Category Archives: Fla. Stat. 627.736 (2008)

Florida Speed Limits May Rise to 75 MPH

Posted speed limits on I-95 and other Florida interstate highways could increase from 65 to 75, if legislation introduced in the Florida legislature by Florida Senator Jeff Clemens (D-Lake Worth) passes.

Senate Bill 392 would allow the Department of Transportation to raise the maximum allowable speed limit on certain highways like Interstate 95 that are part of the National System of Interstate and Defense Highways and have at least four lanes.

There are critics on both sides of the proposed speed limit changes.

Senator Clemens claims that drivers are already traveling at speeds in excess of the posted speed limits, and does not anticipate any increase in the number of accidents. Others fear that any increase in speed limits will result in increased accidents.

Speeding is the third leading contributing factor in traffic crashes, according to the National Highway Traffic Safety Administration.

The Insurance Institute for Highway Safety reports that the likelihood of being severely injured or killed in a crash increases with vehicle speeds.

The www.FLPIPGuide.com reported in a December 27post that Florida Ranks #6 in Worst Drivers Nationally. As mentioned in that article, auto insurance premiums tend to increase as safe driving habits decline in a state. Florida ranks among the top 10 most expensive states for car insurance, at #10, according to a 2012 article in the Palm Beach Post.

SB 392 is scheduled for at least one more vote in the Florida Senate before moving on to the House. If passed, the law would take effect on July 1, 2014.

Click on the link to read the proposed bill on Florida speed limits.

Click on the link to read a fact sheet on speed and safety published by the National Safety Council.

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Filed under Fla. Stat. 627.736 (2008)

Questionable PIP Claims Decline in Florida, Reports NICB

Tighter legislation, enhanced public awareness, and coordinated law enforcement efforts appear to be having a positive effect on PIP fraud in Florida, according to a recent report by the National Insurance Crime Bureau (NICB).

The new study published by the organization showed Florida’s personal injury protection (PIP) questionable claims (QCs) have dropped 7.6 percent from 2012 to 2013. More striking, however, was the extraordinary decline from 2010 through 2013, when Florida’s staged accident QCs decreased 61.82 percent during that time period.

Compare those statistics to 2009, when Florida not only topped the nation in PIP QCs reported to the NICB, but also had twice as many as the second-highest state, New York. From 2008 through 2010, the total number of QCs in Florida increased by 34 percent.

When NICB delved further into these results, it found that about 62 percent of total PIP costs and about 43 percent of PIP treatment costs came from soft tissue treatments. Massage treatments accounted for 22 percent of those treatments, and massage therapists had the largest increase in charges per patient at 51 percent from 2005 through 2010, after factoring in for medical inflation.

“We are encouraged by the decline in questionable claims that we’ve seen recently, but by no means are we declaring victory in Florida,” said NICB President and CEO Joe Wehrle.  “Florida remains a hotbed for fraudulent activity and we can’t afford to ease up for a moment in our fight against those who would abuse the system and burden Florida consumers.”

In September 2011, the Hillsborough County Commission was one of the first legislative bodies to enact a county ordinance to license PIP clinics and deter suspicious vehicle collisions in the county. Although an injunction against the law remains in effect, it hasn’t stopped other legislation. In February 2012, Miami-Dade County passed a similar ordinance requiring registration of PIP clinics, and the Florida legislature passed House Bill 119 in May 2012.

This two-part legislation institutes stronger penalties for medical providers who commit PIP fraud, including a five-year license suspension and a ten-year restriction from PIP reimbursement. It also imposes a 14-day post-accident window for accident victims to seek medical treatment and reduces specified PIP benefits and treatments. A lawsuit and injunction ensued, but eventually, the law was put into effect in late October 2013.

Although NICB does not receive all QC data in Florida, the data used to produce this report came from the same sources used in previous Florida QC reports. “Combining these legislative and regulatory efforts with a robust public awareness campaign and aggressive law enforcement response, the modest improvement in 2013 PIP QC data does suggest the initial stages of a positive downward trend,” NICB confirmed.

Click on the link to read the NICB Data Analytics ForeCAST Report regarding Florida Personal Injury Protection (PIP).

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Filed under Fla. Stat. 627.736 (2008), Insurance Fraud

Insurance Coverage Questions Put the Brakes on Miami Rideshare Programs

Plans to introduce Uber and other rideshare programs utilizing technology-based apps in Miami are on hold for now, according to a recent article in the Miami Herald.

Two key members of the Miami-Dade Board of County Commissioner’s transportation and aviation committee blocked a ride-sharing proposal that would have then gone before the full committee for a vote.

