature, as on a previously signed document, and is not satisfied by the statement "signature on file" or any similar statement.
9. The requirements of this paragraph apply only with respect to the initial treatment or service of the insured by a provider. For subsequent treatments or service, the provider must maintain a patient log signed by the patient, in chronological order by date of service, that is consistent with the services being rendered to the patient as claimed. The requirements of this subparagraph for maintaining a patient log signed by the patient may be met by a hospital that maintains medical records as required by s. 395.3025 and applicable rules and makes such records available to the insurer upon request.
(f) Upon written notification by any person, an insurer shall investigate any claim of improper billing by a physician or other medical provider. The insurer shall determine if the insured was properly billed for only those services and treatments that the insured actually received. If the insurer determines that the insured has been improperly billed, the insurer shall notify the insured, the person making the written notification and the provider of its findings and shall reduce the amount of payment to the provider by the amount determined to be improperly billed. If a reduction is made due to such written notification by any person, the insurer shall pay to the person 20 percent of the amount of the reduction, up to $500. If the provider is arrested due to the improper billing, then the insurer shall pay to the person 40 percent of the amount of the reduction, up to $500.
(g) An insurer may not systematically downcode with the intent to deny reimbursement otherwise due. Such action constitutes a material misrepresentation under s. 626.9541(1)(i)2.
(6) DISCOVERY OF FACTS ABOUT AN INJURED PERSON; DISPUTES.--
(a) Every employer shall, if a request is made by an insurer providing personal injury protection benefits under ss. 627.730-627.7405 against whom a claim has been made, furnish forthwith, in a form approved by the office, a sworn statement of the earnings, since the time of the bodily injury and for a reasonable period before the injury, of the person upon whose injury the claim is based.
(b) Every physician, hospital, clinic, or other medical institution providing, before or after bodily injury upon which a claim for personal injury protection insurance benefits is based, any products, services, or accommodations in relation to that or any other injury, or in relation to a condition claimed to be connected with that or any other injury, shall, if requested to do so by the insurer against whom the claim has been made, furnish forthwith a written report of the history, condition, treatment, dates, and costs of such treatment of the injured person and why the items identified by the insurer were reasonable in amount and medically necessary, together with a sworn statement that the treatment or services rendered were reasonable and necessary with respect to the bodily injury sustained and identifying which portion of the expenses for such treatment or services was incurred as a result of such bodily injury, and produce forthwith, and permit the inspection and copying of, his or her or its records regarding such history, condition, treatment, dates, and costs of treatment; provided that this shall not limit the introduction of evidence at trial. Such sworn statement shall read as follows: "Under penalty of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief." No cause of action for violation of the physician-patient privilege or invasion of the right of privacy shall be permitted against any physician, hospital, clinic, or other medical institution complying with the provisions of this section. The person requesting such records and such sworn statement shall pay all reasonable costs connected therewith. If an insurer makes a written request for documentation or information under this paragraph within 30 days after having received notice of the amount of a covered loss under paragraph (4)(a), the amount or the partial amount which is the subject of the insurer's inquiry shall become overdue if the insurer does not pay in accordance with paragraph (4)(b) or within 10 days after the insurer's receipt of the requested documentation or information, whichever occurs later. For purposes of this paragraph, the term "receipt" includes, but is not limited to, inspection and copying pursuant to this paragraph. Any insurer that requests documentation or information pertaining to reasonableness of charges or medical necessity under this paragraph without a reasonable basis for such requests as a general business practice is engaging in an unfair trade practice under the insurance code.
(c) In the event of any dispute regarding an insurer's right to discovery of facts under this section, the insurer may petition a court of competent jurisdiction to enter an order permitting such discovery. The order may be made only on motion for good cause shown and upon notice to all persons having an interest, and it shall specify the time, place, manner, conditions, and scope of the discovery. Such court may, in order to protect against annoyance, embarrassment, or oppression, as justice requires, enter an order refusing discovery or specifying conditions of discovery and may order payments of costs and expenses of the proceeding, including reasonable fees for the appearance of attorneys at the proceedings, as justice requires.
(d) The injured person shall be furnished, upon request, a copy of all information obtained by the insurer under the provisions of this section, and shall pay a reasonable charge, if required by the insurer.
(e) Notice to an insurer of the existence of a claim shall not be unreasonably withheld by an insured.
(7) MENTAL AND PHYSICAL EXAMINATION OF INJURED PERSON; REPORTS.--
(a) Whenever the mental or physical condition of an injured person covered by personal injury protection is material to any claim that has been or may be made for past or future personal injury protection insurance benefits, such person shall, upon the request of an insurer, submit to mental or physical examination by a physician or physicians. The costs of any examinations requested by an insurer shall be borne entirely by the insurer. Such examination shall be conducted within the municipality where the insured is receiving treatment, or in a location reasonably accessible to the insured, which, for purposes of this paragraph, means any location within the municipality in which the insured resides, or any location within 10 miles by road of the insured's residence, provided such location is within the county in which the insured resides. If the examination is to be conducted in a location reasonably accessible to the insured, and if there is no qualified physician to conduct the examination in a location reasonably accessible to the insured, then such examination shall be conducted in an area of the closest proximity to the insured's residence. Personal protection insurers are authorized to include reasonable provisions in personal injury protection insurance policies for mental and physical examination of those claiming personal injury protection insurance benefits. An insurer may not withdraw payment of a treating physician without the consent of the injured person covered by the personal injury protection, unless the insurer first obtains a valid report by a Florida physician licensed under the same chapter as the treating physician whose treatment authorization is sought to be withdrawn, stating that treatment was not reasonable, related, or necessary. A valid report is one that is prepared and signed by the physician examining the injured person or reviewing the treatment records of the injured person and is factually supported by the examination and treatment records if reviewed and that has not been modified by anyone other than the physician. The physician preparing the report must be in active practice, unless the physician is physically disabled. Active practice means that during the 3 years immediately preceding the date of the physical examination or review of the treatment records the physician must have devoted professional time to the active clinical practice of evaluation, diagnosis, or treatment of medical conditions or to the instruction of students in an accredited health professional school or accredited residency program or a clinical research program that is affiliated with an accredited health professional school or teaching hospital or accredited residency program. The physician preparing a report at the request of an insurer and physicians rendering expert opinions on behalf of persons claiming medical benefits for personal injury protection, or on behalf of an insured through an attorney or another entity, shall maintain, for at least 3 years, copies of all examination reports as medical records and shall maintain, for at least 3 years, records of all payments for the examinations and reports. Neither an insurer nor any person acting at the direction of or on behalf of an insurer may materially change an opinion in a report prepared under this paragraph or direct the physician preparing the report to change such opinion. The denial of a payment as the result of such a changed opinion constitutes a material misrepresentation under s. 626.9541(1)(i)2.; however, this provision does not preclude the insurer from calling to the attention of the physician errors of fact in the report based upon information in the claim file.
(b) If requested by the person examined, a party causing an examination to be made shall deliver to him or her a copy of every written report concerning the examination rendered by an examining physician, at least one of which reports must set out the examining physician's findings and conclusions in detail. After such request and delivery, the party causing the examination to be made is entitled, upon request, to receive from the person examined every written report available to him or her or his or her representative concerning any examination, previously or thereafter made, of the same mental or physical condition. By requesting and obtaining a report of the examination so ordered, or by taking the deposition of the examiner, the person examined waives any privilege he or she may have, in relation to the claim for benefits, regarding the testimony of every other person who has examined, or may thereafter examine, him or her in respect to the same mental or physical condition. If a person unreasonably refuses to submit to an examination, the personal injury protection carrier is no longer liable for subsequent personal injury protection benefits.
(8) APPLICABILITY OF PROVISION REGULATING ATTORNEY'S FEES.--With respect to any dispute under the provisions of ss. 627.730-627.7405 between the insured and the insurer, or between an assignee of an insured's rights and the insurer, the provisions of s. 627.428 shall apply, except as provided in subsection (11).
(9)(a) Each insurer which has issued a policy providing personal injury protection benefits shall report the renewal, cancellation, or nonrenewal thereof to the Department of Highway Safety and Motor Vehicles within 45 days from the effective date of the renewal, cancellation, or nonrenewal. Upon the issuance of a policy providing personal injury protection benefits to a named insured not previously insured by the insurer thereof during that calendar year, the insurer shall report the issuance of the new policy to the Department of Highway Safety and Motor Vehicles within 30 days. The report shall be in such form and format and contain such information as may be required by the Department of Highway Safety and Motor Vehicles which shall include a format compatible with the data processing capabilities of said department, and the Department of Highway Safety and Motor Vehicles is authorized to adopt rules necessary with respect thereto. Failure by an insurer to file proper reports with the Department of Highway Safety and Motor Vehicles as required by this subsection or rules adopted with respect to the requirements of this subsection constitutes a violation of the Florida Insurance Code. Reports of cancellations and policy renewals and reports of the issuance of new policies received by the Department of Highway Safety and Motor Vehicles are confidential and exempt from the provisions of s. 119.07(1). These records are to be used for enforcement and regulatory purposes only, including the generation by the department of data regarding compliance by owners of motor vehicles with financial responsibility coverage requirements. In addition, the Department of Highway Safety and Motor Vehicles shall release, upon a written request by a person involved in a motor vehicle accident, by the person's attorney, or by a representative of the person's motor vehicle insurer, the name of the insurance company and the policy number for the policy covering the vehicle named by the requesting party. The written request must include a copy of the appropriate accident form as provided in s. 316.065, s. 316.066, or s. 316.068.
