Guest Column

Providers share blame in PIP fiasco

By AUTAR KAW
Published October 3, 2007

The sun is setting on personal injury protection, and the consumer is still left as "David" in the story.

Setting fraud aside, when a driver has PIP, providers such as hospitals, clinics and doctors charge anywhere from four to 10 times what they would charge a patient with health insurance. I have not seen automobile insurers question (maybe they cannot or because of the 30-day limit within which they have to pay) the unfair practice, as it must be more cost efficient for them just to pay the bills.

I know personally that providers bill the patient for the 20 percent of the cost (PIP pays 80 percent) even though the patient's health insurance serves as secondary insurance. Health insurance companies make you fill out accident-related paperwork several times, have a not--my-problem stance and delay paying their share until the collection agency comes knocking at the consumer's door. This happens even though in many cases the health insurance company determines that it - or the patient - is required to pay nothing beyond the PIP payment because the automobile insurance company already paid more than what the health insurance company would have paid the provider.

With no PIP, it is expected that 40 percent of emergency accident patients in the Tampa Bay area will have no coverage.

Hospital administrators refuse to admit that they are partly responsible for the PIP fiasco by charging exorbitant rates. Try to ask them to answer the question categorically in an interview and they put slick Willy to shame with their evasive answers or they play coy, saying they do not understand the question. It happened last month in an interview with Florida Matters on our local NPR radio station. However, the same hospital administrators are quick to cry that they will have to absorb the cost of serving these patients and are able to spill out statistics like a blended scientist-auctioneer-robot.

Don't many patients pay monthly if they cannot afford to pay? Don't hospitals send collection agencies after nonpayers? Are all nonpayees filing bankruptcy?

If hospitals and doctors charged fairly, we would have had many more advocates to keep PIP. Now instead we will see more accident victims' lawyers bringing automobile insurance companies to court, charging their share of money, while the consumer will end up losing further with rising health and automobile insurance premiums.

I recommend that PIP be optional to the consumer and encouraged for those without health insurance. If the medically uninsured want to forgo the PIP coverage, they are not being responsible.

Reforms cannot stop there.

The Legislature should control hospital rates for accident victims. It should pass the law for real-time links to insurer databases to see who are allowing their car insurance to lapse. With such reform, PIP coverage would pay the bills of most accident victims in Florida.

Autar Kaw is a mechanical engineering professor at the University of South Florida. Guest columnists write their own views on subjects they choose, which do not necessarily reflect the opinions of this newspaper.

[Last modified October 2, 2007, 20:22:50]