Licznerski Law, PLLCLicznerski Law, PLLC2026-10-23T20:47:54Zhttps://www.licznerskilaw.com/feed/atom/WordPress/wp-content/uploads/sites/1605050/2025/07/cropped-LL_FAV-32x32.pngOn Behalf of Licznerski Law, PLLC<![CDATA[Motorcycle Accidents in Hernando, Citrus, and Sumter Counties: Riding the Nature Coast and Beyond]]>https://www.licznerskilaw.com/?p=470632026-10-16T20:01:14Z2026-10-22T12:00:54ZNorth of Tampa Bay, the roads open up. Long stretches of US 19 along the Nature Coast, rolling hills around Brooksville, and rural highways through Citrus and Sumter counties make the region a favorite for riders. Those same roads bring their own risks: higher speeds, rural intersections, slow-moving farm and service vehicles, and fast-growing communities adding traffic to roads that were built for less. Licznerski Law serves riders throughout Hernando, Citrus, and Sumter counties.
Hernando County
Spring Hill has grown into one of the larger communities on the Gulf Coast, and US 19, Spring Hill Drive, and County Line Road carry heavy local traffic with frequent turns and commercial access points. SR 50 through Brooksville connects to I-75 and the Suncoast Parkway, and the hills east and north of Brooksville draw recreational riders. Rural intersections with limited sight lines and side roads where drivers pull out without seeing an approaching rider are common crash points.
Citrus County
US 19 runs north through Homosassa and Crystal River, with tourist traffic around the springs and waterfront areas. SR 44 and US 41 connect Crystal River, Inverness, and points east. The Suncoast Parkway's northern extension has brought new high-speed traffic into the county. Rural two-lane roads mean passing maneuvers, slower vehicles, and drivers turning into farms and driveways.
Sumter County
Sumter County includes much of The Villages, one of the fastest-growing communities in the country, along with Wildwood and Bushnell. I-75, US 301, and SR 44 carry significant through traffic. In and around The Villages, riders share roads with large numbers of older drivers and golf carts, and new interchanges and commercial development keep changing traffic patterns.
Rural Crash Issues
Rural crashes often raise distinct issues. Emergency response times can be longer, and evidence at the scene may not be documented as thoroughly. Intersections may have limited lighting, overgrown vegetation, or poor signage, which can raise questions about roadway maintenance. Witnesses may be fewer, making helmet camera footage and early scene photographs more important.Coverage problems are also common. Florida does not require most drivers to carry bodily injury coverage, and a rider hit on a rural road may face a driver with minimal insurance. A rider's own UM coverage often becomes the key source of recovery.
Local Court Process
Hernando, Citrus, and Sumter counties, along with Lake and Marion, make up the Fifth Judicial Circuit. Cases are filed in the county where the crash occurred or where a defendant resides, depending on venue rules, and each county has its own courthouse and local practices.
Frequently Asked Questions
Does Licznerski Law handle motorcycle cases in Hernando, Citrus, and Sumter counties?
Yes. The firm represents riders throughout these counties and the greater Tampa Bay area.
Which court handles motorcycle injury cases in these counties?
These counties are in Florida's Fifth Judicial Circuit. The specific court depends on venue and the amount in controversy.
What makes rural motorcycle crashes different?
Higher speeds, limited sight lines at rural intersections, fewer witnesses, and sometimes less thorough scene documentation. Early evidence preservation is especially important.
I was hit by a golf cart near The Villages. Do I have a claim?
Possibly. The golf cart operator's conduct and any applicable insurance coverage, along with your own UM coverage, would need to be reviewed.
