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How Florida Drivers Can Protect Themselves From PIP Fraud

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Posted on September 25, 2013

Updated on October 13, 2023

PIP insurance stands for Personal Injury Protection insurance. In Florida, PIP coverage pays out claims of up to $10,000 in medical expenses and lost wages for each person in a vehicle injured in an accident. Regardless of fault, motorists are required to access the first $10,000 in accident-related costs from their own insurance benefits. Unfortunately, fraudsters often exploit these payouts. Criminals may work alone or as part of organized, elaborate schemes to stage auto accidents and then bill insurance companies for exaggerated or fraudulent injuries.

The Two Most Common PIP Fraud Scenarios and How to Avoid Them

For many years, organized groups in southern Florida have conspired to fraudulently obtain PIP benefits. Coordinated fraud schemes typically involve several parties and can be considerably complex. In many cases, one or more drivers will target an innocent motorist to make an accident seem a bit more plausible.

Staged Accidents: Two or more fraudsters, driving in separate vehicles, may target an innocent, unknowing motorist. One car will pull in front of the “target” driver while the other pulls alongside in the adjacent lane. Without warning, the car in front will slam on the brakes and cause a rear-end collision. If the driver swerves to avoid the rear-end collision, he/she will either be forced to swerve completely off the road or will swerve into the other driver in the adjacent lane. In most cases, the unknowing motorist crashes into one of the fraudsters’ cars. The fraudster will immediately pursue a PIP payout, regardless of if he/she is truly injured.

How to avoid it: Maintain a safe following distance at all times. Even in busy, stop-and-go traffic, accelerate slowly and follow with caution. If another car pulls in front of you and slows down, you should maintain a slow interval. If the car slows down suddenly or acts suspicious, back off or attempt to pass. If you cannot pass and must slow down considerably, turn on your hazard lights and keep a safe distance.

If possible, pull off the road into a parking lot for a few seconds. Fraudsters are seeking impatient drivers who will ride up close behind the lead-fraud vehicle and will be unable to stop in time to avoid the collision. If you are hesitant and exercise caution, it is likely that fraudsters who may be targeting you will abandon their efforts and will move on. They are unlikely to stage an accident with a driver who is already suspicious and working to avoid them.

Falsified Clinical Records: Sometimes, corrupt medical practitioners participate with the drivers described in Case 1. However, fraud is more prevalent among cases in which shady medical practitioners approach innocent drivers who have been in accidents and agree to pay them for using their accident to stage a claim. Low-income drivers are often targeted by corrupt clinicians. They actively recruit drivers by paying them a cut of the $10,000 benefit. These practitioners fabricate a false or exaggerated medical record and treatment plan and file for the full $10,000 benefit, even though the actual cost of treating the injury may be less than $100. A treatment plan never takes place, but benefits payouts are collected by these “accident clinics” and a portion of the cash is given to the driver. In September, two owners of an unlicensed chiropractic office based in Miami were arrested for doing this.

How to avoid it: Cooperating with one of these medical practitioners is insurance fraud. Drivers should never consider this, as those caught can face stiff penalties including jail sentences. Be leery of any unsolicited offers for treatment you receive following an accident. Only receive treatment at legitimate medical offices registered with the state. Select a physician at random and research him/her online. You can start out by using only offices operated by licensed medical doctors. Not all, but many of the fraudulent clinics are run by chiropractors or massage therapists and the majority of MDs will not associate with these types of organizations.