(b) Every insurer with respect to each insurance policy providing personal injury protection benefits shall notify the named insured or in the case of a commercial fleet policy, the first named insured in writing that any cancellation or nonrenewal of the policy will be reported by the insurer to the Department of Highway Safety and Motor Vehicles. The notice shall also inform the named insured that failure to maintain personal injury protection and property damage liability insurance on a motor vehicle when required by law may result in the loss of registration and driving privileges in this state, and the notice shall inform the named insured of the amount of the reinstatement fees required by s. 627.733(7). This notice is for informational purposes only, and no civil liability shall attach to an insurer due to failure to provide this notice.
(10) An insurer may negotiate and enter into contracts with licensed health care providers for the benefits described in this section, referred to in this section as "preferred providers," which shall include health care providers licensed under chapters 458, 459, 460, 461, and 463. The insurer may provide an option to an insured to use a preferred provider at the time of purchase of the policy for personal injury protection benefits, if the requirements of this subsection are met. If the insured elects to use a provider who is not a preferred provider, whether the insured purchased a preferred provider policy or a nonpreferred provider policy, the medical benefits provided by the insurer shall be as required by this section. If the insured elects to use a provider who is a preferred provider, the insurer may pay medical benefits in excess of the benefits required by this section and may waive or lower the amount of any deductible that applies to such medical benefits. If the insurer offers a preferred provider policy to a policyholder or applicant, it must also offer a nonpreferred provider policy. The insurer shall provide each policyholder with a current roster of preferred providers in the county in which the insured resides at the time of purchase of such policy, and shall make such list available for public inspection during regular business hours at the principal office of the insurer within the state.
(11) DEMAND LETTER.--
(a) As a condition precedent to filing any action for benefits under this section, the insurer must be provided with written notice of an intent to initiate litigation. Such notice may not be sent until the claim is overdue, including any additional time the insurer has to pay the claim pursuant to paragraph (4)(b).
(b) The notice required shall state that it is a "demand letter under s. 627.736(11)" and shall state with specificity:
1. The name of the insured upon which such benefits are being sought, including a copy of the assignment giving rights to the claimant if the claimant is not the insured.
2. The claim number or policy number upon which such claim was originally submitted to the insurer.
3. To the extent applicable, the name of any medical provider who rendered to an insured the treatment, services, accommodations, or supplies that form the basis of such claim; and an itemized statement specifying each exact amount, the date of treatment, service, or accommodation, and the type of benefit claimed to be due. A completed form satisfying the requirements of paragraph (5)(d) or the lost-wage statement previously submitted may be used as the itemized statement. To the extent that the demand involves an insurer's withdrawal of payment under paragraph (7)(a) for future treatment not yet rendered, the claimant shall attach a copy of the insurer's notice withdrawing such payment and an itemized statement of the type, frequency, and duration of future treatment claimed to be reasonable and medically necessary.
(c) Each notice required by this subsection must be delivered to the insurer by United States certified or registered mail, return receipt requested. Such postal costs shall be reimbursed by the insurer if so requested by the claimant in the notice, when the insurer pays the claim. Such notice must be sent to the person and address specified by the insurer for the purposes of receiving notices under this subsection. Each licensed insurer, whether domestic, foreign, or alien, shall file with the office designation of the name and address of the person to whom notices pursuant to this subsection shall be sent which the office shall make available on its Internet website. The name and address on file with the office pursuant to s. 624.422 shall be deemed the authorized representative to accept notice pursuant to this subsection in the event no other designation has been made.
(d) If, within 15 days after receipt of notice by the insurer, the overdue claim specified in the notice is paid by the insurer together with applicable interest and a penalty of 10 percent of the overdue amount paid by the insurer, subject to a maximum penalty of $250, no action may be brought against the insurer. If the demand involves an insurer's withdrawal of payment under paragraph (7)(a) for future treatment not yet rendered, no action may be brought against the insurer if, within 15 days after its receipt of the notice, the insurer mails to the person filing the notice a written statement of the insurer's agreement to pay for such treatment in accordance with the notice and to pay a penalty of 10 percent, subject to a maximum penalty of $250, when it pays for such future treatment in accordance with the requirements of this section. To the extent the insurer determines not to pay any amount demanded, the penalty shall not be payable in any subsequent action. For purposes of this subsection, payment or the insurer's agreement shall be treated as being made on the date a draft or other valid instrument that is equivalent to payment, or the insurer's written statement of agreement, is placed in the United States mail in a properly addressed, postpaid envelope, or if not so posted, on the date of delivery. The insurer shall not be obligated to pay any attorney's fees if the insurer pays the claim or mails its agreement to pay for future treatment within the time prescribed by this subsection.
(e) The applicable statute of limitation for an action under this section shall be tolled for a period of 15 business days by the mailing of the notice required by this subsection.
(f) Any insurer making a general business practice of not paying valid claims until receipt of the notice required by this subsection is engaging in an unfair trade practice under the insurance code.
(12) CIVIL ACTION FOR INSURANCE FRAUD.--An insurer shall have a cause of action against any person convicted of, or who, regardless of adjudication of guilt, pleads guilty or nolo contendere to insurance fraud under s. 817.234, patient brokering under s. 817.505, or kickbacks under s. 456.054, associated with a claim for personal injury protection benefits in accordance with this section. An insurer prevailing in an action brought under this subsection may recover compensatory, consequential, and punitive damages subject to the requirements and limitations of part II of chapter 768, and attorney's fees and costs incurred in litigating a cause of action against any person convicted of, or who, regardless of adjudication of guilt, pleads guilty or nolo contendere to insurance fraud under s. 817.234, patient brokering under s. 817.505, or kickbacks under s. 456.054, associated with a claim for personal injury protection benefits in accordance with this section.
(13) MINIMUM BENEFIT COVERAGE.--If the Financial Services Commission determines that the cost savings under personal injury protection insurance benefits paid by insurers have been realized due to the provisions of this act, prior legislative reforms, or other factors, the commission may increase the minimum $10,000 benefit coverage requirement. In establishing the amount of such increase, the commission must determine that the additional premium for such coverage is approximately equal to the premium cost savings that have been realized for the personal injury protection coverage with limits of $10,000.
(14) FRAUD ADVISORY NOTICE.--Upon receiving notice of a claim under this section, an insurer shall provide a notice to the insured or to a person for whom a claim for reimbursement for diagnosis or treatment of injuries has been filed, advising that:
(a) Pursuant to s. 626.9892, the Department of Financial Services may pay rewards of up to $25,000 to persons providing information leading to the arrest and conviction of persons committing crimes investigated by the Division of Insurance Fraud arising from violations of s. 440.105, s. 624.15, s. 626.9541, s. 626.989, or s. 817.234.
(b) Solicitation of a person injured in a motor vehicle crash for purposes of filing personal injury protection or tort claims could be a violation of s. 817.234, s. 817.505, or the rules regulating The Florida Bar and should be immediately reported to the Division of Insurance Fraud if such conduct has taken place.
History.--s. 7, ch. 71-252; s. 3, ch. 76-168; s. 4, ch. 76-266; s. 1, ch. 77-457; s. 33, ch. 77-468; s. 3, ch. 78-374; s. 114, ch. 79-40; s. 165, ch. 79-164; s. 239, ch. 79-400; s. 3, ch. 80-206; s. 430, ch. 81-259; ss. 2, 3, ch. 81-318; ss. 554, 563, ch. 82-243; s. 31, ch. 87-226; s. 1, ch. 87-282; ss. 19, 20, 21, 22, ch. 88-370; s. 2, ch. 89-243; s. 1, ch. 89-313; s. 40, ch. 90-119; s. 7, ch. 90-232; s. 11, ch. 90-248; s. 36, ch. 90-295; s. 7, ch. 91-106; s. 66, ch. 91-282; s. 84, ch. 92-318; s. 7, ch. 93-289; s. 1, ch. 94-123; s. 8, ch. 95-202; s. 83, ch. 95-211; s. 381, ch. 96-406; s. 1738, ch. 97-102; s. 2, ch. 98-270; s. 262, ch. 99-8; s. 62, ch. 2001-63; s. 6, ch. 2001-271; s. 1195, ch. 2003-261; ss. 8, 19, ch. 2003-411; s. 124, ch. 2004-5; s. 121, ch. 2005-2; s. 13, ch. 2006-305.
1Note.--Section 19, ch. 2003-411, provides that:
"(1) Effective October 1, 2007, sections 627.730, 627.731, 627.732, 627.733, 627.734, 627.736, 627.737, 627.739, 627.7401, 627.7403, and 627.7405, Florida Statutes, constituting the Florida Motor Vehicle No-Fault Law, are repealed, unless reenacted by the Legislature during the 2006 Regular Session and such reenactment becomes law to take effect for policies issued or renewed on or after October 1, 2006.
"(2) Insurers are authorized to provide, in all policies issued or renewed after October 1, 2006, that such policies may terminate on or after October 1, 2007, as provided in subsection (1)."
Wednesday, January 30, 2008
Personal Injury Accident Investigations
Personal Injury TopicsAuto Accident Information:
Auto Accidents Info
Car Accident Private Investigator in South Florida
What to Do if You Are Involved in an Auto Accident in Florida
How will a Car Accident Private Investigator or Attorney Help?