Working With [nap_names id="FIRM-NAME-3"]
[nap_names id="FIRM-NAME-1"] is a boutique personal injury and insurance law firm based in Oldsmar, serving riders throughout Hillsborough, Pinellas, Pasco, Hernando, Citrus, Sumter, and surrounding counties, and statewide. When you hire the firm, Alexander Licznerski handles your case personally. Your calls and questions go to your attorney, not a rotating case manager, and the firm keeps a selective caseload so each case gets real attention.Motorcycle cases also draw on the firm's insurance coverage and PIP litigation practice. Because riders have no PIP, finding every available source of coverage, including UM, medical payments, household policies, and responsible third parties, is often what determines whether a serious injury is fully compensated.Motorcycle injury cases are handled on a contingency fee. The written fee agreement explains the percentage and how case costs are handled, including whether you could be responsible for any costs, before you sign anything.A candid note on HB 837: The 2023 tort reform law changed several rules that matter to injured riders. It shortened the general negligence deadline to two years, adopted the rule that bars recovery for a plaintiff found more than 50% at fault, changed how medical expenses are proven at trial, and eliminated the automatic attorney's fee award that once applied when an insured successfully sued their own auto insurer. Those changes make early investigation and realistic case evaluation more important, and the firm will tell you plainly how they apply to your situation.
Talk to Your Attorney Directly
If you or someone in your family was hurt in a motorcycle crash anywhere in the Tampa Bay area, you can speak directly with attorney Alexander Licznerski about what happened and what options may be available.[nap_names id="FIRM-NAME-1"] | Oldsmar, FloridaPhone: [nap_phone id="LOCAL-CT-NUMBER-1"] | Web: licznerskilaw.com | Email: alicznerski@licznerskilaw.comBoutique Representation. Real Results. Your Attorney, Not a Case Number.This article provides general information about Florida law and is not legal advice. Reading it does not create an attorney-client relationship. Every case depends on its own facts, and past results do not guarantee a similar outcome.]]>On Behalf of Licznerski Law, PLLC<![CDATA[Pasco County Motorcycle Accidents: New Port Richey, Wesley Chapel, and a County on the Move]]>https://www.licznerskilaw.com/?p=470612026-10-16T19:59:43Z2026-10-21T12:00:14ZPasco County has changed dramatically in a short time. Neighborhoods that were pasture a decade ago are now subdivisions, shopping centers, and new road projects. For riders, that growth means more traffic, more construction, and more drivers on roads built for far fewer cars. Our Oldsmar office is just minutes from the Pasco line, and Pasco riders are a growing part of our practice.
Corridors Riders Know
US 19 along the west coast through Holiday, New Port Richey, Port Richey, and Hudson carries heavy traffic, frequent turns, and dense commercial access points.
SR 54 connects the coast to Wesley Chapel and Zephyrhills and has been in near-constant expansion, with lane shifts and changing traffic patterns.
SR 52 and SR 56 serve fast-growing areas where new intersections and signals keep appearing.
US 41 through Land O' Lakes and Lutz mixes commuter traffic with residential access.
I-75, the Suncoast Parkway, and US 301 bring high-speed traffic, and the rolling roads in east Pasco around Dade City and San Antonio draw recreational riders on weekends.
Construction Zones and Changing Roads
Road work across Pasco creates hazards that are especially dangerous to motorcycles: uneven lanes, loose gravel, steel plates, temporary striping, and sudden lane shifts. When a construction hazard causes a crash, the responsible party may be a private contractor, a government entity, or both. Government claims have damages caps and strict pre-suit notice requirements, while contractor claims follow ordinary negligence rules. Documenting the hazard immediately is essential, because construction conditions change daily.
New Roads, New Drivers
Rapid growth also means many drivers are new to the area and unfamiliar with the roads. New signals, new turn lanes, and changing traffic patterns contribute to failure-to-yield and left-turn crashes, which are among the most dangerous for riders.
Local Court Process
Pasco County civil cases are part of the Sixth Judicial Circuit, which covers Pasco and Pinellas counties. Pasco has court facilities on both the west and east sides of the county. Knowing local procedures and the judges' practices helps cases move efficiently.
Frequently Asked Questions
Where are Pasco County motorcycle injury cases filed?
In the Sixth Judicial Circuit's county or circuit court, depending on the amount in controversy. Pasco has courthouse facilities in both west and east Pasco.
Who is responsible for a crash caused by a construction zone hazard on SR 54?
It may be the contractor performing the work, the government entity responsible for the road, or both. Each has different legal rules and deadlines.
What should I document if road conditions caused my crash?
Photograph and measure the hazard, note construction signs and company names on equipment, and record the exact location. Conditions often change within days.
Does Licznerski Law handle cases in east Pasco?
Yes. The firm serves riders throughout Pasco County, from the coast to Wesley Chapel, Zephyrhills, and Dade City.