Popular rideshare services, like Uber X, Lyft and Sidecar, have seen accelerated growth in major U.S. cities. Using technology that the taxi industry finds highly disruptive, people with regular driver’s licenses can use their personal vehicles to transport riders for a fee. These drivers register for dispatch services. Accepted drivers are then able to connect to customers and collect fares via credit cards by using smartphone apps.

Critics, however, have accused these providers of working outside the constraints set for taxi and other commercial transit services, for questionable business practices, and for having inadequate insurance coverage for drivers and their vehicles.

San Francisco-based Uber recently announced that it has new insurance to cover the gap “during the time that ridesharing drivers are not providing transportation services for hire, but have the Uber app open and are available to receive a trip request,” according to an article in Insurance Journal.

Uber appears to be the first company, the article notes, to have a policy that extends insurance of ridesharing drivers to cover the potential insurance gap. This liability coverage kicks in only if a driver’s personal insurance fails to cover an incident and provides up to $50,000/individual/incident for bodily injury; $100,000 total/incident for bodily injury; and $25,000/incident for property damage.

A tragic accident over New Year’s Eve in which an Uber driver struck and killed a 6-year old girl when he was logged on to Uber’s app brought national attention to the nascent rideshare industry. Uber has been hit with a wrongful death lawsuit as a result, according to a March 14 Verge article.

Chicago’s City Council has also stepped up efforts to further investigate the insurance gap of the three companies operating in the city and recently subpoenaed their insurance records. The Council is still working to get the necessary evidence of still-undisclosed policies, according to a March 14 article in the Chicago Tribune.

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Filed under Fla. Stat. 627.736 (2008)

South Florida Man Accused of Car Insurance Fraud

A Weston man is accused of bilking insurance companies out of hundreds of thousands of dollars by filing claims based on details contained in accident reports from traffic accidents involving unsuspecting drivers and other consumers who never received claims payments, according to a press release issued by the Florida Department of Financial Services.

David M. Glincher has been charged with 25 counts of insurance fraud, 22 counts of grand theft, 19 counts of uttering forged instruments, and 1 count of aggravated white collar crime.

Total theft is estimated at almost $300,000, according to the announcement. The widespread scheme involved 270 victims.

Auto Loss Claim Consultants, LLC, a Florida business owned by Glincher, was used to obtain copies of crash reports. Glincher allegedly then sent fliers to victims, urging them to file “diminished-value” insurance claims. “Diminished-value” claims allow victims to recover the difference between a car’s value before the accident and after repairs have been made.

Even when people did not contact him to complete the claim forms, Glincher used information from the accident reports to file the claims and had the checks sent to him at his business, typically netting a few thousand dollars per claim.

An insurer reported Glincher after it received five suspicious claims, and an investigation revealed that Glincher had forged 19 signatures in order to file “diminished-value” claims for other people’s traffic accidents without them knowing it.

“Insurance fraud drives up costs for all Floridians, and we will not allow it to continue,” said Florida Chief Financial Officer Jeff Atwater.

Glincher is now free on $29,500 bond after being booked into the Broward County Jail. He faces up to 30 years in prison.

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Filed under Fla. Stat. 627.736 (2008), Insurance Fraud

Fraudulent Rental Car Schemes an Emerging Trend in Auto-Related Crime

Auto insurance claims adjusters and special investigative units (SIU) have been put on notice about a proliferation of fraudulent auto schemes involving rental cars. This type of criminal activity will impact states with top hospitality industries, like Florida, where tourism was ranked number one and was responsible for welcoming 91.5 million visitors in 2012.

According to a recent Claims Journal article, Kraig Palmer, an investigator with the California Highway Patrol, warned that he has seen rental car schemes “rise faster than any other auto fraud trend” in the past 12 months.

Perpetrators are often found to be opportunistic drug addicts and knowledgeable street gangs, the article revealed. The crux of the fraud targets car rental companies and involves renting multiple cars. Then, the rented cars are used to commit crimes. They eventually are recovered, but often burned out or with significant collision damage.

It is a difficult crime to nail down because it can occur on many different levels—using multiple fraudulent or stolen identities. Also, incentive programs at the car rental companies make it easy to rent a car, often with online registration and no face-to-face interaction.

It’s not surprising, then, that insurers will see more claims involving fraudulently rented cars. The criminals and gangs have access to money, and will use that money to educate themselves on companies’ processes. All it takes is paying one disgruntled employee to gain knowledge of the claims process, Palmer added.

