71ºF

Chiropractor's challenge to 'PIP' law rejected

photo

Rejecting arguments by a chiropractor, a South Florida appeals court Wednesday upheld part of a 2012 overhaul of the state's person-injury protection auto insurance system.

The ruling by the 3rd District Court of Appeal focused on part of the law that limit's so-called "PIP" benefits to $2,500 for non-emergency conditions.

Chiropractor Eduardo Garrido treated Alejandro Godoy after an accident in 2013 and submitted invoices totaling $6,075 to Godoy's insurer, Progressive American Insurance Company, according to Wednesday's ruling.

Progressive paid $2,500 but declined to pay more because a physician had not determined that Godoy suffered from an emergency condition.

Garrido filed a lawsuit in Miami-Dade County seeking a determination that the insurer should pay up to the policy limit of $10,000 and challenging the constitutionality of the law because it bars chiropractors from diagnosing patients with emergency conditions.

A county judge ruled that the law was unconstitutional and that Garrido should be paid more than $2,500. But in the 14-page ruling Wednesday, a panel of the appeals court overturned the lower-court decision.

In part, the appeals court pointed to legislative arguments that the 2012 law was intended to help prevent fraud in the PIP insurance system.

"It is entirely reasonable that fraud will be reduced by limiting the full $10,000 PIP benefit to only those claimants who --- as diagnosed by specifically identified medical providers --- have suffered an (emergency medical condition)," said the ruling, written by appeals-court Judge Edwin Scales and joined by Chief Judge Richard Suarez and Judge Barbara Lagoa. "Under constitutional equal protection analysis, our inquiry is not whether we believe chiropractors are qualified to provide an (emergency medical condition) diagnosis and, therefore, should have been included in (the) … statutory schedule. Indeed, it is certainly arguable that chiropractors are as qualified to provide an (emergency medical condition) diagnosis as some of the other professionals authorized by the statute to provide such a diagnosis. But the rational basis test does not allow judicial fact-finding to replace legislative fact-finding."