What are the medical benefits coverage required to be paid in Florida under no fault insurance (aka PIP).

Under Florida Statute, 80% of all reasonable expenses for medically necessary services must be paid out by the insurance carrier. The Statute even makes a provision for treatment for injured people that rely on spiritual means through prayer alone for healing. If the case proceeds to trial, all that is required from the PIP claimant is a testimony that the jury will have to decide are reasonable and necessary expenses. Garrett v. Morris Kirschman & Co., 336 So.2d 566 (Fla. 1976). Luckily, Florida courts are more interested in the perspective of the person injured to determine the reasonableness and necessity of medical expenses rather than that of a medical expert. This could be because the Florida courts do not want to be the ones setting the bar for the wages that health care providers should be charging. However, the plaintiff does bear the burden of proof that the medical treatment was reasonable and necessary. Auto Owners Insurance Co. v. Marzulli, 788 So.2d 1031 (Fla. 2d DCA 2001). Did you know that a thermogram may be a considered a “necessary” expense for PIP purposes; and Florida Statute has set specific limits on the amount recoverable for MRI based on allowable fees under Medicare Part B? If you are a Medicare recipient who has been injured, prior to making demands to your insurance carrier your Palm Beach County accident attorney should be familiar with that part of the Florida Statute. A recent Florida court decisions has ruled that the transportation costs incurred for reasonable and necessary treatment were reimbursable, which seemingly means that you will not have to bear the expenses for the ambulance trip if you have been injured in a car accident. Often times, insurance companies will use computer generated software to calculate the payments for an injured. Even though Florida courts don’t like this practice, the court ruled that the burden was on the insured to prove the reasonableness of the medical bills. State Farm Automobile Insurance Co. v. Sestile, 821 So.2d 1244 (Fla. 2d DCA 2002).