Working With [nap_names id="FIRM-NAME-3"]
[nap_names id="FIRM-NAME-1"] is a boutique personal injury and insurance law firm based in Oldsmar, serving riders throughout Hillsborough, Pinellas, Pasco, Hernando, Citrus, Sumter, and surrounding counties, and statewide. When you hire the firm, Alexander Licznerski handles your case personally. Your calls and questions go to your attorney, not a rotating case manager, and the firm keeps a selective caseload so each case gets real attention.Motorcycle cases also draw on the firm's insurance coverage and PIP litigation practice. Because riders have no PIP, finding every available source of coverage, including UM, medical payments, household policies, and responsible third parties, is often what determines whether a serious injury is fully compensated.Motorcycle injury cases are handled on a contingency fee. The written fee agreement explains the percentage and how case costs are handled, including whether you could be responsible for any costs, before you sign anything.A candid note on HB 837: The 2023 tort reform law changed several rules that matter to injured riders. It shortened the general negligence deadline to two years, adopted the rule that bars recovery for a plaintiff found more than 50% at fault, changed how medical expenses are proven at trial, and eliminated the automatic attorney's fee award that once applied when an insured successfully sued their own auto insurer. Those changes make early investigation and realistic case evaluation more important, and the firm will tell you plainly how they apply to your situation.
Talk to Your Attorney Directly
If you or someone in your family was hurt in a motorcycle crash anywhere in the Tampa Bay area, you can speak directly with attorney Alexander Licznerski about what happened and what options may be available.[nap_names id="FIRM-NAME-1"] | Oldsmar, FloridaPhone: [nap_phone id="LOCAL-CT-NUMBER-1"] | Web: licznerskilaw.com | Email: alicznerski@licznerskilaw.comBoutique Representation. Real Results. Your Attorney, Not a Case Number.This article provides general information about Florida law and is not legal advice. Reading it does not create an attorney-client relationship. Every case depends on its own facts, and past results do not guarantee a similar outcome.]]>On Behalf of Licznerski Law, PLLC<![CDATA[Pinellas County Motorcycle Accidents: Clearwater, St. Petersburg, and the Roads Riders Know]]>https://www.licznerskilaw.com/?p=470592026-10-16T19:58:02Z2026-10-20T12:00:26ZPinellas County is one of the most densely populated counties in Florida, packed onto a peninsula with heavy commuter traffic, seasonal visitors, and beach roads that draw riders year-round. Our office in Oldsmar sits at the county's northeastern edge, and Pinellas riders and their families are a core part of the community we serve.
Roads That Demand Attention
Every rider in Pinellas knows certain corridors call for extra caution:
US 19 runs the length of the county with heavy traffic, frequent lane changes, and busy commercial driveways from Pinellas Park through Clearwater, Palm Harbor, and Tarpon Springs.
Gulf to Bay Boulevard and the Courtney Campbell Causeway carry heavy traffic between Clearwater and Tampa, with frequent turns into businesses along the boulevard.
Ulmerton Road crosses mid-county with multiple lanes and high volumes near the airport and industrial areas.
Gulf Boulevard and the beach communities bring pedestrians, rental vehicles, and visitors unfamiliar with the area.
Alternate 19 through Dunedin and Palm Harbor, and the Bayside Bridge, are popular with riders and busy with commuters.
The common thread is drivers turning across traffic, changing lanes, and pulling out of driveways and parking lots. Those are the movements most likely to put a car in a rider's path.
Visitors and Rental Vehicles
During peak season and events, Pinellas roads fill with drivers unfamiliar with the area. A crash with a rental car or an out-of-state driver raises coverage questions, including which insurer covers the rental and what limits apply. These claims can involve rental company policies, the driver's own policy from another state, and the rider's UM coverage.
Local Court Process
Pinellas County civil cases are filed in the Sixth Judicial Circuit, which covers Pinellas and Pasco counties. Smaller claims may be filed in county court and larger ones in circuit court. Knowing local practices and procedures helps a case move efficiently.