Florida’s No-Fault Insurance Law
Uninsured Motorist Coverage
Frequently Asked Questions about Florida Automobile Insurance
Frequently Asked Questions about Motor Vehicle Accidents
Personal Injury Topics:
Brain Injury
Bicycle Accidents
Boating Accidents
Motorcycle Accidents
Dog Bites
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Auto Accidents Info - Car Accident Private Investigator in South Florida
Careless and aggressive driving is an unfortunate reality in our daily lives, and auto accidents have become a regular occurrence on our highways and streets. Most of us have at one time or another been involved in a car accident, but we often fail to realize the extent to which we are vulnerable on the road. At CTK INVESTIGATIONS, LLC, we have seen firsthand the devastating consequences auto accidents can have on innocent victims and their families. From sky high medical bills to lost wages and crippling injuries, victims must overcome serious obstacles to get their lives back in order. This is why following auto accidents, our private investigators and attorneys in south Florida are committed to helping victims recover.
If you have been involved in a car accident, you may be entitled to compensation for property damage, injuries, and pain and suffering. Even if you are unsure of who was at fault, our private investigation agency may be able to help. Please contact Cory T. Knight at CTK INVESTIGATIONS, LLC today to speak with our car accident investigators, located in Hollywood and cities throughout Florida.
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How will a Car Accident Private Investigator or Attorney Help?
What You Should Know?
Following serious auto accidents, victims can expect vehicle property damage to be the least of their problems. Serious bodily injury can be sustained not only from the initial contact with the other vehicle, but from the secondary impact within your own vehicle. And despite the fact that vehicles are designed with new and improved safety features, auto accidents remain the leading cause of death among young adults. Unfortunately our Florida private investigation agency has investigated thousands of car crashes, we have investigated rear end collisions, head on collisions, pedestrians struck by motor vehicles, bicycle accidents, as well as fatalities as a result of Florida auto crashes.
Our private investigator agency is well aware that injuries associated with auto accidents can wreak havoc on the lives of victims and also the lives of their family members. For this reason, the car accident private investigators at our Hollywood, Florida investigation agency are committed to offering the kind of invaluable investigative and guidance that puts families on the path to recovery. Our Florida auto accident investigators and the attorneys we deal with can help you and your family receive financial compensation for:
• Property damage
• Lost wages
• Your Pain and suffering
• Loss of Consortium
• Medical Expenses
• Scaring, Disfigurement and traumatic brain injury
• Funeral costs (following the death of a loved one)
• Emotional trauma
If you would like to speak with one of our auto accident private investigators, please feel free to contact Cory T. Knight at C.T.K. INVESTIGATIONS, LLC in Hollywood, Florida today.
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What to Do if You Are Involved in an Auto Accident
Many private investigation agencies may offer similar advice, however we realize that while we handle thousands of Florida auto accident investigations a year, this may be your (or your family members) first auto accident. The first moments following an auto accident can be extremely freighting, hectic and confusing. If you are involved in a traffic collision, our auto accident investigators advise you to take the following steps immediately to ensure that your rights are protected:
• First Dial 911 – In Florida, a police report must be completed after all auto accidents involving property damage exceeding $500.00, injury, or death. We recommend that you Call 911 to report the accident and make sure to advise the 911 operator of any injuries that you sustained as a result of this accident.
• If you are physically able, we suggest you move your vehicle to the side of the road and turn off your ignition (and the ignition of other cars involved in the accident). Raise the hood (if possible) and turn on your hazard lights. Stand apart from the vehicle (in a safe location away from traffic) while calling for help to avoid injury in case the car is hit again. If other people are injured, do not attempt to move them unless they are in immediate danger.
• From our years of car accident investigation experience, we always recommend that you avoid admitting fault or discussing fault with other parties involved in the car crash. It is best to avoid confrontation and cooperate fully with the police. While this is an emotional time, try and state the facts, ask that the officer document your injuries as well as any witnesses.
• Our Florida private investigators recommend that you exchange information with all parties involved in the collision (again, avoid discussions of fault). Make sure to write down the tag number, registration numbers, driver’s license info, and insurance information. If possible take pictures of the cars, location of the accident. If a camera is not available, take note of exactly where the accident occurred so that our detectives can help with your accident reconstruction.
• We recommend that you check for witnesses to the auto accident – if there are witnesses obtain their contact information (including work and home phone numbers). Ask the officer that responded to note them in the report. Always be kind to the officer.
• If you are experiencing any pain, seek medical attention immediately (even if you feel the injury is minor). If you have any questions about medical intervention, feel free to contact us.
• Make sure to photograph your vehicle (before repairs are completed) and injuries sustained from the crash. If you have a cell phone camera available, you may want to photograph the crash scene and vehicles involved in the collision. As well as any signs or trees that may have contributed to the accident.
Above all, protect your rights. You are not required to give any statements to the other party's (defendants) insurance company. While you should cooperate with your own insurance company, you may want to consider consulting one of the auto accident investigators or we can recommend one of the attorneys that have assisted our clients over the years before giving a statement.
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How can a Car Accident Private Investigator Help?
Anyone who has been involved in a minor auto accident knows that you can sometimes resolve these types of claims without the assistance of an investigator or attorney; however, when serious injury or property damage is involved, victims of Florida auto accidents can benefit greatly from the assistance of the car accident private investigator. Our Florida private investigators have investigated thousands of car accidents and we can assist with your claim. Call us today to discuss how we can help you.
The reality is that car accident claims are anything but simple to resolve. Our Florida auto accident investigators understand the rules of the road, and we employ experts who are capable of reconstructing accident scenes to discover the true causes of collisions. We are familiar with the tactics insurance companies use to avoid paying out claims, and we fight aggressively for victims to ensure they receive the compensation they deserve. If you have been involved in an auto accident, having one of our knowledgeable Florida car accident investigators securing your interests can be the difference between receiving a small settlement or the substantial sum you deserve. It is our goal on every Florida car accident, Florida motorcycle accident, Florida bicycle accident, Florida trip and fall, Florida slip and fall, Florida scooter accident, etc.. to help you to obtain the tort feasor’s policy limits and any uninsured or underinsured motorist limits if possible.
If you or someone you love has recently been involved in an auto accident, our car accident investigators in Hollywood and throughout Florida can evaluate your claim and help you move forward with your case. Please visit our car accident section of our web page (www.ctkinvestigations.com) to view answers to common questions about auto accidents and find out what do to following a collision. If you would like to speak directly with one of our Florida auto accident investigators or you would like to hear about some of the attorneys that have represented some of our clients throughout the years, contact the offices of Cory T. Knight at CTK INVESTIGATIONS, LLC.
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Florida’s No-Fault Insurance Law
I can tell you that I hear the following on a daily basis, "I have full coverage." Yet our years of experience have proven that if we were generous one out of fifty callers to our private investigation agency actually do have FULL COVERAGE. Full coverage would include the following: PIP, BI, UM, Med-Pay, Umbrella, and Stacking Coverage. If you doubt this, feel free to contact your insurance company and request a copy of your "dec" (declaration) page. In the state of Florida, especially the active city of Hollywood, Florida car accidents occur every day and accident victims, particularly those who do not have uninsured motorist coverage, may need a Private Investigator to help them properly investigate their accident in order to maximize your chances of receiving compensation to pay their medical bills. Uninsured motorist coverage is one of the most important types of insurance you can have, especially in Florida, where it will protect you in the event of a hit and run accident, as well as a traffic collision involving an underinsured motorist. However, for those who do not have uninsured motorist coverage and are injured in a car accident in South Florida, having Ft. Lauderdale car accident Private Investigator Cory T. Knight and our entire investigation agency may be in your best interest.
In an attempt to reduce the number of lawsuits filed each year, Florida implemented a no-fault insurance law. This law requires motorists to carry $10,000 in personal injury protection (PIP) coverage, as well as $10,000 in property damage liability. With PIP insurance, a motorist injured in a car accident will not have to hire a Florida injury lawyer or Private Investigator to retrieve money for medical expenses or disability. Instead, a motorist injured in an auto accident in Ft. Lauderdale, Hollywood, or other areas of Florida will be reimbursed by their own insurance company for medical bills, disability, or death expenses related to the accident, regardless of who was at fault. While the number of auto accident lawsuits filed in Florida is reduced through the no-fault law, an individual may still file a lawsuit against a negligent driver. We understand that while you were not at fault in the accident your own insurance company should be responsible for paying the first $10,000.00 of related expenses but that is the law. That is where the term No-Fault was derived.
While motorists in Florida are required to carry PIP and property damage liability to cover themselves and any property that is harmed in the event of an accident, they are not required to carry bodily injury liability insurance to cover the injuries of the other drivers involved. Over 50 percent of drivers are underinsured when it comes to covering the injuries of another driver involved in an accident. This is typically not a problem since most drivers have PIP insurance to cover their own injuries. However, motorcyclists and individuals visiting Florida, who are not required to have PIP coverage, are at risk.
Motorcyclists involved in an accident with a driver carrying PIP coverage are automatically eligible to receive compensation for pain and suffering, whether or not they sustained a permanent injury, whereas motorists must prove that their injuries are permanent. However, motorcyclists are not able to receive compensation for medical bills or disability unless the driver involved was carrying bodily injury insurance. For this reason, it is especially important for motorcyclists and those traveling through the state of Florida to carry what is called uninsured motorist coverage. Please feel free to contact your personal injury Private Investigator Cory T. Knight at (954) 652-0733. We are available 24 hours a day 7 days a week to answer your personal injury related questions. If you prefer you can click here to contact us via e-mail. We also may be able to recommend you to a Florida auto accident attorney that has successfully represented many of our clients in the past.
