More on the Emergency Medical Condition Rule

I’ve received a couple of cases already where PIP insurance companies are capping benefits at $2,500 even though the patient went to a hospital with broken bones! The insurance companies are claiming that the treating doctor at the hospital did not write “emergency medical condition” on his/her paperwork so the patient doesn’t qualify for an EMC. Insurance companies know that it is extremely unlikely that an ER doctor would change a report.

Be on the look out for these cases and please send them to my office. These are great test cases to make the argument that PIP benefits still start off at $10,000 and only go down to $2,500 when a treating provider states that there is “no emergency medical condition.”

We offer free consultations and perform the work on a contingency basis so please call our office if you have a case like this!


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