Matthew Scarborough

Conflicting Authorities When PIP Benefits Cut Off

  • By: Scarborough Attorneys at Law
  • Published: January 26, 2011

Apparently there are conflicting authorities as to when an IME permits an insurer to cut-off PIP benefits.  According to the Eleventh Judicial Circuit, the question as to when an IME serves to cut-off an insurer’s obligation to pay PIP benefits is a question of fact for the jury.  United vs. Asclepius Medical, Inc. (2010).  In United vs. Asclepius Medical, Inc., the Circuit Court addressed in its appellate capacity whether the date of the IME, the date of the subsequent cut-off letter, or the date the clinic receives the cut-off letter is the date when the insurer can cut-off paying PIP benefits.  The Court evidently refrained from ruling on the issue by holding such a scenario represents a question of fact for the jury to determine. Alternatively, however, the Eleventh Judicial Circuit held in United vs. Canal (2010) the date of the IME is the date on which the insurance company can cease making PIP benefit payments.  Based on these conflicting rulings in the Circuit Court, we can expect the Third District Court of Appeal to resolve this issue.

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