He recommends that insurance companies thoroughly examine auto property damage or auto bodily injury claims involving rental cars, searching for patterns such as: how long the vehicle was rented, how many vehicles were rented by the same individual, and if there were more vehicles rented by the same individual that experienced damage.

If there are red flags, Palmer suggests going to the regional security manager instead of the car rental agency. That manager will have access to the complete contract and credit amount. Due to privacy regulations, law enforcement will likely need to be involved, he concluded.

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Filed under Fla. Stat. 627.736 (2008), Insurance Fraud

Medical Costs Associated with Auto Accidents Rise Despite Reduced Injury Severity

Medical expenses tied to auto injury insurance claims have outpaced inflation, even though there has been a downturn in the seriousness of those reported injuries, according to a study recently released by the Insurance Research Council (IRC).

According to the report—Auto Injury Insurance Claims: Countrywide Patterns in Treatment, Cost and Compensation—the average claimed economic losses reached $14,207 per personal injury protection (PIP) claimant in 2012, growing at an annualized rate of 8 percent from 2007.  Economic losses include expenses for medical care, lost wages and other out-of-pocket expenditures. Among bodily injury (BI) claimants, the rate of average claimed losses grew 4 percent to $10,541 in 2012 from 2007.

However, the study found that over the same period, measures such as the “percentage of claimants who had no visible injuries at the accident scene” or who had “fewer than 10 days in which they were unable to perform their usual daily activities” provided evidence of a continuing decline in the severity of injuries.

The study also looked at a variety of factors in the upswing of medical care expenses, including the shift toward more costly treatments and diagnostic alternatives as well as dramatic increases in billed charges for visits to numerous types of medical providers. The use of pain clinics, attorney involvement, and claim abuse were found to exacerbate the increases in medical care expenses, the study found.

“Medical care costs continue to escalate, especially among first-party claimants,” Elizabeth Sprinkel, senior vice president of the IRC, announced. “Looking forward, the industry will need to continue its vigilance in contending with these expanding costs, particularly as it monitors the possible spillover effects from general healthcare reform.”

The 2014 edition of the study is the seventh of its kind conducted by the IRC.  The council collected data on more than 35,000 auto injury claims closed with payment under the five principal private passenger coverages. Twelve insurers, representing 52 percent of the private passenger auto insurance market in the United States, participated in the study. For more information, visit IRC’s website at http://www.insurance-research.org.

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Filed under Fla. Stat. 627.736 (2008)

Property-Casualty Insurers Face Cost Shifting Risk from The Affordable Care Act

The Insurance Research Council (IRC) has studied the possible impact of the Affordable Care Act (ACA) on the property-casualty industry. The IRC’s study concludes that there will be significant and long-lasting consequences to the property-casualty industry due to the change in healthcare markets and health insurance systems in the United States. Summarized below are some of the issues raised by the IRC’s research.

The first potential impact, which the IRC predicts will be major, is cost shifting from health insurance systems to property-casualty insurance systems. To offset anticipated reductions in revenues from health insurance providers due to cost containment efforts and initiatives by public and private health insurers, medical providers may seek to increase revenues from other payers, including property-casualty insurers. To do so, medical providers may seek higher reimbursements from other payers and increase the volume and mix of services provided to patients covered by other payers.

The widely varying levels of reimbursement leave some payers, including property-casualty insurers, particularly vulnerable to cost-shifting efforts by hospitals and other providers. While large health insurers are able to negotiate lower prices or significant discounts for medical services, the authority and ability of property-casualty insurers to negotiate reimbursement levels varies from state to state. This leaves the property-casualty insurer vulnerable to cost shifting from medical provider to insurer.

A second potential impact of the ACA is to prompt individuals with injuries to file a claim with a property-casualty insurer instead of a health insurer. The reason for the “claim shift” is that the ACA may have made it more expensive or difficult for the individual to file a health insurance claim. Many people are insured under health insurance plans that have high deductibles and coinsurance provisions that increase out-of-pocket costs for insured individuals. The claimant, therefore, may be motivated to file their claim with a property-casualty insurer, if possible, in order to avoid incurring costs due to high deductibles and cost-sharing requirements.

Additionally, health insurers may become more aggressive under the ACA in refusing to provide coverage for certain procedures. If insureds fear that their desired treatment will be denied by the health insurer, they may contend—legitimately or not—that their claim is covered by property-casualty insurance. Fraudulent or not, either way a claim shift will have occurred.

