tap to call954-951-0000

read our google reviews

review us on google

Start Your Free Case Evaluation
999-999-9999

RossAbramowitz

check mark State Farm Jams PIP Case Dockets

State Farm Insurance, Florida's dominant auto insurance company, also has become the most aggressive defense litigator in county courts with its cases dominating court calendars.

Personal injury protection lawyers for policyholders claim State Farm's strategy amounts to harassment of medical providers assigned the right to sue for reimbursement and makes it financially untenable for some providers to pursue what they were owed.

Ross Abramowitz, a Fort Lauderdale PIP attorney, said he first noticed a change in State Farm legal tactics in 2012. Plaintiffs attorneys contend company attorneys rely on unnecessarily lengthy and intrusive depositions.

"It was about two years ago that it really started to affect county court dockets and clog them up," Abramowitz said.

State Farm spokeswoman Michal Brower in Winter Haven said South Florida courts handle a lopsided share of the company's PIP litigation because plaintiffs attorneys file 80 percent to 85 percent in the region no matter where the accident occurred.

"State Farm has always decided whether to defend or settle a case based on the individual merits of a particular claim," she said.

PIP medical providers and their attorneys have had a contentious relationship with insurance companies for years. The law was changed most recently in 2013 to reduce the cap on a claim from $10,000 to $2,500 for all providers. The cap can only be expanded to the previous $10,000 limit if an "emergency medical condition" is determined by licensed medical professionals.

PIP attorneys and the insurance industry also have battled over a standard for covering medical-related fees. PIP attorneys preferred a standard based on what was reasonable, usual and customary in a geographic area. The insurance industry ultimately secured a standard of "80 percent of 200 percent of Medicare."

Abramowitz attributes State Farm's rigorous litigation strategy in part to a Florida Supreme Court decision issued July 3, 2013, in Virtual Imaging Services v. GEICO General Insurance, which upheld the Third District Court of Appeal.

GEICO claimed insurers could limit reimbursement based on Medicare fee schedules without providing notice in its policies that it would use Medicare fee schedules as the basis for its payments.

The Supreme Court ruled a 2008 amendment that allowed auto insurers to use Medicare fee schedules did not mandate them, and auto insurers that used the schedules would have to explicitly refer to them in policies.

The Legislature later changed the PIP law to incorporate a notice requirement effective July 1, 2012. All pre-existing claims under policies without Medicare references could not use it as a baseline reimbursement standard.

"State Farm switched its stance. They said, 'We're not going to argue that our policy is good enough. We're saying you need to prove the bill is reasonably related and necessary. And for you to prove it, we're going to make sure to take every deposition under the sun,' " Abramowitz said.

In one case, he said State Farm requested seven and took five depositions on a $354 medical bill. A transcript for just one deposition would cost about $800, far more than the bill itself.

Abramowitz maintains the company is pursuing a deliberate strategy to intimidate and discourage the plaintiffs.

Brower said most of the lawsuits are filed by medical providers who have received partial payment and are seeking more.

"The most frequent dispute in these cases is the difference between the amount billed by the medical provider and the amount paid by State Farm," the company spokeswoman said. "In our experience, PIP litigation is driven more by the possible award of attorneys' fees to the plaintiff lawyer rather than the amount of the dispute itself. If the plaintiff prevails, their attorney receives an hourly rate for their time, which often includes excessive discovery and aggressive motion filings, which increases the amount of the attorney fee award."

Market Leader

State Farm starts with the state's largest chunk of the PIP pie at 20 percent, according to Quotelab.com. However, the number of cases against State Farm in Broward and Miami-Dade counties is more than double its market share.

Responding to a public information request, Broward County Court Judge Robert Lee said about 7,100 cases, or about 42 percent of all pending PIP cases, involved State Farm as of Aug. 31.

"Currently, 18 judges are assigned to handle PIP cases. Of these, 11 have more than 75 percent of their daily work involving PIP cases, while the other seven would be 50 percent or less. We do not assign any judge to handle solely State Farm cases, but rather all PIP cases," Lee said.

The comparison between State Farm's market share and pending court cases does not show the whole picture because of the volume of State Farm pleadings. Although the company's cases amount to about 42 percent of PIP cases in Broward, a survey of Broward County Court Judge Steven Deluca's docket revealed State Farm hearings on the daily motion calendar accounted for 70 percent to almost 90 percent of them. On one day, 31 of the 35 cases on the calendar, or 89 percent, were State Farm cases.

Miami-Dade County was proportionately identical. A total of 50,165 PIP cases were pending Aug. 30. Of those, State Farm was a defendant in 21,837 cases, or 44 percent of them, said court spokeswoman Eunice Sigler.

County court judges in the Miami courthouse spend more than three-quarters of their time on PIP cases, she added. The cases are divided among 19 judges.

State Farm's case concentration in Palm Beach County is similar. Of the PIP cases filed since Jan. 1, 2012, the Palm Beach clerk of courts & comptroller reported 2,894 State Farm cases, or 51 percent more than second-place Allstate.

