2012 PIP REFORM BILL – WHAT DOES “EMERGENCY MEDICAL CONDITION” MEAN FOR ACCIDENT VICTIMS?

This is an excellent and important question in regards to the recently passed 2012 personal injury protection (PIP) reform bill. This is what the bill says regarding “emergency medical conditions.”

A patient must have a physician, osteopath, dentist, supervised physician’s assistant, or advanced registered nurse practitioner officially diagnose him with an “emergency medical condition” to receive the entire $10,000 PIP benefit; otherwise, the patient is limited to $2,500.

First we must determine what “emergency medical condition” means before we can truly analyze this provision. The bill provides the following definition: “’Emergency medical condition’ means a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following: serious jeopardy to patient health, serious impairment of bodily functions, serious dysfunction of any bodily organ or part.”

Why do lawmakers write in such an unnecessarily complicated way? Basically, this provision states that the full $10,000 amount of PIP benefits is available to an auto accident victim only if a specific type of medical care provider listed in the provision subjectively decides that the patient has an “emergency medical condition.” If the patient cannot obtain an “emergency medical condition” diagnosis, he is entitled to only $2,500 in PIP benefits.

This provision in essence transforms the current personal injury protection law into a medical emergency protection law by apportioning 75% of PIP’s benefits for “emergency medical conditions.” In other words, unless you suffered serious a near life-threatening injuries from an auto accident, your allotted PIP maximum is 25% of the PIP maximum. It is true, as confusing as it might sound. The PIP law affords all Florida drivers $10,000 for personal injuries sustained during an auto accident. This provision, however, now cuts that benefit to $2,500 unless you were severely and immediately injured. Furthermore, the $7,500 hanging in limbo becomes available only if the incredibly high standard for “emergency medical condition” is met.

This provision not only substantially changes the current PIP law; it also goes against and tries to defeat the essence and spirit of PIP. PIP was passed into law in 1972 for the express purpose of ensuring Florida drivers that they could quickly receive money to pay for their accident-related medical bills no matter what the situation was or who was at fault. This provision removes the 75% of the safety net that PIP is supposed to provide by law.

For more information on the 2012 PIP Reform bill, please see:

2012 PIP Reform Bill – How it Will Impact Accident Victims

I am local accident attorney Jeffrey Meldon and I strongly believe that public education is the first step in the prevention of and/or recovery from a serious accident. My office and I take pride in our work, and the results we get for our clients.

Meldon Law is a regional law firm that is located in Gainesville, Florida. We are personal injury lawyers, litigators and trial lawyers that have been working to get accident victims the justice they deserve for over 40 years throughout North Florida and all over Florida. Accidents involving a car crash, truck wreck, motorcycle, ATVs, bicycle, pedestrian accidents, and dog bites, slip and falls, medical malpractice, and criminal defense are all included in our practice.

For more information on how we can help you, or with any other question you may have, feel free to contact our office at 352-373-8000.

Jeffrey Meldon
Founder of the Meldon Law Firm