A third important potential impact of the ACA is a rise in fraudulent claims due to increased fraud-fighting emphasis. The IRC refers to a paper published by the National Insurance Crime Bureau (NICB) in which the NICB concludes: “because property-casualty insurance is not covered by the ACA, career criminals and unscrupulous medical providers will shift their attention to the property-casualty business to avoid increased scrutiny from health insurers.” The NICB did not estimate the magnitude of this potential effect, but did suggest some actions that property-casualty insurers could take to mitigate its potential impact (e.g., market-based fee schedules and bill review authority).

In conclusion, although not specifically targeted by the ACA, property-casualty insurers may nonetheless experience significant and long-lasting effects from the implementation of the ACA. The IRC recommends that property-casualty insurers begin considering and implementing tools to reduce the ACA’s potentially negative impact on the industry.

Click on the link to read the IRC study.

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Filed under Fla. Stat. 627.736 (2008)

Jacksonville Woman Faces Insurance Fraud Charges in North Carolina

A Jacksonville, Florida, woman was arrested in connection with an auto insurance fraud scheme that occurred in North Carolina—her place of residence at the time.  Stacy Lasondo Jackson, 39, was charged with 10 counts each of insurance fraud and obtaining property by false pretense, according to a newscast on WRAL TV.

Investigators with North Carolina’s Department of Insurance found that Jackson was paid several thousand dollars from a variety of insurance companies after filing fraudulent insurance claims.  The claims were made for damage to her automobile and motorcycle between January and May of 2013.  Authorities believe the damage never happened or was reported more than once.

This past December, Jackson was arrested on similar charges in Florida, investigators said.  She has been extradited to North Carolina and placed in the Cumberland County jail under a $10,000 bond.

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Filed under Fla. Stat. 627.736 (2008), Insurance Fraud

Uninsured Florida Drivers May Be Factor in the State’s Rising Number of Hit-and-Runs

The Florida Highway Patrol (FHP) reports that there was an 8 percent increase in the number of hit-and-run crashes from 2012. Uninsured drivers may be a significant contributing factor in the 78,000 hit-and-run accidents occurring in 2013, a recent story in the Bradenton Herald postulates.

According to the article, about one in four Florida drivers have no auto insurance, and Florida has the fifth-highest auto insurance rates in the United States—figures that lay the groundwork for a spate of drivers with no insurance fleeing the scene.

The 78,000 hit-and-runs last year—which involved bodily harm or property damage—caused more than 17,000 injuries and 154 deaths, the FHP says.

A spokesperson for the Insurance Information Institute, Lynne McChristian, says the link between having no auto insurance and the increase in hit-and-runs can be expected.

“They bolt when they have an accident because they are already breaking the law by not having insurance, and then they have caused an accident on top of it,” McChristian said in the article.

Other factors contributing to the wave of hit-and-runs are driving under the influence of alcohol or drugs, driving with a suspended operator’s license, driving while on probation, or driving scared due to any of the other factors, according to FHP Lt. Greg Bueno.

However, FHP is fighting the growing number of hit-and-runs statewide, Bueno said, with a new awareness campaign: “Hit & Run, Bad 2 Worse.”  The campaign intends to educate drivers about the consequences of leaving the scene of an accident.

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Filed under Fla. Stat. 627.736 (2008)

Motor Vehicle Crashes No Longer Leading Cause of Spinal Cord Injuries

Falls have taken the lead from motor vehicle accidents as the primary cause of serious traumatic spinal cord injuries in the United States, according to a recent study published online in the Journal of Neurotrama by the Johns Hopkins University School of Medicine.

A nationally representative sample of 43,137 adults treated in hospital emergency rooms for spinal cord injury in the U.S. between 2007 and 2009 was studied by Johns Hopkins researchers. What they discovered is that the incidence of falls per million in patients 65 and older increased from 79.4 per million to 87.7 per million at the same time that the number of falls in 18- to 64-year olds actually dropped from 52.3 per million in 2007 to 49.9 per million.

Motor vehicle crashes were found to be the leading cause of 35.5 percent of traumatic spinal cord injury, in second place behind falls at 41.5 percent. Also, the average age of adults with traumatic spinal cord injuries rose from 41 years to 51 years.

Researchers believe a triple combination of the general aging of the population, more active lifestyles of many Americans over 65, and airbags and seatbelt laws may be contributing factors as to why falls have surpassed car crashes as the leading cause of traumatic spinal cord injuries.

The National Spinal Cord Injury Statistical Center figured the lifetime costs of care for someone with a serious spinal cord injury can range from $1 million to $5 million, depending on age of the person at the time of injury and the severity of the injury. Advances in patient care have led to longer life expectancies, but also bigger medical bills.

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Filed under Fla. Stat. 627.736 (2008)