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Improper health insurance billing can ruin your PI case!

Recently a new issue has arisen in regard to treating doctors in personal injury (PI) cases attempting to avoid interacting the patients PIP/NoFault insurer by simply billing the patients health insurance directly. The problem with this is that Fla. Stat. 627.736(5) mandates that THE DOCTOR must bill the PIP carrier directly for any service from a motor vehicle accident in which there is PIP coverage. Under that statute, if the health care provider fails to timely submit such billing (essentially 35 days from date of service) the bill is nullified for BOTH the PIP insurance carrier AND the patient/client. By submitting the charges to a health insurer, many health insurers simpy pay the charges, without inquiry about the origin of the bills or application of the PIP statute, and then seek to enforce a lien for the monies paid out agaist the insured/patient’s personal injury recovery. As you can imagine, this is of great concern when personal injury patients are forced to re-imburse monies to thier health insurer for medical bills that were nullified by the treating doctors misconduct an the health insurer’s incompetence. It is critical to make sure that your treating doctors are submitting bills to the right insurer to avoid this issue. If you have had this happen already, make sure you notify your personal injury lawyer as quickly as possible so that he may challenge the lien repayment as appropriate.

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