News & Updates

Blog

Policyholder Brings PIP Challenge

Policyholder Brings PIP Challenge

A recently filed South Florida lawsuit seeks to have Florida’s 2012 Personal Injury Protection (PIP) reforms declared unconstitutional.  The reforms were an effort to stem rising PIP rates and included a $2500 cap on non-emergency services while also removing certain types of services from PIP altogether.

This is not the first lawsuit to challenge the PIP reforms–  challenges brought by the capped or excluded provider groups have been winding their way through the court system.  This case, however, involves a claim by policyholder Yesenia Boatswain against Garrison Property and Casualty Insurance Company.

The central issue in the case is expected to be “access to courts.”  In general, citizens must have access to the court system to bring claims.  However, access to courts can be limited or replaced by a system providing an adequate alternative remedy.  The PIP system is such an alternative remedy and historically has been upheld because the limitations of the system have been considered appropriate when weighed against the benefits of eliminating disputes over fault and providing faster compensation to injured persons.  In the current round of PIP challenges, plaintiffs argue that the 2012 reforms tipped the balance against injured persons–  the benefits of the system are no longer adequate in relation to the rights given up by policyholders.

Of course, the 2012 reforms also included a mandate for insurers to recognize the benefits in their rate filings.  Since the changes went into effect, PIP rates reportedly have declined by about 13%.  If the 2012 reforms are determined to be ineffective, then PIP rates would need to increase as they were doing steadily under prior law.  

The continuing controversy surrounding the PIP reforms also lends support to opponents of the no-fault system, who say PIP should be scrapped altogether and injuries should be handed in the tort system with mandatory bodily injury limits.  Proponents of moving away from the PIP system have not gathered enough momentum to advance the repeal in recent legislative sessions, but the uncertainty is sure to keep the issue alive going forward.