Texting Laws Appear to Reduce Traffic Fatalities

States with primary enforcement laws against texting while driving appear to be having an impact on reducing traffic deaths, a new study released by the University of Alabama at Birmingham (UAB) – School of Public Health has found.

Primary enforcement means that there doesn’t have to be another reason for a police officer to stop a vehicle.

A recent Claims Journal article summarized some of the UAB findings, one of the most notable being a three percent decrease in fatalities among all age groups associated with states supporting primary texting bans. This translates to an average of 19 deaths prevented per year in states with such bans.

However, researchers revealed that states with secondary enforcement of texting bans (an officer must have another reason to stop a vehicle) didn’t see any real decrease in fatalities. Researchers also found bans on texting are most effective with young drivers, while bans on handheld cell phones are most effective with older adult drivers.

According to 2011 data from the Centers for Disease Control and Prevention, 31 percent of U.S. drivers, aged 18-64 years, said that they had read or sent text or email messages while driving at least once in the 30 days prior. That year saw 3,331 fatalities and 387,000 injuries involving distracted drivers.

Using roadway fatality data captured in the Fatality Analysis Reporting System between 2000 and 2010, Alva O. Ferdinand, Dr.P.H., J.D., led the longitudinal panel study. She wanted to examine what impact texting laws have had on roadway crash-related fatalities and how variations in states’ laws affect those results to ultimately determine which laws are most beneficial in improving roadway safety.

Researchers’ results indicated that states with primary texting bans:

  • Were “significantly associated” with reduced traffic fatalities in all age groups
  • In all age groups, a 3 percent reduction in traffic deaths equates to 19 deaths prevented each year
  • Reduced fatalities 11 percent among 15- to 21-year olds when targeted to young drivers.

States with secondary enforced restrictions also saw no significant reduction in traffic fatalities. In addition, states that prohibit use of cell phones without hands-free technology saw significant reductions in fatalities among the 21- to 64-year old age group.

Ferdinand hopes the findings help policymakers implement laws that are most effective in reducing traffic deaths. Her results are published in the August issue of the American Journal of Public Health.

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Filed under Fla. Stat. 627.736 (2008)

Allstate to Recover Almost $1 Million in PIP Case against Dr. Sara Vizcay

In a case brought by Allstate in the Florida Middle District, the court ruled on August 1st that the Defendant’s Motion for Declaration of Mistrial was denied, the Plaintiff’s Motion for Declaratory Judgment was granted in part, and the final judgment was ordered.

Dr. Sara C. Vizcay and the seven medical clinics listed below were the Defendants in the case.

  • Best Care Medical Center, Inc.
  • Caleb Health Care, Inc.
  • Florida Rehabilitation Practice, Inc.
  • Global Diagnostic Center, Inc.
  • Personal Medical Center, Inc.
  • P.V.C. Medical Center, Inc.
  • Regional Enterprises for Health Corporation

Fraudulent billing practices and failure to comply with the licensing requirements of the Florida Health Care Clinic Act (HCCA) formed the basis of Plaintiff allegations. In a jury trial earlier this year, the jury found that each Defendant misrepresented material facts.

The court noted that the “jury unanimously found Plaintiffs proved, by a preponderance of evidence, that Dr. Vizcay failed to substantially comply with her statutory medical director duties to systematically review bills … and to ensure those bills were not fraudulent or unlawful.”

The total amount to be recovered by Allstate is $942,883.41, and Plaintiff is not obligated to pay any unpaid amounts.

The case is Allstate v. Sara C. Vizcay, M.D. et al., U.S. District Court for the Middle District of Florida, Case No. 8:11-CV-804-EAK-EAJ. Click on the link to read the August 1, 2014 Order of Judgment.

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Filed under Case Law, Insurance Fraud

Eleventh Circuit Dismisses PIP Case Involving EMC and Massage Therapy

A class action suit filed by plaintiff Accumed Chiropractic against Progressive Select Insurance was dismissed on July 31, 2014 by Circuit Court Judge Antonio Arzola. Judge Arzola concluded that the action was inappropriate for class action treatment.

The suit was brought on behalf of plaintiff itself and two putative classes. The first class was to be anyone who was denied payment by Progressive under PIP or MedPay insurance coverage where Progressive’s denial was based on an assertion that an Emergency Medical Condition for the insured was not established.

The second class was to be defined as anyone whose PIP or MedPay claim was denied because the health care service was for massage therapy or acupuncture. Plaintiff sought both declaratory relief and damages for breach of contract.

Plaintiff stipulated at the hearing that it did not have standing to sue for MedPay benefits. As for the PIP claims, Judge Arzola found that the “necessary and individualized questions associated with the underlying PIP claims of the class will predominate in this Action.” As a matter of law, therefore, plaintiff’s case could not proceed as a class action, and the complaint was dismissed without prejudice.

The case is Accumed Chiropractic & Wellness Center, Inc. v. Progressive Select Insurance Company, Case No. 13-CA-029396 (Fla. 11th Cir. Ct., July 31, 2014). Click on the link to view the court order.

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Filed under Case Law

FL PIP Guide Readers: Vote Now for the 100 Best Legal Blawgs

Readers of the FL PIP Guide are invited to show their support for the blog by voting in the ABA Journal’s annual competition for the 100 Best Legal Blawgs.

Please nominate Roig Lawyers’ FL PIP Guide blog by clicking here to provide a brief explanation on why you like the blog!