What Pinellas Riders Should Do After a Crash
Make sure the responding agency, whether a city police department, the Pinellas County Sheriff's Office, or the Florida Highway Patrol, completes a crash report. Photograph the scene, especially intersections and driveways. Note nearby businesses, since many along US 19 and Gulf to Bay have cameras that may have recorded the crash, and that footage may be overwritten quickly.
Frequently Asked Questions
Where are motorcycle injury lawsuits in Pinellas County filed?
In the Sixth Judicial Circuit's county or circuit court, depending on the amount in controversy.
I was hit by a tourist in a rental car. Whose insurance pays?
It depends on the rental agreement, the driver's own policy, and whether coverage was purchased from the rental company. Your own UM coverage may also apply.
Do I need a lawyer located in Pinellas County?
Your lawyer should know the local courts and practices. Our Oldsmar office is located at the edge of Pinellas County and serves riders throughout the county.
Which agency investigates crashes on US 19?
It depends on the location. City police departments, the Pinellas County Sheriff's Office, or the Florida Highway Patrol may respond.
Working With [nap_names id="FIRM-NAME-3"]
[nap_names id="FIRM-NAME-1"] is a boutique personal injury and insurance law firm based in Oldsmar, serving riders throughout Hillsborough, Pinellas, Pasco, Hernando, Citrus, Sumter, and surrounding counties, and statewide. When you hire the firm, Alexander Licznerski handles your case personally. Your calls and questions go to your attorney, not a rotating case manager, and the firm keeps a selective caseload so each case gets real attention.Motorcycle cases also draw on the firm's insurance coverage and PIP litigation practice. Because riders have no PIP, finding every available source of coverage, including UM, medical payments, household policies, and responsible third parties, is often what determines whether a serious injury is fully compensated.Motorcycle injury cases are handled on a contingency fee. The written fee agreement explains the percentage and how case costs are handled, including whether you could be responsible for any costs, before you sign anything.A candid note on HB 837: The 2023 tort reform law changed several rules that matter to injured riders. It shortened the general negligence deadline to two years, adopted the rule that bars recovery for a plaintiff found more than 50% at fault, changed how medical expenses are proven at trial, and eliminated the automatic attorney's fee award that once applied when an insured successfully sued their own auto insurer. Those changes make early investigation and realistic case evaluation more important, and the firm will tell you plainly how they apply to your situation.
Talk to Your Attorney Directly
If you or someone in your family was hurt in a motorcycle crash anywhere in the Tampa Bay area, you can speak directly with attorney Alexander Licznerski about what happened and what options may be available.[nap_names id="FIRM-NAME-1"] | Oldsmar, FloridaPhone: 813-406-0782 | Web: licznerskilaw.com | Email: alicznerski@licznerskilaw.comBoutique Representation. Real Results. Your Attorney, Not a Case Number.This article provides general information about Florida law and is not legal advice. Reading it does not create an attorney-client relationship. Every case depends on its own facts, and past results do not guarantee a similar outcome.]]>On Behalf of Licznerski Law, PLLC<![CDATA[Fatal Motorcycle Accidents in Florida: Wrongful Death Claims for Riders’ Families]]>https://www.licznerskilaw.com/?p=470572026-10-16T19:56:14Z2026-10-19T12:00:46ZLosing someone in a motorcycle crash is devastating, and the legal questions that follow are often the last thing a family wants to think about. This post is meant to give families a clear, calm overview of how Florida law works when a rider or passenger is killed because of another person's negligence, so they understand their options when they are ready.
Florida's Wrongful Death Act
Florida's Wrongful Death Act, sections 768.16 through 768.26 of the Florida Statutes, allows a claim when a person's death is caused by the wrongful act or negligence of another. The claim is brought by the personal representative of the deceased person's estate, on behalf of the estate and the surviving family members. If no estate has been opened, one generally must be opened in probate court so a personal representative can be appointed.
Who Can Recover
The statute defines survivors to include the spouse, children, and parents, and in some circumstances other blood relatives and adoptive siblings who were partly or wholly dependent on the deceased for support or services. Which survivors may recover which kinds of damages depends on rules in the statute, including rules tied to the ages of children and whether there is a surviving spouse.
What Can Be Recovered
Depending on the survivor and the facts, damages may include:
The value of lost support and services the deceased would have provided.
Loss of companionship and protection for a surviving spouse.
