What happens if my PIP insurance carrier fails to make a timely payment on my claim?

Your insurance carrier usually has 30 days to make payment on your valid written notice of your covered loss. Receipt of medical verification of the claim does not count as effective notice to the insurance carrier. If your insurance carrier fails to make a valid claim within the 30 day window without supplying proof that it is not responsible for paying you, interest will start accruing on the amount and the carrier will also be liable for attorneys’ fees; however, the carrier can still contest the claim. United Automobile Insurance Co. v. Rodriguez, 808 So.2d 82 (Fla. 2002). The carrier can’t use their investigation rights to extend the 30 day time limit. Also, if the carrier mails the payment within the 30 day limit but it is not received within 30 days, this will not be seen as an overdue payment. The insurer is responsible for paying any medical benefits directly to the health provider and disability payments to you. Your insurer can not get away with stating that they made a mistake, even if it was an honest mistake, because they will still be forced to pay attorneys’ fees and interest will start accruing. If your health care provider doesn’t provide a statement within 35 days of treatment or care, excluding emergency services, care in hospital emergency department, or by an ambulance, the insurer does not have to pay for those charges and only has to pay for past due amounts billed previously in a timely manner; However, if the health care provider does give the insurance company a notice of initiation of treatment within 21 days of the first treatment/examination of the claim, the statement can include treatment for up to 75 days prior to the postmarked date of the statement. Ivey v. Allstate Insurance Co., 774 So.2d 679 (Fla. 2000). If your health care provider fails to timely submit the statement to the insurer and the insurer refuses payment because of this, the health care provider can’t recover the amount from you (injured person). If your insurer fails to resolve your PIP medical or disability claim, your Palm Beach County accident attorney will probably initiate a lawsuit against your insurer.