Allstate Objects To FMA Brief In 'PIP' Fees Case

Mar 29, 2016

Allstate Insurance is objecting to an attempt by the Florida Medical Association to file a brief in a state Supreme Court case about fees paid to health providers who treat people injured in auto accidents.

Allstate filed a document last week asking justices to reject an FMA motion to submit a friend-of-the-court brief.

The Supreme Court in January agreed to take up Allstate's appeal of a 4th District Court of Appeal ruling last year in 32 consolidated cases that involve the state's personal-injury protection, or PIP, auto insurance system.

The appeals court ruled in favor of a health-care provider, Orthopedic Specialists, with a key issue focused on whether policies were clear that Allstate would make payments under a fee schedule for Medicare services. That fee schedule includes limits on payments.

Providers argued that the insurance policies were "ambiguous" on the issue, and a majority of a three-judge panel of the appeals court agreed, leading Allstate to take the case to the Supreme Court.

The FMA on March 11 filed a motion seeking to submit a friend-of-the-court brief.

"This case is important to the FMA because it involves the application of a statute that deals with reimbursement rates for FMA member physicians who provide treatment to patients with personal injury protection insurance,'' the motion said. "These patients typically receive treatment and then execute an assignment of benefits by which they assign to FMA members the right to collect from the PIP insurance carriers for treatment provided by FMA physicians."

But Allstate objected Wednesday by saying the proposed FMA brief "does nothing more than attempt to present the same argument as Orthopedics Specialists has asserted."