Loss of parental companionship, instruction, and guidance for qualifying children.
Mental pain and suffering for qualifying survivors.
Medical and funeral expenses paid by survivors or the estate.
Certain losses to the estate, such as lost earnings from the date of injury to death and, in some cases, net accumulations.
Coverage in Fatal Motorcycle Cases
The same coverage issues that affect injury claims affect wrongful death claims. PIP generally does not apply to motorcycle crashes, so recovery usually comes from the at-fault driver's bodily injury coverage, uninsured/underinsured motorist coverage, and any other responsible parties such as a driver's employer or a vehicle owner. Identifying all available UM coverage in the household is especially important when the at-fault driver carried little or no insurance.
The Deadline
A wrongful death action generally must be filed within two years of the date of death. Opening an estate and appointing a personal representative takes time, so families benefit from beginning that process well before the deadline.
Frequently Asked Questions
Who files a wrongful death lawsuit in Florida?
The personal representative of the deceased person's estate files the claim on behalf of the estate and the surviving family members.
How long does a family have to file a wrongful death claim?
Generally two years from the date of death.
Can the family recover if the rider was partly at fault?
Comparative fault rules apply. Recovery may be reduced by the deceased rider's share of fault and barred if that share is found to be more than 50%.
What if the driver who caused the crash had no insurance?
The family may be able to recover through UM coverage on the rider's own policies or household policies, and from other responsible parties depending on the facts.
Working With [nap_names id="FIRM-NAME-3"]
[nap_names id="FIRM-NAME-1"] is a boutique personal injury and insurance law firm based in Oldsmar, serving riders throughout Hillsborough, Pinellas, Pasco, Hernando, Citrus, Sumter, and surrounding counties, and statewide. When you hire the firm, Alexander Licznerski handles your case personally. Your calls and questions go to your attorney, not a rotating case manager, and the firm keeps a selective caseload so each case gets real attention.Motorcycle cases also draw on the firm's insurance coverage and PIP litigation practice. Because riders have no PIP, finding every available source of coverage, including UM, medical payments, household policies, and responsible third parties, is often what determines whether a serious injury is fully compensated.Motorcycle injury cases are handled on a contingency fee. The written fee agreement explains the percentage and how case costs are handled, including whether you could be responsible for any costs, before you sign anything.A candid note on HB 837: The 2023 tort reform law changed several rules that matter to injured riders. It shortened the general negligence deadline to two years, adopted the rule that bars recovery for a plaintiff found more than 50% at fault, changed how medical expenses are proven at trial, and eliminated the automatic attorney's fee award that once applied when an insured successfully sued their own auto insurer. Those changes make early investigation and realistic case evaluation more important, and the firm will tell you plainly how they apply to your situation.
Talk to Your Attorney Directly
If you or someone in your family was hurt in a motorcycle crash anywhere in the Tampa Bay area, you can speak directly with attorney Alexander Licznerski about what happened and what options may be available.[nap_names id="FIRM-NAME-1"] | Oldsmar, FloridaPhone: [nap_phone id="LOCAL-CT-NUMBER-1"] | Web: licznerskilaw.com | Email: alicznerski@licznerskilaw.comBoutique Representation. Real Results. Your Attorney, Not a Case Number.This article provides general information about Florida law and is not legal advice. Reading it does not create an attorney-client relationship. Every case depends on its own facts, and past results do not guarantee a similar outcome.]]>On Behalf of Licznerski Law, PLLC<![CDATA[Injured as a Motorcycle Passenger in Florida: Your Rights and Coverage Options]]>https://www.licznerskilaw.com/?p=470552026-10-16T19:52:08Z2026-10-18T12:00:23ZPassengers on motorcycles have no control over the bike, no control over the other vehicles, and often the least protection of anyone involved. When a crash happens, passengers frequently have claims that look different from the rider's, and sometimes the claim is against the person they were riding with.
No PIP for Passengers Either
Like riders, motorcycle passengers generally cannot use PIP for injuries from a motorcycle crash, because Florida's no-fault statute excludes motorcycles. Passengers need to look to liability coverage, UM coverage, medical payments coverage, and health insurance.