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Uninsured Motorist Coverage
Uninsured motorist coverage is one of the most important types of auto insurance you can buy, as it will allow you to receive compensation for the medical and disability expenses of both you and the passengers riding in your vehicle when the car accident occurs. This way, you are guaranteed coverage whether the driver of the other vehicle is insured or not.
If you own one or more vehicles, Ft. Lauderdale car accident Private Investigator Cory T. Knight recommends that you invest in stackable insurance, which will allow you to provide uninsured motorist coverage for all your vehicles. For example, if your coverage for one vehicle covers $25,000 and you have stackable insurance that covers three vehicles, then you should have $75,000 in uninsured motorist coverage under which to make a claim. Considering how many Florida drivers are uninsured, it is likely that if you are involved in an accident the uninsured motorist coverage can easily pay for itself.
Uninsured motorist coverage can also protect you in Florida if you are the unfortunate victim of a hit and run accident. If a driver hits you or your vehicle, but does not stop to exchange information, this is called a hit and run. Without proper insurance coverage, a hit and run accident can cost you money out of your own pocket to pay for any medical expenses and repair property damage. For more information on uninsured motorist coverage and how it can help you in the event of a car accident, speak with a Private Investigator in Hollywood, Ft. Lauderdale, Miami, Miami-Dade, South Florida, Orlando or the Central Florida area today.
For more information regarding auto insurance options for Florida residents, or for a review of your Miami, Ft. Lauderdale, Hollywood, Florida Keys hit and run or car accident claim, contact a Private Investigator at the Florida private investigation agency of CTK INVESTIGATIONS, LLC today for your FREE consultation, or you can call us today at (954)652-0733.
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Bicycle Accidents
Our Florida private investigators at CTK INVESTIGATIONS, LLC have investigated more bicycle accidents than we can count. In reality, I guess we could count the number, but the main point is we have years of experience investigating bicycle related accidents. In Florida, bicycling accidents cause many fatalities and personal injuries each year. Unfortunately many bicycle accidents are completely preventable, as they are usually caused by the negligence of motorists or by defective bicycles and products. If you are a pedestrian or cyclist who has survived a bicycle accident or if you've lost a loved one to a bicycle accident, the south Florida private investigation agency of CTK INVESTIGATIONS, LLC can help. We have successfully assisted many clients who have suffered due to the negligence of another person. Our Florida private investigators have worked in conjunction with your south Florida bicycle accident attorney to obtain the best medical care and support needed to reconstruct your lives after the trauma of a bicycle or pedestrian accident.
It is clear that bicycle collisions and bicycle accidents can cause severe injuries. You do not need to be a physicist or accident reconstruction expert to realize that a six thousand pound vehicle would cause potentially fatal injuries to a bicycle that may weight three to five pounds. Common injuries such as neck and head injuries are very common, and many bicyclists suffer brain damage and closed head trauma, after a serious bicycle accident. Spinal cord injuries, nerve damage, broken limbs, and even permanent injuries are not uncommon with bicycle accidents. Due to the severity of injuries as well as the lack of protection, cyclists involved in accidents often miss considerable amounts of work while they are recovering. These injuries may require reconstructive surgery or lengthy and expensive medical treatment. Not all insurance companies are willing to pay a bicyclist without a hassle. You probably hear this on every attorney commercial, but it is true…many insurance companies hire attorneys of their own to protect their interests, why should you not do everything possible to protect your interests. We have assisted bicyclists with accident reconstruction, as well as worked in conjunction with your Florida personal injury attorney to investigate the accident represent your interests so that you can get the best medical treatment and the best support possible.
A bicyclist or pedestrian who has been injured in an accident may be entitled to Personal Injury Protection (PIP) benefits up to $10,000 from the vehicle that injured them or from any vehicle owned in their household. In order to get the full Personal Injury Protection (PIP) benefits you may be entitled to, it is important to speak to qualified South Florida Private Investigator. The investigators at CTK INVESTIGATIONS, LLC -- who have experience dealing with bicycle injury cases.
Our qualified Florida Private Investigators can help you understand your rights and can help you decide from the many options available to you. Our Florida private investigators can investigate your case, evaluate your situation, and work with you and your family and any insurance companies to make sure that you get the help you need quickly. With Cory T. Knight and our Florida private investigators by your side, you may be able to enjoy better medical care and additional assistance that you may need to get back on your feet.
If you or a loved one has been injured in a bicycle accident, or if you've lost someone due to bicycling accident, contact The South Florida Private Investigators at CTK INVESTIGATIONS, LLC or call us at (954) 652-0733 to set up a FREE consultation. There is no obligation for this complimentary consultation, and we can easily meet in your office, hospital room, or home to discuss your case.
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Boating Accidents
According to the United States Coast Guard, there were 4967 recreational boat accidents in 2006, 710 fatalities resulting from boating accidents, and 3,474 injuries coupled with $43,670,424.00 in property damage. While we live in sunny south Florida, many of us enjoy activities such as boating, fishing, jet skiing, water skiing, not to mention the privately owned vessels, commercial boats, and other watercraft that are utilized for work. Unfortunately boating accidents can make excursions out to canals, lakes or oceans deadly. If you or a loved one has been injured in a boating accident or if you have lost a loved one in a boating collision, contact CTK INVESTIGATIONS, LLC today. We are your South Florida Boating Accident private investigators. We have successfully assisted boating accident survivors and victims' families and have helped them get the assistance and the help they needed in order to recover from the accident. Moreover, we work in conjunction with your Florida boat accident attorney.
Statically speaking, the vast majority of boating accidents are entirely preventable. Many collisions and accidents involving personal watercraft and other vessels are caused by inadequate training, negligence, equipment failure, intoxication, or weather and water conditions. The inexperience or the errors of the person operating the vessel also cause collisions. Under Florida law, boating operators and boat owners must display a great deal of responsibility and care in order to insure that swimmers, divers, other boats, boat passengers, and others are not injured killed or hurt. A traumatic brain injury can disrupt functioning of the brain and can cause anything from a mild concussion to permanent injury, coma, and even fatalities. According to the Brain Injury Association of America: The National Stroke Association: year in the U. S., roughly 1.4 million people sustain a TBI. One million people are treated and released annually from hospital emergency rooms after sustaining a brain injury. Brain injury claims more than 50,000 lives and leaves more than 80,000 individuals with livelong disabilities each year. Furthermore, the Centers for Disease Control and Prevention (CDC), there are at least 5.3 million Americans living with a disability as a result of brain injury. Unfortunately many traumatic brain injuries and closed head traumas often occur from trip and fall accidents, slip and fall accidents, automobile accidents, firearm related injuries, boating accidents, and other traumatic injuries. It is not just the victims of brain injury that suffer; the families that provide round the clock support suffer as well. In many cases, these injuries require them to hire caregivers, undergo extensive medical testing and treatments, undergo modifications to your home, and miss significant amount of time from work. The qualified Florida private investigators at CTK INVESTIGATIONS, LLC have assisted and worked with many clients who have suffered brain injuries. Our experienced in investigating and dealing with South Florida brain injury attorneys have helped people obtain the medical treatment and the assistance they needed to rebuild their lives after serious brain injury.
If you have been injured or if you lost a loved one due to boating collision or an accident, call our experienced and qualified South Florida private investigator today. Our Florida personal injury investigators are able to assist your South Florida personal injury lawyers with your case. We can help you understand your options can discuss your specific case, so that you know what to expect. The South Florida personal injury lawyers that we have worked with on boating accidents can provide you with legal advice. We can also work with insurance companies and others who were involved in your particular situation. Our Florida private detectives can obtain witness statements, and affidavits to protect your interests. Our investigators are here to ensure that you get excellent care and medical attention quickly and effectively. Call us today to see if we can assist you with your south Florida boating accident, Florida jet ski accident, Florida fishing accident, Jones Act, or Longshoreman case.
The Florida private detectives at CTK INVESTIGATIONS, LLC have extensive experience in handling boating accident / injury cases. Our investigators have worked in conjunction with many Florida personal injury lawyers to protect your rights. If you have been injured, suffered fractures, closed head injuries, sprain / strains or a lost loved one in a boating collision, CTK INVESTIGATIONS, LLC may also be able to help you get the compensation you deserve. With correct private investigation and legal assistance, you may be able to get coverage with paying for your medical bills, paying for the damage or replacement of your boat, and paying for any pain and suffering you have sustained as a result of your accident, not to mention lost wages.
If you wish, we may be able to provide you with some names of Florida Personal Injury Lawyers that have handled numerous boating related cases. These attorneys will work on a contingency basis, which means that you do not pay unless and until they either win your case or settle out of court. If you were injured on a vessel while at work, do not hesitate to contact us. As always, we offer a FREE, no obligation consultation so that you can ask any questions and get a real advice upfront. Please feel free to contact Cory T. Knight or one of our South Florida private investigators at (954) 652-0733 to discuss your investigative needs. If you prefer, you can contact CTK INVESTIGATIONS, LLC via e-mail by clicking here.
