Interestingly, this class action is asking the court to declare parts of Florida law unconstitutional, although the defendant is not the state but a car insurance company. The complaint claims that State Farm Mutual Automobile Insurance Company has been “systematically and routinely denying” all Personal Injury Protection (PIP) claims when the person involved does not receive initial treatment without fourteen days of an accident. According to the complaint, State Farm’s denials are based on “the 2012 PIP amendments” to Florida law.
The class for this action is all persons who have State Farm PIP insurance coverage for services or care, and all persons insured under those policies, to whom State Farm denied payments giving solely Reason Code SF 793 or a combination of Reason Code SF 793 and SF 493 as a reason for denial.
In 2012, Florida laws were amended to change Section 627.736(1), Florida Statutes (2012). Under the new law, Florida drivers must still carry $10,000 in PIP insurance. The insurance entitles them to benefits for “[e]ighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services” including initial services and follow-up services.
But there’s a catch: Under the new law, they may only receive a payout from that insurance if they receive “initial services and care … within 14 days after the motor vehicle accident.” The new law went into effect on January 1, 2013.
In this case, plaintiff Era Lowry was in an automobile accident while covered by a State Farm insurance policy. Lowry received treatment from Scenic Health Alliance, Inc. (SHA).
The complaint claims that SHA performed “medically necessary services” for Lowry and that it billed Lowry for the amount of $8,628. According to the complaint, Lowry is entitled to $2,000 of the amount billed. However, State Farm refused to pay on the grounds that she did not receive initial treatment until more than fourteen days after the accident.
The complaint claims that the limitation on the payment of bills “are a violation of the due process, equal protection, and access to courts provisions of the Florida Constitution.” The first thing that the complaint requests is declaratory relief, declaring the limitations unconstitutional.
The complaint also asserts breach of contract claims against State Farm individually only, that is, on Lowry’s behalf and not on behalf of the class. The complaint does not ask for monetary damages on behalf of the class.
Article Type: LawsuitTopic: Consumer
Most Recent Case Event
State Farm Mutual PIP Auto Insurance and Florida Law Complaint
October 26, 2018
This class action is asking the court to declare parts of Florida law unconstitutional, although the defendant is not the state but a car insurance company. The complaint claims that State Farm Mutual Automobile Insurance Company has been “systematically and routinely denying” all Personal Injury Protection (PIP) claims when the person involved does not receive initial treatment without fourteen days of an accident. According to the complaint, State Farm’s denials are based on “the 2012 PIP amendments” to Florida law.
state_farm_pip_claims_complaint.pdfCase Event History
State Farm Mutual PIP Auto Insurance and Florida Law Complaint
October 26, 2018
This class action is asking the court to declare parts of Florida law unconstitutional, although the defendant is not the state but a car insurance company. The complaint claims that State Farm Mutual Automobile Insurance Company has been “systematically and routinely denying” all Personal Injury Protection (PIP) claims when the person involved does not receive initial treatment without fourteen days of an accident. According to the complaint, State Farm’s denials are based on “the 2012 PIP amendments” to Florida law.
state_farm_pip_claims_complaint.pdf