In addition to your name and affiliation, you will be asked to provide the URL to the FL PIP Guide (www.flpipguide.com).

You also have the chance to identify a specific blog post that you consider to be representative of the quality of coverage provided by the FL PIP Guide.

Click on the link below to get started.
http://www.abajournal.com/blawgs/blawg100_submit/

Friend-of-the-blawg briefs are due no later than 5 p.m. ET on Friday, August 8, 2014.

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Filed under Uncategorized

Defendant’s Motion to Dismiss Granted with Prejudice in PIP Benefits Case Involving Challenge to “Emergency Medical Condition” (EMC) Provision

In a second ruling within one week involving Florida’s amended PIP law, the U.S. District Court for the Southern District of Florida dismissed a case challenging reimbursement under the amended statute’s “emergency medical condition” or “EMC” provision. See our earlier post titled Court Grants Defendant’s Motion to Dismiss in Robbins v. Garrison P & C.

Sendy Enivert sued her auto insurance company, Progressive Select, alleging breach of contract for failing to pay her PIP benefits to a limit of $10,000. Enivert’s claim involved the newly added provision to Florida’s PIP law which limits PIP benefits depending on whether a claimant has suffered an emergency medical condition.

Plaintiff Enivert interpreted this language to mean that an insured is limited to $2,500 only if a medical provider determines that there is no emergency medical condition. She argued that because, in her case, no medical provider ever made such a determination, she was entitled to the full $10,000. In other words, because no medical provider determined that she did not have an emergency medical condition, she was entitled to full benefits.

Defendant Progressive read the statute to mean the opposite, i.e., that a medical provider must affirmatively determine that an emergency medical condition does exist in order for the insured to be eligible for reimbursement of the full amount.

The court agreed with Progressive, concluding that the PIP statute clearly indicates that a determination that a claimant has suffered an emergency medical condition is required in order to receive benefits in excess of the $2,500 limit. Since a medical provider did not determine that Enivert had an emergency medical condition, she was not entitled to the full $10,000 in benefits.

The court also looked to the legislative intent behind the PIP statute. It concluded that the clear legislative intent was to decrease PIP fraud by placing more stringent requirements in order to receive the maximum amount of benefits.

Based on the above, the court granted Progressive’s motion to dismiss Enivert’s case.

The case is Sendy Enivert v. Progressive Select Insurance Co., Civil Action No. 14-CV-80279-Ryskamp/Hopkins (S.D. Fla. July 23, 2014). Click on the link to read the court ruling.

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Filed under Case Law, Fla. Stat. 627.736 (2012)

Court Grants Defendant’s Motion to Dismiss in Robbins v. Garrison P & C

On July 18, the U.S. District Court for the Southern District of Florida dismissed a case in which the plaintiff challenged reimbursement under the amended statute’s “emergency medical condition” (“EMC”) provision.

Glenaan Robbins sued her auto insurer, Garrison P&C Insurance Co., alleging that Garrison violated the 2013 provision of Florida’s PIP law that limits PIP benefits depending on a determination of whether or not the claimant suffered an emergency medical condition.

Robbins sustained injuries in an April 2013 car accident. She was treated for her injuries and alleged that ultimately “no determination was made that she did not have an emergency medical condition.” When Robbins submitted her claim to her insurer Garrison, Garrison limited her reimbursement to $2,500.

FL PIP law requires that an insurance company must reimburse its injured insured up to $10,000 if certain medical providers determine that the injured person had an emergency medical condition. Reimbursement is limited to $2,500 if a provider determines that the injured person did not have an emergency medical condition.

In this case, no determination was made either way that an emergency medical condition did or did not exist. Plaintiff Robbins argued that where there has been no such determination, insurance companies must reimburse medical expenses up to $10,000. In other words, unless a determination of no emergency medical condition is made, the plaintiff is entitled to the higher amount.

Reviewing the language of the statute and legislative intent, however, the court concluded that Robbins’ argument had no merit. Rather, where there has been no determination of an emergency medical condition made, PIP medical benefits are not to exceed $2,500. Thus, contrary to Robbins’ argument, the conclusion of the court was that unless there is a determination of an emergency condition, the reimbursement is limited to $2,500.

The court therefore held that Robbins had failed to allege a statutory claim and her case was dismissed.

The case is Glenaan Robbins v. Garrison Property & Casualty Insurance Co., Civil Action No. 13-81259-Civ-Scola (S.D. Fla. July 18, 2014). Click on the link to read the court ruling.

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Filed under Case Law, Fla. Stat. 627.736 (2012)

Fraud Charges Filed in West Palm Beach False Insurance Claim Case

The fact that Frank Assouman was not even in his truck at the time it was hit in a Boca Raton parking lot did not stop him from filing more than $25,000 in false insurance claims.

The crash report and a witness statement taken at the time of the accident indicate that the West Palm Beach resident was not in his parked vehicle when it was struck by another driver. Damage to Assouman’s vehicle was estimated at $1,500.

Days later he sought medical care, including an MRI at Delray Diagnostics and other treatment obtained from Modern Medicine, Inc.

In addition to filing a claim for property damage, Assouman reportedly filed a $21,815 injury claim with State Farm and a $3,035 claim with his own carrier of Windhaven Insurance.  Both claims were denied.

The Florida Division of Insurance Fraud filed a fraud charge against Assouman for less than $20,000.

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Filed under Insurance Fraud