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Brain Injury
The national institute of neurological disorders and stroke, explains that a traumatic brain injury (TBI) refers to a blow or a jolt to the head. A traumatic brain injury can disrupt functioning of the brain and can cause anything from a mild concussion to permanent injury, coma, and even fatalities. According to the Brain Injury Association of America: The National Stroke Association: year in the U. S., roughly 1.4 million people sustain a TBI. One million people are treated and released annually from hospital emergency rooms after sustaining a brain injury. Brain injury claims more than 50,000 lives and leaves more than 80,000 individuals with livelong disabilities each year. Furthermore, the Centers for Disease Control and Prevention (CDC), there are at least 5.3 million Americans living with a disability as a result of brain injury. Unfortunately many traumatic brain injuries and closed head traumas often occur from trip and fall accidents, slip and fall accidents, automobile accidents, firearm related injuries, boating accidents, and other traumatic injuries. It is not just the victims of brain injury that suffer; the families that provide round the clock support suffer as well. In many cases, these injuries require them to hire caregivers, undergo extensive medical testing and treatments, undergo modifications to your home, and miss significant amount of time from work. The qualified Florida private investigators at CTK INVESTIGATIONS, LLC have assisted and worked with many clients who have suffered brain injuries. Our experienced in investigating and dealing with South Florida brain injury attorneys have helped people obtain the medical treatment and the assistance they needed to rebuild their lives after serious brain injury.
Because of our extensive experience, CTK INVESTIGATIONS, LLC understands how traumatic TBI can be, both to the victim and to the family. We also understand how important it is to get help quickly from a qualified south Florida TBI lawyer. We may be able to let you know which South Florida personal injury attorneys have successfully worked on many TBI cases. Is important to get immediate assistance and guidance so that your medical bills can be paid and lost income can potentially be recouped. If you have suffered from a closed head injury, brain injury or have a loved one who has sustained a TBI, feel free to contact our office so that we can discuss your situation. We work with attorneys that may be able to help ensure that insurance companies will continue to pay for any future medical treatments, home modifications, and any other durable medical equipment necessary in order to help the injury heal as much as possible. Our Florida private investigators will comprehensively evaluate your case, help you understand all your options, and work hard to ensure that you get the maximum amount of assistance as quickly as possible.
The brutal reality is that in many cases, brain injuries can change lives forever. However, with the right Florida private investigator, and with the assistance of a qualified Florida personal injury lawyer, you may be able to get the help you need to rebuild your life. CTK INVESTIGATION, LLC has the closed head injury, TBI, and brain injury experience you need to get you the help you or your family deserve.
Our Florida Private Investigators can meet in your home, hospital room, or office to discuss your particular case. Our FREE consultation comes with no obligation whatsoever, this is simply a chance for you to ask questions and get the information you need to make an informed decision. Keep in mind, too, that the attorneys we work with work on a contingency fee basis. They are willing to defer fees until you reach an out-of-court settlement or win your case.
Please feel free to contact Cory T. Knight or one of our South Florida private investigators at (954) 652-0733 to discuss your investigative needs. If you prefer, you can contact CTK INVESTIGATIONS, LLC via e-mail by clicking here.
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Frequently Asked Questions about Florida Automobile Insurance
Florida Automobile Insurance
Our Florida private investigators get questions every day from clients about their auto insurance. Even if you haven’t been in an accident, it helps to understand the general language of Florida auto insurance. Below are descriptions of the various types of coverage in the state of Florida. If you are in an accident, the type of coverage you and the other party carry can often determine what type of settlement beyond medical expenses and lost wages you may be able to receive.
Personal Injury Protection Coverage (mandatory)
Florida is a "No Fault" State, which means that regardless of who is at fault in an accident, you must go to your own auto insurance to pay your medical bills. This insurance is referred to as PIP or Personal Injury Protection coverage; this coverage is mandatory for all automobile owners in Florida. PIP coverage provides for payment of 80% of medical bills and 60% of lost wages up to $10,000.00. Because of this limit, many people purchase additional extended PIP coverage or Medical Payments Coverage. If you were not at fault in the accident, you may also claim against the person who was at fault for the balance of your medical bills as well as money or compensatory damages. However, your medical bills will still be paid at 80% by your own PIP carrier. PIP covers you, your spouse, relatives living with you at the time of the accident who do not own a motor vehicle, and drivers/passengers of your vehicle who do not own a motor vehicle nor live with a relative who owns a vehicle.
Property Damage Liability Coverage (mandatory)
This coverage pays the other party's property damage in the event you are at fault in an accident. If you were not at fault in the accident, it does not apply. Property Damage Liability Coverage and PIP are the only two types of coverage which are mandatory in the State of Florida.
Bodily Injury Liability Coverage
This coverage applies only in the event that you are at fault in an accident. Bodily Injury Liability Coverage will pay money or compensatory damages to a claimant, if he/she meets certain requirements under Florida's No Fault Law, up to the limit of your coverage. Your insurance company will also pay your legal fees. While most states have statutes requiring motorists to have at least some Bodily Injury Liability Coverage, Florida does not require this type of coverage.
Medical Payments Coverage
MEDPAY coverage provides payment of the other 20% of your medical bills not covered by Personal Injury Protection coverage.
Collision Coverage
If you are at fault in an accident, or the at-fault party has no insurance coverage, collision coverage may be the only source of payment for damage to your vehicle.
Uninsured-Underinsured Motorist Protection
If the at fault party does not carry Bodily Injury Liability insurance, this coverage is crucial. Instead of making a claim for money damages to the at-fault party, the claim is made to your own insurance company and treated as if you were proceeding against the other party.
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Frequently Asked Questions about Motor Vehicle Accidents:
Q: Can I recover even if the accident was my fault?
A: Whether you can recover if the accident was your fault depends on the laws of your state. Some states do not consider fault with regards to some damages, and in those states some of your economic losses may be paid by your own no-fault policy. Other states consider fault, but you may still be able to recover for your injuries, even if the accident was partially your fault. However, in that case, you may be required to prove that the other party's fault was greater than yours, or to reduce the amount of your compensation by your percentage of fault.
Q: Who can I sue to recover my damages?
A: In some cases, an accident victim may be able to sue parties other than the at-fault driver. For example, if the at-fault driver did not own the car, the car's owner may also be liable for your damages. If the at-fault driver was impaired from consuming too much alcohol, you may be able to bring a "dram shop" complaint against a business that served alcohol to the driver even though he was visibly impaired. In some cases, you may be able to bring an action against another party, such as an automobile manufacturer or construction company, if a defect in the vehicle or the roadway caused the accident. If the accident involved a tractor-trailer, the driver's violation of rules and regulations may be the basis for a lawsuit against the driver or his or her employer.
Q: What is my case worth?
A: The value of a case depends on a variety of factors and cannot be determined without analyzing information regarding the injury, medical bills, loss of income, and permanency of the injury. There is no rule of thumb, and each set of facts results in a different amount of damages.
Q: Will I have to go to court?
A: Not necessarily. Many motor vehicle accident cases are concluded without even filing a lawsuit. Most lawsuits are settled without an actual trial. A settlement avoids the costs and delay of a trial and may result in a greater net recovery. However, if the case cannot be settled on satisfactory terms, it may be necessary to go to trial.
Q: Where will the money come from to compensate me?
A: The at-fault party's insurance typically pays for your damages in many states. If you are in a no-fault state, your own insurance may pay for some of your damages. If the at-fault party is not adequately insured, your own insurance policy may include coverage that will compensate you for your injuries.
Q: How long will it take me to receive my money?
A: The length of time necessary to conclude your automobile accident injury case depends upon a number of factors. For example, if you suffer a serious injury, you will not want to settle your claim until you have received sufficient medical care so that either your physician has released you or your future medical expenses related to the accident can be determined with reasonable certainty. Therefore, the amount of time you need to heal may determine the length of time necessary to conclude your claim. The amount of time before you recover also depends on whether your case is settled or goes to trial.
Q: What should I do if I can't afford an attorney?
A: Many law firms will agree to pursue a personal injury claim for a contingent fee, which means that the law firm's fee is subtracted from any amount that the firm collects for you. If no amount is recovered, then the firm receives no fee, but the client is typically responsible for actual expenses, such as court filing fees or witness fees, whether he or she wins or loses.
Q: Do I have to see a doctor?
A: If you are injured in an automobile accident, you should seek medical attention. Whether or not you have a claim, you should be examined by a doctor, both for your own peace of mind and to document the injury to support your claim. Frequently, an automobile accident injury will not be immediately apparent. Whenever symptoms first appear, go to your family doctor, a hospital emergency room, or another medical professional to obtain medical help.
Q: How soon must I bring my claim?
A: Each state sets a time limitation for bringing a personal injury claim. Both the length of that period and the way it is measured in motor vehicle accident cases varies from state to state. Even within a state, the time period may vary depending on the circumstances surrounding the accident, such as the plaintiff's age, the type of personal injury claim, the particular facts giving rise to the injury, and when the injury is discovered. You must be absolutely certain that you know the time limitation period that applies to you, or you risk jeopardizing your legal rights.
Q: Should I accept a check from the at-fault driver or his or her insurance company?
A: Accepting a check may be construed as a settlement that prohibits you from obtaining any additional amounts from the at-fault driver or his or her insurance company. Therefore, you should not accept a check or sign a release from the at-fault driver or his or her insurance company until after you have conferred with an attorney. Typically, an attorney will encourage you to wait to accept a check until you have completed your medical treatment and have been released by a doctor, so you know you have received an amount that adequately covers your medical bills and other damages. An insurance adjuster may push you to settle the claim for the lowest possible amount and may discourage you from contacting an Florida personal injury attorney. If so, you should ignore his or her advice, and consult an qualified personal injury attorney immediately before accepting any payment, signing any release, or otherwise settling your claim to insure that you are receiving fair compensation and not jeopardizing your right to a full and fair recovery.
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Auto Accidents Info
Car Accident Private Investigator in South Florida
What to Do if You Are Involved in an Auto Accident in Florida
How will a Car Accident Private Investigator or Attorney Help?
