Joslyn Restivo, left, and Oner J. Kiziltan, right, of Marshall Dennehey. Courtesy photos Fla. High Court Clears Path for Insurance Companies to Utilize Payment Methodologies Enumerated in PIP Statute
The "billed amount" issue deals with both policy language and Section 627.736(5)(a)(5) of the PIP statute. In plain language, the issue can be summarized as whether an insurer is eligible to reimburse a bill at 80% of the amount billed when that amount is less than 200% of the Medicare fee schedule rate for the corresponding year for which the service was rendered.
May 23, 2024 at 11:53 AM
8 minute read
Board of Contributors
The Florida Supreme Court recently issued its decision on one of the most longstanding issues in Florida PIP law by ruling in favor of Allstate in Allstate Insurance v. Revival Chiropractic, No. SC2022-0735 (Fla. Apr 25, 2024). The "billed amount" issue deals with both policy language and Section 627.736(5)(a)(5) of the PIP statute. In plain language, the issue can be summarized as whether an insurer is eligible to reimburse a bill at 80% of the amount billed when that amount is less than 200% of the Medicare fee schedule rate for the corresponding year for which the service was rendered.
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