Personal Injury Protection (PIP) fraud is widespread in Miami-Dade County, say state investigators. They found regulatory violations at 90 percent of the pain clinics that primarily or exclusively treat automobile accident victims.
The rampant abuse is the biggest reason that many Miami-Dade drivers pay upwards of $2,000 a year for their PIP coverage.
Investigators at the Agency for Health Care Administration found irregularities at 43 of 49 clinics during a three-day period. Some of the problems were egregious:
- Medical staff were hired without required background screening.
- Many clinic owners had no prior health care experience.
- One employee was retained even after a background check showed he should be fired.
- One insurer was charged $19,000 for massage therapy for one patient.
- Employees at some clinics said they had never seen a patient.
- Staff at one clinic said they had not seen the owner or medical director in six months.
- Many clinics had advertisements for law firms and attorneys who handle traffic accident cases.
The state agency may revoke licenses and file criminal charges. The Florida Division of Insurance Fraud, which has been highly active in rooting out PIP fraud, is conducting its own investigation.
These findings are typical of most PIP clinics now operating. They all know how easy it is to rip off the PIP system. Florida needs PIP reform now to reduce the fraud tax that honest drivers and insurance companies have to pay. Legislators should pass PIP legislation to bring the problem under control.
PIP fraud in Florida could reach $1 billion this year, according to the Insurance Information Institute. Florida has the highest rate of PIP fraud in the nation, and Miami-Dade is a leading metropolitan market for the crime. The expense is absorbed by insurance companies and passed along to drivers.