Florida’s No-Fault Insurance Law
Uninsured Motorist Coverage
Frequently Asked Questions about Florida Automobile Insurance
Frequently Asked Questions about Motor Vehicle Accidents
Personal Injury Topics:
Brain Injury
Bicycle Accidents
Boating Accidents
Motorcycle Accidents
Dog Bites
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Auto Accidents Info - Car Accident Private Investigator in South Florida
Careless and aggressive driving is an unfortunate reality in our daily lives, and auto accidents have become a regular occurrence on our highways and streets. Most of us have at one time or another been involved in a car accident, but we often fail to realize the extent to which we are vulnerable on the road. At CTK INVESTIGATIONS, LLC, we have seen firsthand the devastating consequences auto accidents can have on innocent victims and their families. From sky high medical bills to lost wages and crippling injuries, victims must overcome serious obstacles to get their lives back in order. This is why following auto accidents, our private investigators and attorneys in south Florida are committed to helping victims recover.
If you have been involved in a car accident, you may be entitled to compensation for property damage, injuries, and pain and suffering. Even if you are unsure of who was at fault, our private investigation agency may be able to help. Please contact Cory T. Knight at CTK INVESTIGATIONS, LLC today to speak with our car accident investigators, located in Hollywood and cities throughout Florida.
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How will a Car Accident Private Investigator or Attorney Help?
What You Should Know?
Following serious auto accidents, victims can expect vehicle property damage to be the least of their problems. Serious bodily injury can be sustained not only from the initial contact with the other vehicle, but from the secondary impact within your own vehicle. And despite the fact that vehicles are designed with new and improved safety features, auto accidents remain the leading cause of death among young adults. Unfortunately our Florida private investigation agency has investigated thousands of car crashes, we have investigated rear end collisions, head on collisions, pedestrians struck by motor vehicles, bicycle accidents, as well as fatalities as a result of Florida auto crashes.
Our private investigator agency is well aware that injuries associated with auto accidents can wreak havoc on the lives of victims and also the lives of their family members. For this reason, the car accident private investigators at our Hollywood, Florida investigation agency are committed to offering the kind of invaluable investigative and guidance that puts families on the path to recovery. Our Florida auto accident investigators and the attorneys we deal with can help you and your family receive financial compensation for:
• Property damage
• Lost wages
• Your Pain and suffering
• Loss of Consortium
• Medical Expenses
• Scaring, Disfigurement and traumatic brain injury
• Funeral costs (following the death of a loved one)
• Emotional trauma
If you would like to speak with one of our auto accident private investigators, please feel free to contact Cory T. Knight at C.T.K. INVESTIGATIONS, LLC in Hollywood, Florida today.
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What to Do if You Are Involved in an Auto Accident
Many private investigation agencies may offer similar advice, however we realize that while we handle thousands of Florida auto accident investigations a year, this may be your (or your family members) first auto accident. The first moments following an auto accident can be extremely freighting, hectic and confusing. If you are involved in a traffic collision, our auto accident investigators advise you to take the following steps immediately to ensure that your rights are protected:
• First Dial 911 – In Florida, a police report must be completed after all auto accidents involving property damage exceeding $500.00, injury, or death. We recommend that you Call 911 to report the accident and make sure to advise the 911 operator of any injuries that you sustained as a result of this accident.
• If you are physically able, we suggest you move your vehicle to the side of the road and turn off your ignition (and the ignition of other cars involved in the accident). Raise the hood (if possible) and turn on your hazard lights. Stand apart from the vehicle (in a safe location away from traffic) while calling for help to avoid injury in case the car is hit again. If other people are injured, do not attempt to move them unless they are in immediate danger.
• From our years of car accident investigation experience, we always recommend that you avoid admitting fault or discussing fault with other parties involved in the car crash. It is best to avoid confrontation and cooperate fully with the police. While this is an emotional time, try and state the facts, ask that the officer document your injuries as well as any witnesses.
• Our Florida private investigators recommend that you exchange information with all parties involved in the collision (again, avoid discussions of fault). Make sure to write down the tag number, registration numbers, driver’s license info, and insurance information. If possible take pictures of the cars, location of the accident. If a camera is not available, take note of exactly where the accident occurred so that our detectives can help with your accident reconstruction.
• We recommend that you check for witnesses to the auto accident – if there are witnesses obtain their contact information (including work and home phone numbers). Ask the officer that responded to note them in the report. Always be kind to the officer.
• If you are experiencing any pain, seek medical attention immediately (even if you feel the injury is minor). If you have any questions about medical intervention, feel free to contact us.
• Make sure to photograph your vehicle (before repairs are completed) and injuries sustained from the crash. If you have a cell phone camera available, you may want to photograph the crash scene and vehicles involved in the collision. As well as any signs or trees that may have contributed to the accident.
Above all, protect your rights. You are not required to give any statements to the other party's (defendants) insurance company. While you should cooperate with your own insurance company, you may want to consider consulting one of the auto accident investigators or we can recommend one of the attorneys that have assisted our clients over the years before giving a statement.
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How can a Car Accident Private Investigator Help?
Anyone who has been involved in a minor auto accident knows that you can sometimes resolve these types of claims without the assistance of an investigator or attorney; however, when serious injury or property damage is involved, victims of Florida auto accidents can benefit greatly from the assistance of the car accident private investigator. Our Florida private investigators have investigated thousands of car accidents and we can assist with your claim. Call us today to discuss how we can help you.
The reality is that car accident claims are anything but simple to resolve. Our Florida auto accident investigators understand the rules of the road, and we employ experts who are capable of reconstructing accident scenes to discover the true causes of collisions. We are familiar with the tactics insurance companies use to avoid paying out claims, and we fight aggressively for victims to ensure they receive the compensation they deserve. If you have been involved in an auto accident, having one of our knowledgeable Florida car accident investigators securing your interests can be the difference between receiving a small settlement or the substantial sum you deserve. It is our goal on every Florida car accident, Florida motorcycle accident, Florida bicycle accident, Florida trip and fall, Florida slip and fall, Florida scooter accident, etc.. to help you to obtain the tort feasor’s policy limits and any uninsured or underinsured motorist limits if possible.
If you or someone you love has recently been involved in an auto accident, our car accident investigators in Hollywood and throughout Florida can evaluate your claim and help you move forward with your case. Please visit our car accident section of our web page (www.ctkinvestigations.com) to view answers to common questions about auto accidents and find out what do to following a collision. If you would like to speak directly with one of our Florida auto accident investigators or you would like to hear about some of the attorneys that have represented some of our clients throughout the years, contact the offices of Cory T. Knight at CTK INVESTIGATIONS, LLC.
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Florida’s No-Fault Insurance Law
I can tell you that I hear the following on a daily basis, "I have full coverage." Yet our years of experience have proven that if we were generous one out of fifty callers to our private investigation agency actually do have FULL COVERAGE. Full coverage would include the following: PIP, BI, UM, Med-Pay, Umbrella, and Stacking Coverage. If you doubt this, feel free to contact your insurance company and request a copy of your "dec" (declaration) page. In the state of Florida, especially the active city of Hollywood, Florida car accidents occur every day and accident victims, particularly those who do not have uninsured motorist coverage, may need a Private Investigator to help them properly investigate their accident in order to maximize your chances of receiving compensation to pay their medical bills. Uninsured motorist coverage is one of the most important types of insurance you can have, especially in Florida, where it will protect you in the event of a hit and run accident, as well as a traffic collision involving an underinsured motorist. However, for those who do not have uninsured motorist coverage and are injured in a car accident in South Florida, having Ft. Lauderdale car accident Private Investigator Cory T. Knight and our entire investigation agency may be in your best interest.
In an attempt to reduce the number of lawsuits filed each year, Florida implemented a no-fault insurance law. This law requires motorists to carry $10,000 in personal injury protection (PIP) coverage, as well as $10,000 in property damage liability. With PIP insurance, a motorist injured in a car accident will not have to hire a Florida injury lawyer or Private Investigator to retrieve money for medical expenses or disability. Instead, a motorist injured in an auto accident in Ft. Lauderdale, Hollywood, or other areas of Florida will be reimbursed by their own insurance company for medical bills, disability, or death expenses related to the accident, regardless of who was at fault. While the number of auto accident lawsuits filed in Florida is reduced through the no-fault law, an individual may still file a lawsuit against a negligent driver. We understand that while you were not at fault in the accident your own insurance company should be responsible for paying the first $10,000.00 of related expenses but that is the law. That is where the term No-Fault was derived.
While motorists in Florida are required to carry PIP and property damage liability to cover themselves and any property that is harmed in the event of an accident, they are not required to carry bodily injury liability insurance to cover the injuries of the other drivers involved. Over 50 percent of drivers are underinsured when it comes to covering the injuries of another driver involved in an accident. This is typically not a problem since most drivers have PIP insurance to cover their own injuries. However, motorcyclists and individuals visiting Florida, who are not required to have PIP coverage, are at risk.
Motorcyclists involved in an accident with a driver carrying PIP coverage are automatically eligible to receive compensation for pain and suffering, whether or not they sustained a permanent injury, whereas motorists must prove that their injuries are permanent. However, motorcyclists are not able to receive compensation for medical bills or disability unless the driver involved was carrying bodily injury insurance. For this reason, it is especially important for motorcyclists and those traveling through the state of Florida to carry what is called uninsured motorist coverage. Please feel free to contact your personal injury Private Investigator Cory T. Knight at (954) 652-0733. We are available 24 hours a day 7 days a week to answer your personal injury related questions. If you prefer you can click here to contact us via e-mail. We also may be able to recommend you to a Florida auto accident attorney that has successfully represented many of our clients in the past.
