Miami Lawsuit Alleges Geico Denies Legitimate No-Fault PIP Claims
A dispute over insurance coverage for post-car crash physical therapy is playing out in Miami-Dade Circuit Court, where a medical center has accused Geico General Insurance Co. of systematically refusing to cover legitimate personal injury protection claims. Florida’s PIP statute, also known as no-fault car insurance provides coverage to all drivers injured in a crash, regardless of who was to blame.
The plaintiff alleges Geico used its denial letters as a negotiating tactic, aimed at lowering costs or avoiding the claims outright. The insurer is accused of defaming Florida Spine and Joint Institute by writing to its patients to say it suspected the center had fraudulently billed them, without providing any evidence. The complaint says Geico gave multiple unsubstantiated reasons for denying coverage, including allegations that the center had charged too much, that its medical directors weren’t properly fulfilling their duties or that the company’s billing time codes didn’t match its hours of operation. According to the lawsuit, Geico did offer to pay the claims if the medical center waived any interest.
Personal Injury Protection (PIP) Benefits in Florida
Damages are the amount of money which a plaintiff (the person suing) may be awarded in a lawsuit. There are many types of damages. Special damages are those which actually were caused by the injury and include medical and hospital bills, ambulance charges, loss of wages, property repair or replacement costs. Monetary recovery (money won) in a lawsuit for injuries suffered (such as pain, suffering, inability to perform certain functions) or breach of contract for which there is no exact dollar value which can be calculated. Damages are the sum of money which a person wronged is entitled to receive from the wrongdoer as compensation for the wrong. A driver needs an insurance policy that pays an established percentage of reasonable medical expenses up to a certain limit. Florida law provides that no-fault
Personal-injury-protection (PIP) benefits include medical benefits consisting of a prescribed percentage of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices and medically necessary ambulance, hospital, and nursing services if the individual receives initial services and care within 14 days after the motor vehicle accident. The medical benefits provide reimbursement only for initial services and care that are lawfully provided, supervised, ordered, or prescribed by a licensed physician, a licensed dentist, or a licensed chiropractic physician or that are provided in a hospital or in a facility that owns, or is wholly owned by, a hospital. Initial services and care may also be provided by a person or entity licensed under specified provisions that provide emergency transportation and treatment. For an insured to be entitled to PIP benefits, the medical expenses must be related to the accident in question, reasonable, and necessary.
Speak With a Car Accident Attorney Today!
The attorneys at Suarez & Montero are experienced in all types of vehicle accidents. If you have been injured in a car accident, you can obtain compensation by filing a car accident injury claim. You may recover damages such as your medical expenses, any wages that you may have lost because of your injuries and recovery, and any pain that you have suffered. We have handled thousands of car accident cases and have successfully fought for our clients to ensure they receive proper compensation for their injuries and damages. Our attorneys are committed to ensuring you have the strongest case possible, regardless of whether your claim is against an insurance company or a vehicle manufacturer.
Let us help you get the medical care you need and fight to make sure you are compensated for your injuries! Our attorneys are ready to provide proven legal representation in pursuing your claim and stand ready to protect your rights.
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