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Florida Insurance Defense Law Blog

Overpayments: getting the advantage for the insurer

Overpayments to providers by insurers happen all the time. It’s not a matter of fraud but the complexities of the system. Medical providers rarely have fixed tables of cost for any given services and the actual price for any given treatment is often negotiable.

Insurers have a disadvantage in this system. The position is made even weaker by Florida law. The only way to regain the advantage, when necessary, is to be prepared for civil litigation.

PIP fraud still rampant

As the Florida legislature considers changes to Florida's no-fault insurance system, sentencing has begun in one of the most intricate PIP fraud conspiracies in recent years. A total of $23 million dollars in fraudulent PIP claims was racked up over seven years.

The case places in the public eye some details about how PIP fraud operates, which is educational. Without giving away too many details on how to uncover auto insurance fraud it highlights the severity of the problem and why all claims have to be diligently inspected.

Settling the case: mediation and arbitration

If you have an insurance claim against your company, it is definitely in your best interest to come to some kind of settlement if it is possible. Sometimes, however, that simply cannot be done and a lawsuit is the only possible option.

That does not mean that negotiation is over, however. Courts in Florida require all civil lawsuits to go through mediation before proceeding to trial. In mediation it may make sense for the case to be referred to arbitration. These alternative dispute resolution procedures are an important part of the process, especially for insurance claims.

How much security is enough?

In the wake of several incidents involving mass casualties, many Americans have become concerned for their safety. Property owners of large, public spaces are increasingly being called on to tighten security and provide adequate protection to their patrons.

But what is expected? The law is open to changing conditions and times for a lot of reasons. But property owners in general are not always expected to take into account every potential risk to the public. It’s important to understand the potential liabilities all property owners have and how they can cover them.

Tips for preventing insurance fraud claims against your business

According to the FBI website, insurance fraud (non-health insurance) is estimated to cost $40 billion a year. American consumers pay between $400 and $700 a year in increased premiums due to fraudulent claims.

As a business owner, you've worked hard to maintain a profitable and successful business. Each year employees and customers make claims for Workers' Compensation, slip and fall accidents, product liability and more. Many people are being sincere and truthful.

No fault insurance fraud leads law makers to consider options

Lawmakers are considering replacing Florida’s no fault auto insurance law. Currently, Florida is one a dozen states with no fault insurance laws. These laws are designed to keep insurance premiums low, but Florida has the fifth highest premium rates in the nation.

As a replacement, lawmakers are considering a mandatory bodily injury (BI) coverage system. Whereas Personal Injury Protection (PIP) protects the driver, BI protects the other person injured, placing the fault on the negligent party.

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