Birth Control

Svetlana Pimanova, a 23-year-old Russian immigrant, suffered a back injury after a 2011 rear-end collision in Sunny Isles Beach. On Sept. 25, she underwent a two-hour deposition without her attorney present on why she needed an MRI. The plaintiff was Pan Am Diagnostic Services Inc., and Pimanova was asked questions like the hair color of her treating physician.

At one point, State Farm attorney Dawn Cortese of Roig, Tutan, Rosenberg, Martin, Stoller, Zumpano & Bellido in Deerfield Beach asked Pimanova who was prescribing her birth control two years after the accident. Cortese did not return a call for comment by deadline.

The Pan Am Diagnostics attorney to whom she had assigned rights, Cris Boyar of Boyar & Freeman in Coral Springs, interrupted to say, "I'm not your lawyer, but I wouldn't answer that question."

On cross-examination, Boyar asked Pimanova how she felt about being deposed for two hours.

"Not too happy, considering they canceled my insurance," she said.

"Do you believe it's appropriate for a lawyer for an insurance company to ask you about your birth control pills?" he asked.

"No, absolutely not," Pimanova said.

Cortese objected on grounds of relevance.

"It's not relevant to ask about your question? Fair enough," Boyar said.

Witness Harassment

State Farm attorneys have become notorious among plaintiffs attorneys for using depositions to put their clients through maddeningly long mental drills.

"This is about taking the insureds, dragging them through 2½ depositions when they've been customers 20-plus years and finding every reason to defame the insured—claiming there's fraud, bringing up miscellaneous accusations in order not to pay a simple bill," Abramowitz said. "I would almost call it a witch hunt. It's going after everyone and creating issues to avoid payment."

Larry Fishman, a licensed massage therapist, used to earn a living providing massages to PIP patients. In 2013, the Legislature changed the PIP law to exclude reimbursement for massage therapists. He ended his practice and is going to nursing school.

Fishman is still waiting to be paid on a $374 bill. On Aug. 8, he appeared for a deposition and advised State Farm's counsel at the start that he would have to take his daughter to the doctor that afternoon.

According to the transcript, he sat for a 2-hour, 45-minute deposition that wasn't expected to last more than two hours. Exasperated with the attorney's repetitive questions, he drew it to a close over the attorney's objections.

"We're going to end this, first of all. Secondly, you guys are trained at what you do, OK? You are very trained at how to manipulate the situation, how to ask questions that put words in people's mouths, and you keep asking the same question over and over and over hoping that I say things differently," Fishman said.

"These are the same answers the you got, not your company, but every time that I've been deposed you get the same answers every single time. I don't know what the problem is. You're making money, you're making money, and I'm sitting here waiting for $300 with a daughter sick at home going through this."

The State Farm attorney moved to compel Fishman to return for another deposition. Abramowitz asked for a protective order to stop it. At an Oct. 13 hearing, Lee sided with Fishman.

Abramowitz told Lee that State Farm's attorney, Alan Blose of Vernis & Bowling in Hollywood, had a propensity to take hourslong depositions.

"He actually just took one of my clients last week for seven hours. And in this case, 2½ hours is more than enough time for them to get all the pertinent information," Abramowitz told Lee.

The judge read the transcript, found the deposition length excessive and questioned his line of questioning.

"Asking him questions that clearly he's not going to be able to answer as to desiccation, medical necessity—that are clearly not his realm—that's at your peril if you folks decide to go down that path," the judge said. "It looks to me to be harassing this witness when it's not this witness' responsibility to determine whether something's medically necessary but rather to do what he's requested to do because he's a licensed massage therapist."

Read more: http://www.dailybusinessreview.com/id=1202675978807/State-Farm-Jams-PIP-Case-Dockets#ixzz3L9gFpy4I

Fort Lauderdale

2000 N.E. 45th Street
Ft. Lauderdale, FL 33308

Phone (954) 951-0000
Fax: (954) 951-1000
Email: info@flinjuryfirm.com

West Palm Beach

500 South Australian Ave.
Suite 600
West Palm Beach, Florida 33401
(by appointment)

Toll-free: 833-332-1333

Boston

71 Commercial Street #40
Merchantile Building
Boston, MA 02109
(by appointment)

Toll-free: 833-332-1333

The information contained in this website is provided for informational purposes only.  This website may contain information about The Injury Firm's past results, testimonials about the firm or a lawyer within the firm, and statements regarding the quality of The Injury Firm's work product. This information has not been reviewed or approved by The Florida Bar. Please be advised that: 1) the facts and circumstances of your case may differ from the matters for which results and testimonials have been provided: 2) Not all results of cases handled by the firm or its lawyers are provided and not all clients have given testimonials; and 3) The results and testimonials provided are not necessarily representative of results obtained by the firm or by its lawyers or of the experience of all clients or others within the firm or its lawyers. Every case is different, and each client’s case must be evaluated and handled on its own merits.