Almost five years ago, Delray Beach teenager Farrah Fox was so badly injured in a car accident that she had to learn how to walk, talk and eat herself all over again. She fears a bill advancing in the Florida Legislature could prevent future crash victims from receiving the same level of life-changing care.
An insurance reform bill or tort reform bill could put a cap on what insurance companies have to pay out in insurance claims.
The cap can be about 140% of what Medicaid would charge for a procedure.
One of the bill’s opponents, Southwest Florida personal injury attorney Preston Shiner, gave the following example of how he believes the restriction will affect patients who are not at fault.
“If an injured person is catastrophically injured in a shipwreck and transported to Lee Memorial Hospital and has a lower extremity procedure, the hospital will bill them $92,129 as a self-pay patient,” Shiner said. “The Medicare reimbursement rate is $13,000. So an uninsured patient who is transported to the hospital runs up a $92,000 bill that the hospital is entitled to collect. The patient would be limited under this language to recovering $13,000 from the responsible party, the insurance company in this case. The $80,000 difference will be on that person’s credit report as debt because they won’t be able to recover it.
Farrah Fox: Teen recovering after off-duty crash with deputy left her in coma
In August 2018, Fox was injured when investigators say an off-duty PBSO deputy, Michael D’Avonzo, ran a stop sign and hit the car Fox was riding in. Judge fines D’Avanzo $500, suspended his license for three months and appointed aggressive driving school.
Fox, who was a student at the University of Central Florida at the time, suffered a traumatic brain injury and was in a coma for more than four weeks. She will probably need therapy for the rest of her life.
After the crash, unable to speak, she said she felt trapped in her body.
“Because I got the care I needed, I’m no longer trapped in my body,” Fox said.
The injured teenager continues a remarkable recovery
She said that because she was on Medicaid at the time, it was harder to find a top-notch treatment clinic that would accept her. She received a letter of protection, which essentially tells a medical clinic or doctor to begin treatment immediately with a promise to pay for treatment in the future, often when a civil case is resolved.
“I can’t imagine what life, my life, her life, our family’s life would be like if Farrah couldn’t get this kind of treatment because of the letters of protection and the installment plan,” her father, Ira Fox, said.
He fears that future accident victims injured through no fault of their own may receive less money to cover medical bills and treatments at private clinics like the one where Farah was treated. He worries that clinics may not accept people if they don’t think they’ll be paid more than 140 percent of the Medicaid rate.
“This is not fair. Not at all,” Farah said.
They joined dozens of people who traveled to Tallahassee to urge lawmakers not to pass the bill.
But supporters say capping insurance payouts is one way to remove the incentive for people to file frivolous lawsuits and balance the state’s insurance industry.
“A $20,000 procedure billed by a physician under a [Letter of Protection] for $200,000, I see that a lot,” Joe Tessitore of the Florida Chamber of Commerce told lawmakers. “How does that make sense in a system? We do not compensate actual bills. We turn it into a money generator for the plaintiff’s bar and the rich doctors. That’s what’s happening in this state.”
The bill continues to move through House and Senate committees.
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