Florida Supreme Court Addresses Prerequisites To Coverage Under Personal Injury Protection Insurance System

As this blog has previously discussed on several occasions, Florida is one of twelve states that has adopted a “no fault” insurance scheme. Florida’s system requires motorists involved in auto accidents to submit claims for compensation to their own insurance company, regardless of which party is at fault for the accident.

Florida has further mandated that motorists must carry a minimum of $10,000 of personal injury protection (“PIP”) insurance which covers medical treatment and other economic damages that might arise from a motor vehicle accident up to 80% of medical bills, 60% of lost wages, and a $5,000 death benefit.

Florida’s PIP system has been the subject of much scrutiny over the last year as lawmakers continue to tinker with its provisions through new legislation. The PIP system is intended to provide benefits for to those injured in automobile accidents in an expedited manner. Recently, the Florida Supreme Court issued a decision in Nunez v. Geico holding that the placement of certain obstacles to obtaining recovery by insurers frustrates the purpose of the PIP system and are therefore unlawful.

In Nunez, Merly Nunez was injured in a car accident in September 2008 and sought PIP benefits from her insurance company, Geico. Geico denied Nunez coverage, claiming that she had to submit to an examination under oath, as required by her policy, prior to seeking treatment. Nunez sued Geico in a class action, arguing that Geico’s examination requirement violated Florida’s PIP statute.

After the federal district court dismissed the lawsuit, Nunez appealed to the 11th Circuit U.S. Court of Appeals, which certified the issue for resolution by the Florida Supreme Court. Before the Florida Supreme Court could decide the case, Governor Rick Scott signed into law amendments to the PIP statute that required any individual seeking benefits to comply with the terms of his or her insurance policy, including an examination under oath requirement. However, according to the Supreme Court, because Nunez’s policy with Geico was issued in 2008 and the accident was in 2008, the amendments to the PIP statute were inapplicable to Nunez’s case.
In ruling that Geico’s policy violated the provisions of the PIP statute, the Court recognized that the statute’s stated purpose is to provide for “swift and virtually automatic payment” to those eligible for PIP benefits and Geico’s examination requirement clearly frustrated that purpose by preventing Nunez from recovering in a “swift and virtually automatic” way.

If you or someone you know has been injured in a car accident you may need legal representation to protect your right to compensation. It is imperative that it your claim be evaluated by an experienced personal injury attorney as soon as possible after the accident to preserve your right to compensation.

The Miami personal injury attorneys of Gerson & Schwartz, P.A. have extensive experience representing individuals who have been injured by negligent drivers. If you or someone you know has been injured in automobile or car accident, contact the attorneys of Gerson & Schwartz, P.A. today.

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