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Uninsured Motorist Coverage
Uninsured motorist coverage is one of the most important types of auto insurance you can buy, as it will allow you to receive compensation for the medical and disability expenses of both you and the passengers riding in your vehicle when the car accident occurs. This way, you are guaranteed coverage whether the driver of the other vehicle is insured or not.
If you own one or more vehicles, Ft. Lauderdale car accident Private Investigator Cory T. Knight recommends that you invest in stackable insurance, which will allow you to provide uninsured motorist coverage for all your vehicles. For example, if your coverage for one vehicle covers $25,000 and you have stackable insurance that covers three vehicles, then you should have $75,000 in uninsured motorist coverage under which to make a claim. Considering how many Florida drivers are uninsured, it is likely that if you are involved in an accident the uninsured motorist coverage can easily pay for itself.
Uninsured motorist coverage can also protect you in Florida if you are the unfortunate victim of a hit and run accident. If a driver hits you or your vehicle, but does not stop to exchange information, this is called a hit and run. Without proper insurance coverage, a hit and run accident can cost you money out of your own pocket to pay for any medical expenses and repair property damage. For more information on uninsured motorist coverage and how it can help you in the event of a car accident, speak with a Private Investigator in Hollywood, Ft. Lauderdale, Miami, Miami-Dade, South Florida, Orlando or the Central Florida area today.
For more information regarding auto insurance options for Florida residents, or for a review of your Miami, Ft. Lauderdale, Hollywood, Florida Keys hit and run or car accident claim, contact a Private Investigator at the Florida private investigation agency of CTK INVESTIGATIONS, LLC today for your FREE consultation, or you can call us today at (954)652-0733.
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Bicycle Accidents
Our Florida private investigators at CTK INVESTIGATIONS, LLC have investigated more bicycle accidents than we can count. In reality, I guess we could count the number, but the main point is we have years of experience investigating bicycle related accidents. In Florida, bicycling accidents cause many fatalities and personal injuries each year. Unfortunately many bicycle accidents are completely preventable, as they are usually caused by the negligence of motorists or by defective bicycles and products. If you are a pedestrian or cyclist who has survived a bicycle accident or if you've lost a loved one to a bicycle accident, the south Florida private investigation agency of CTK INVESTIGATIONS, LLC can help. We have successfully assisted many clients who have suffered due to the negligence of another person. Our Florida private investigators have worked in conjunction with your south Florida bicycle accident attorney to obtain the best medical care and support needed to reconstruct your lives after the trauma of a bicycle or pedestrian accident.
It is clear that bicycle collisions and bicycle accidents can cause severe injuries. You do not need to be a physicist or accident reconstruction expert to realize that a six thousand pound vehicle would cause potentially fatal injuries to a bicycle that may weight three to five pounds. Common injuries such as neck and head injuries are very common, and many bicyclists suffer brain damage and closed head trauma, after a serious bicycle accident. Spinal cord injuries, nerve damage, broken limbs, and even permanent injuries are not uncommon with bicycle accidents. Due to the severity of injuries as well as the lack of protection, cyclists involved in accidents often miss considerable amounts of work while they are recovering. These injuries may require reconstructive surgery or lengthy and expensive medical treatment. Not all insurance companies are willing to pay a bicyclist without a hassle. You probably hear this on every attorney commercial, but it is true…many insurance companies hire attorneys of their own to protect their interests, why should you not do everything possible to protect your interests. We have assisted bicyclists with accident reconstruction, as well as worked in conjunction with your Florida personal injury attorney to investigate the accident represent your interests so that you can get the best medical treatment and the best support possible.
A bicyclist or pedestrian who has been injured in an accident may be entitled to Personal Injury Protection (PIP) benefits up to $10,000 from the vehicle that injured them or from any vehicle owned in their household. In order to get the full Personal Injury Protection (PIP) benefits you may be entitled to, it is important to speak to qualified South Florida Private Investigator. The investigators at CTK INVESTIGATIONS, LLC -- who have experience dealing with bicycle injury cases.
Our qualified Florida Private Investigators can help you understand your rights and can help you decide from the many options available to you. Our Florida private investigators can investigate your case, evaluate your situation, and work with you and your family and any insurance companies to make sure that you get the help you need quickly. With Cory T. Knight and our Florida private investigators by your side, you may be able to enjoy better medical care and additional assistance that you may need to get back on your feet.
If you or a loved one has been injured in a bicycle accident, or if you've lost someone due to bicycling accident, contact The South Florida Private Investigators at CTK INVESTIGATIONS, LLC or call us at (954) 652-0733 to set up a FREE consultation. There is no obligation for this complimentary consultation, and we can easily meet in your office, hospital room, or home to discuss your case.
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Boating Accidents
According to the United States Coast Guard, there were 4967 recreational boat accidents in 2006, 710 fatalities resulting from boating accidents, and 3,474 injuries coupled with $43,670,424.00 in property damage. While we live in sunny south Florida, many of us enjoy activities such as boating, fishing, jet skiing, water skiing, not to mention the privately owned vessels, commercial boats, and other watercraft that are utilized for work. Unfortunately boating accidents can make excursions out to canals, lakes or oceans deadly. If you or a loved one has been injured in a boating accident or if you have lost a loved one in a boating collision, contact CTK INVESTIGATIONS, LLC today. We are your South Florida Boating Accident private investigators. We have successfully assisted boating accident survivors and victims' families and have helped them get the assistance and the help they needed in order to recover from the accident. Moreover, we work in conjunction with your Florida boat accident attorney.
Statically speaking, the vast majority of boating accidents are entirely preventable. Many collisions and accidents involving personal watercraft and other vessels are caused by inadequate training, negligence, equipment failure, intoxication, or weather and water conditions. The inexperience or the errors of the person operating the vessel also cause collisions. Under Florida law, boating operators and boat owners must display a great deal of responsibility and care in order to insure that swimmers, divers, other boats, boat passengers, and others are not injured killed or hurt. A traumatic brain injury can disrupt functioning of the brain and can cause anything from a mild concussion to permanent injury, coma, and even fatalities. According to the Brain Injury Association of America: The National Stroke Association: year in the U. S., roughly 1.4 million people sustain a TBI. One million people are treated and released annually from hospital emergency rooms after sustaining a brain injury. Brain injury claims more than 50,000 lives and leaves more than 80,000 individuals with livelong disabilities each year. Furthermore, the Centers for Disease Control and Prevention (CDC), there are at least 5.3 million Americans living with a disability as a result of brain injury. Unfortunately many traumatic brain injuries and closed head traumas often occur from trip and fall accidents, slip and fall accidents, automobile accidents, firearm related injuries, boating accidents, and other traumatic injuries. It is not just the victims of brain injury that suffer; the families that provide round the clock support suffer as well. In many cases, these injuries require them to hire caregivers, undergo extensive medical testing and treatments, undergo modifications to your home, and miss significant amount of time from work. The qualified Florida private investigators at CTK INVESTIGATIONS, LLC have assisted and worked with many clients who have suffered brain injuries. Our experienced in investigating and dealing with South Florida brain injury attorneys have helped people obtain the medical treatment and the assistance they needed to rebuild their lives after serious brain injury.
If you have been injured or if you lost a loved one due to boating collision or an accident, call our experienced and qualified South Florida private investigator today. Our Florida personal injury investigators are able to assist your South Florida personal injury lawyers with your case. We can help you understand your options can discuss your specific case, so that you know what to expect. The South Florida personal injury lawyers that we have worked with on boating accidents can provide you with legal advice. We can also work with insurance companies and others who were involved in your particular situation. Our Florida private detectives can obtain witness statements, and affidavits to protect your interests. Our investigators are here to ensure that you get excellent care and medical attention quickly and effectively. Call us today to see if we can assist you with your south Florida boating accident, Florida jet ski accident, Florida fishing accident, Jones Act, or Longshoreman case.
The Florida private detectives at CTK INVESTIGATIONS, LLC have extensive experience in handling boating accident / injury cases. Our investigators have worked in conjunction with many Florida personal injury lawyers to protect your rights. If you have been injured, suffered fractures, closed head injuries, sprain / strains or a lost loved one in a boating collision, CTK INVESTIGATIONS, LLC may also be able to help you get the compensation you deserve. With correct private investigation and legal assistance, you may be able to get coverage with paying for your medical bills, paying for the damage or replacement of your boat, and paying for any pain and suffering you have sustained as a result of your accident, not to mention lost wages.
If you wish, we may be able to provide you with some names of Florida Personal Injury Lawyers that have handled numerous boating related cases. These attorneys will work on a contingency basis, which means that you do not pay unless and until they either win your case or settle out of court. If you were injured on a vessel while at work, do not hesitate to contact us. As always, we offer a FREE, no obligation consultation so that you can ask any questions and get a real advice upfront. Please feel free to contact Cory T. Knight or one of our South Florida private investigators at (954) 652-0733 to discuss your investigative needs. If you prefer, you can contact CTK INVESTIGATIONS, LLC via e-mail by clicking here.
