DAYTONA BEACH PERSONAL INJURY PROTECTION (PIP) ATTORNEY

We Handle PIP Claims in Daytona Beach and Throughout Central Florida

In Florida, Personal Injury Protection (PIP) benefits are intended to provide prompt payment for medical services after an automobile accident, regardless of who was at fault. In practice, insurers routinely delay, reduce, or deny legitimate claims. For both medical providers and insureds, enforcing payment rights under PIP often requires experienced legal representation.

At My Affordable Attorney, we have litigated thousands of PIP cases, including matters that resulted in published opinions. Our firm understands how PIP carriers operate and how to compel payment when benefits are wrongfully withheld.

Frequent Issues Providers Face

Medical providers in Daytona Beach and across Florida regularly encounter the same PIP problems, including:

1. Partial Payments or Underpayments: The insurer pays less than the billed amount, often by misapplying the fee schedule, relying on Medicare rates improperly, or using incorrect reductions.
2. Denials Based on “Medical Necessity”: Claims are denied after insurer-arranged independent medical examinations (IMEs) that dispute the need for ongoing treatment or services.
3. EMC Reductions: Insurers cap coverage at $2,500 by asserting that there is no valid Emergency Medical Condition determination, even where the records support such a finding or the provider has supplied a clear EMC opinion.
4. Coverage Disputes: Claims are rejected based on alleged misrepresentations, application issues, purported gaps in coverage, or technical paperwork arguments that do not justify nonpayment.

These tactics reduce reimbursement and shift the financial burden onto providers. A careful legal review often reveals that the insurer has not complied with Florida’s PIP statute and related case law.

Legal Remedies for Providers

Providers are not required to accept improper reductions or denials. Florida law gives medical practices meaningful tools to enforce their rights under PIP.

1. Audit and File Review: We conduct a detailed review of billing, explanation of benefits (EOBs), and insurer correspondence to identify underpayments, improper reductions, and unpaid claims. This analysis often reveals additional reimbursement that is still recoverable.
2. Demand Letters: Before suit, we prepare and serve statutory pre-suit demands that put the insurer on notice of specific violations. These demands frequently lead to payment of outstanding benefits, plus interest and applicable penalties.
3. Litigation: If the insurer does not resolve the claim within 30 days after a proper demand, we may be able to file suit. Florida PIP law allows recovery of attorney’s fees under certain situations when an insurer wrongfully withholds payment. This fee-shifting structure makes litigation an effective enforcement tool and removes the need for providers to pay fees out of their collections.

We offer a free consultation to providers who wish to discuss their PIP portfolios, individual problem claims, or patterns of underpayment.

Why Work With Us

My Affordable Attorney represents health care providers across Florida in actions to recover unpaid and underpaid PIP benefits.

• We focus on enforcing PIP rights for medical practices, imaging centers, chiropractors, physical therapists, and other treating providers.
• Our litigation is cost-effective.  In fact, in certain situations, Florida law places responsibility for attorneys’ fees on insurers when they lose PIP disputes.
• We seek not only overdue benefits, but also interest and statutory penalties that insurers regularly ignore.

If your practice has outstanding or denied PIP claims, we can enforce your rights and pursue the amounts owed. You retain 100 percent of your outstanding benefits. We do not charge providers for our PIP litigation services.

You may contact our office for a free review of your PIP files and for a discussion of your options.

Contact Our Daytona Beach PIP Attorney Today

At My Affordable Attorney, our Daytona Beach car accident lawyer and PIP team have the skills and experience necessary to handle complex PIP claims and disputes. If you have questions about PIP coverage, billing issues, denials, or underpayments, contact us, we are available to assist.

With an office in Daytona Beach, we handle PIP claims throughout Central Florida, including Volusia County, Seminole County, Lake County, Flagler County, and Brevard County.

Our firm also represents injured persons involved in car accidents and other injury-producing events in the Daytona Beach area. We help clients pursue personal injury claims when a serious injury results from another party’s negligence. If you are an injured person who has suffered pain, lost income, or other damages after an accident, our team works to seek both economic and non-economic damages and to pursue the maximum compensation available under Florida law.