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Brain Injury
The national institute of neurological disorders and stroke, explains that a traumatic brain injury (TBI) refers to a blow or a jolt to the head. A traumatic brain injury can disrupt functioning of the brain and can cause anything from a mild concussion to permanent injury, coma, and even fatalities. According to the Brain Injury Association of America: The National Stroke Association: year in the U. S., roughly 1.4 million people sustain a TBI. One million people are treated and released annually from hospital emergency rooms after sustaining a brain injury. Brain injury claims more than 50,000 lives and leaves more than 80,000 individuals with livelong disabilities each year. Furthermore, the Centers for Disease Control and Prevention (CDC), there are at least 5.3 million Americans living with a disability as a result of brain injury. Unfortunately many traumatic brain injuries and closed head traumas often occur from trip and fall accidents, slip and fall accidents, automobile accidents, firearm related injuries, boating accidents, and other traumatic injuries. It is not just the victims of brain injury that suffer; the families that provide round the clock support suffer as well. In many cases, these injuries require them to hire caregivers, undergo extensive medical testing and treatments, undergo modifications to your home, and miss significant amount of time from work. The qualified Florida private investigators at CTK INVESTIGATIONS, LLC have assisted and worked with many clients who have suffered brain injuries. Our experienced in investigating and dealing with South Florida brain injury attorneys have helped people obtain the medical treatment and the assistance they needed to rebuild their lives after serious brain injury.
Because of our extensive experience, CTK INVESTIGATIONS, LLC understands how traumatic TBI can be, both to the victim and to the family. We also understand how important it is to get help quickly from a qualified south Florida TBI lawyer. We may be able to let you know which South Florida personal injury attorneys have successfully worked on many TBI cases. Is important to get immediate assistance and guidance so that your medical bills can be paid and lost income can potentially be recouped. If you have suffered from a closed head injury, brain injury or have a loved one who has sustained a TBI, feel free to contact our office so that we can discuss your situation. We work with attorneys that may be able to help ensure that insurance companies will continue to pay for any future medical treatments, home modifications, and any other durable medical equipment necessary in order to help the injury heal as much as possible. Our Florida private investigators will comprehensively evaluate your case, help you understand all your options, and work hard to ensure that you get the maximum amount of assistance as quickly as possible.
The brutal reality is that in many cases, brain injuries can change lives forever. However, with the right Florida private investigator, and with the assistance of a qualified Florida personal injury lawyer, you may be able to get the help you need to rebuild your life. CTK INVESTIGATION, LLC has the closed head injury, TBI, and brain injury experience you need to get you the help you or your family deserve.
Our Florida Private Investigators can meet in your home, hospital room, or office to discuss your particular case. Our FREE consultation comes with no obligation whatsoever, this is simply a chance for you to ask questions and get the information you need to make an informed decision. Keep in mind, too, that the attorneys we work with work on a contingency fee basis. They are willing to defer fees until you reach an out-of-court settlement or win your case.
Please feel free to contact Cory T. Knight or one of our South Florida private investigators at (954) 652-0733 to discuss your investigative needs. If you prefer, you can contact CTK INVESTIGATIONS, LLC via e-mail by clicking here.
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Frequently Asked Questions about Florida Automobile Insurance
Florida Automobile Insurance
Our Florida private investigators get questions every day from clients about their auto insurance. Even if you haven’t been in an accident, it helps to understand the general language of Florida auto insurance. Below are descriptions of the various types of coverage in the state of Florida. If you are in an accident, the type of coverage you and the other party carry can often determine what type of settlement beyond medical expenses and lost wages you may be able to receive.
Personal Injury Protection Coverage (mandatory)
Florida is a "No Fault" State, which means that regardless of who is at fault in an accident, you must go to your own auto insurance to pay your medical bills. This insurance is referred to as PIP or Personal Injury Protection coverage; this coverage is mandatory for all automobile owners in Florida. PIP coverage provides for payment of 80% of medical bills and 60% of lost wages up to $10,000.00. Because of this limit, many people purchase additional extended PIP coverage or Medical Payments Coverage. If you were not at fault in the accident, you may also claim against the person who was at fault for the balance of your medical bills as well as money or compensatory damages. However, your medical bills will still be paid at 80% by your own PIP carrier. PIP covers you, your spouse, relatives living with you at the time of the accident who do not own a motor vehicle, and drivers/passengers of your vehicle who do not own a motor vehicle nor live with a relative who owns a vehicle.
Property Damage Liability Coverage (mandatory)
This coverage pays the other party's property damage in the event you are at fault in an accident. If you were not at fault in the accident, it does not apply. Property Damage Liability Coverage and PIP are the only two types of coverage which are mandatory in the State of Florida.
Bodily Injury Liability Coverage
This coverage applies only in the event that you are at fault in an accident. Bodily Injury Liability Coverage will pay money or compensatory damages to a claimant, if he/she meets certain requirements under Florida's No Fault Law, up to the limit of your coverage. Your insurance company will also pay your legal fees. While most states have statutes requiring motorists to have at least some Bodily Injury Liability Coverage, Florida does not require this type of coverage.
Medical Payments Coverage
MEDPAY coverage provides payment of the other 20% of your medical bills not covered by Personal Injury Protection coverage.
Collision Coverage
If you are at fault in an accident, or the at-fault party has no insurance coverage, collision coverage may be the only source of payment for damage to your vehicle.
Uninsured-Underinsured Motorist Protection
If the at fault party does not carry Bodily Injury Liability insurance, this coverage is crucial. Instead of making a claim for money damages to the at-fault party, the claim is made to your own insurance company and treated as if you were proceeding against the other party.
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Frequently Asked Questions about Motor Vehicle Accidents:
Q: Can I recover even if the accident was my fault?
A: Whether you can recover if the accident was your fault depends on the laws of your state. Some states do not consider fault with regards to some damages, and in those states some of your economic losses may be paid by your own no-fault policy. Other states consider fault, but you may still be able to recover for your injuries, even if the accident was partially your fault. However, in that case, you may be required to prove that the other party's fault was greater than yours, or to reduce the amount of your compensation by your percentage of fault.
Q: Who can I sue to recover my damages?
A: In some cases, an accident victim may be able to sue parties other than the at-fault driver. For example, if the at-fault driver did not own the car, the car's owner may also be liable for your damages. If the at-fault driver was impaired from consuming too much alcohol, you may be able to bring a "dram shop" complaint against a business that served alcohol to the driver even though he was visibly impaired. In some cases, you may be able to bring an action against another party, such as an automobile manufacturer or construction company, if a defect in the vehicle or the roadway caused the accident. If the accident involved a tractor-trailer, the driver's violation of rules and regulations may be the basis for a lawsuit against the driver or his or her employer.
Q: What is my case worth?
A: The value of a case depends on a variety of factors and cannot be determined without analyzing information regarding the injury, medical bills, loss of income, and permanency of the injury. There is no rule of thumb, and each set of facts results in a different amount of damages.
Q: Will I have to go to court?
A: Not necessarily. Many motor vehicle accident cases are concluded without even filing a lawsuit. Most lawsuits are settled without an actual trial. A settlement avoids the costs and delay of a trial and may result in a greater net recovery. However, if the case cannot be settled on satisfactory terms, it may be necessary to go to trial.
Q: Where will the money come from to compensate me?
A: The at-fault party's insurance typically pays for your damages in many states. If you are in a no-fault state, your own insurance may pay for some of your damages. If the at-fault party is not adequately insured, your own insurance policy may include coverage that will compensate you for your injuries.
Q: How long will it take me to receive my money?
A: The length of time necessary to conclude your automobile accident injury case depends upon a number of factors. For example, if you suffer a serious injury, you will not want to settle your claim until you have received sufficient medical care so that either your physician has released you or your future medical expenses related to the accident can be determined with reasonable certainty. Therefore, the amount of time you need to heal may determine the length of time necessary to conclude your claim. The amount of time before you recover also depends on whether your case is settled or goes to trial.
Q: What should I do if I can't afford an attorney?
A: Many law firms will agree to pursue a personal injury claim for a contingent fee, which means that the law firm's fee is subtracted from any amount that the firm collects for you. If no amount is recovered, then the firm receives no fee, but the client is typically responsible for actual expenses, such as court filing fees or witness fees, whether he or she wins or loses.
Q: Do I have to see a doctor?
A: If you are injured in an automobile accident, you should seek medical attention. Whether or not you have a claim, you should be examined by a doctor, both for your own peace of mind and to document the injury to support your claim. Frequently, an automobile accident injury will not be immediately apparent. Whenever symptoms first appear, go to your family doctor, a hospital emergency room, or another medical professional to obtain medical help.
Q: How soon must I bring my claim?
A: Each state sets a time limitation for bringing a personal injury claim. Both the length of that period and the way it is measured in motor vehicle accident cases varies from state to state. Even within a state, the time period may vary depending on the circumstances surrounding the accident, such as the plaintiff's age, the type of personal injury claim, the particular facts giving rise to the injury, and when the injury is discovered. You must be absolutely certain that you know the time limitation period that applies to you, or you risk jeopardizing your legal rights.
Q: Should I accept a check from the at-fault driver or his or her insurance company?
A: Accepting a check may be construed as a settlement that prohibits you from obtaining any additional amounts from the at-fault driver or his or her insurance company. Therefore, you should not accept a check or sign a release from the at-fault driver or his or her insurance company until after you have conferred with an attorney. Typically, an attorney will encourage you to wait to accept a check until you have completed your medical treatment and have been released by a doctor, so you know you have received an amount that adequately covers your medical bills and other damages. An insurance adjuster may push you to settle the claim for the lowest possible amount and may discourage you from contacting an Florida personal injury attorney. If so, you should ignore his or her advice, and consult an qualified personal injury attorney immediately before accepting any payment, signing any release, or otherwise settling your claim to insure that you are receiving fair compensation and not jeopardizing your right to a full and fair recovery.
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