Who May Be Responsible
The Other Driver
If another driver caused the crash, the passenger has a claim against that driver's bodily injury coverage, just as the rider does. When both rider and passenger are injured, they may be competing for the same limited coverage, which affects how the claims should be handled.
The Motorcycle Operator
If the rider's own conduct caused or contributed to the crash, the passenger may have a claim against the rider. This is uncomfortable when the rider is a spouse, partner, family member, or friend, but the claim is typically paid by the rider's liability insurance, not the rider personally, if coverage exists. Check whether the rider's motorcycle policy includes bodily injury coverage that extends to passengers. Some motorcycle policies limit or exclude passenger coverage unless it was purchased.
Both
Fault can be shared. Under Florida's comparative fault rules, a passenger who did nothing to cause the crash can generally recover from each party in proportion to that party's fault.
UM Coverage for Passengers
A passenger may be able to claim UM benefits under the motorcycle's policy, under the passenger's own auto policy, or under a resident relative's policy, depending on the policy language and stacking elections. When the at-fault driver has little or no coverage, identifying every available UM policy is especially important.
When Rider and Passenger Want the Same Lawyer
Riders and passengers often want to hire one lawyer together. That can work in some cases, but it raises potential conflicts of interest: the passenger may have a claim against the rider, and both may be competing for the same limited policy. A lawyer must evaluate those conflicts at the outset, explain them, and obtain informed consent where joint representation is permissible. In some cases, separate counsel is the right answer.
Frequently Asked Questions
Does PIP cover a motorcycle passenger in Florida?
Generally no. Florida's PIP statute excludes motorcycles, so passengers usually rely on liability, UM, medical payments, and health coverage.
Can I make a claim against the rider I was riding with?
Yes, if the rider's conduct contributed to the crash. These claims are typically paid by the rider's liability insurance, if the policy covers passengers.
What if both the rider and the other driver were at fault?
A passenger can generally pursue both, with each party's responsibility reflecting their share of fault.
Can one lawyer represent both the rider and the passenger?
Sometimes, but potential conflicts must be evaluated and explained first. When the passenger may have a claim against the rider, separate counsel is often appropriate.
Working With [nap_names id="FIRM-NAME-3"]
[nap_names id="FIRM-NAME-1"] is a boutique personal injury and insurance law firm based in Oldsmar, serving riders throughout Hillsborough, Pinellas, Pasco, Hernando, Citrus, Sumter, and surrounding counties, and statewide. When you hire the firm, Alexander Licznerski handles your case personally. Your calls and questions go to your attorney, not a rotating case manager, and the firm keeps a selective caseload so each case gets real attention.Motorcycle cases also draw on the firm's insurance coverage and PIP litigation practice. Because riders have no PIP, finding every available source of coverage, including UM, medical payments, household policies, and responsible third parties, is often what determines whether a serious injury is fully compensated.Motorcycle injury cases are handled on a contingency fee. The written fee agreement explains the percentage and how case costs are handled, including whether you could be responsible for any costs, before you sign anything.A candid note on HB 837: The 2023 tort reform law changed several rules that matter to injured riders. It shortened the general negligence deadline to two years, adopted the rule that bars recovery for a plaintiff found more than 50% at fault, changed how medical expenses are proven at trial, and eliminated the automatic attorney's fee award that once applied when an insured successfully sued their own auto insurer. Those changes make early investigation and realistic case evaluation more important, and the firm will tell you plainly how they apply to your situation.
Talk to Your Attorney Directly
If you or someone in your family was hurt in a motorcycle crash anywhere in the Tampa Bay area, you can speak directly with attorney Alexander Licznerski about what happened and what options may be available.[nap_names id="FIRM-NAME-1"] | Oldsmar, FloridaPhone: [nap_phone id="LOCAL-CT-NUMBER-1"] | Web: licznerskilaw.com | Email: alicznerski@licznerskilaw.comBoutique Representation. Real Results. Your Attorney, Not a Case Number.This article provides general information about Florida law and is not legal advice. Reading it does not create an attorney-client relationship. Every case depends on its own facts, and past results do not guarantee a similar outcome.]]>On Behalf of Licznerski Law, PLLC<![CDATA[Potholes, Gravel, and Road Defects: Motorcycle Crashes Caused by Dangerous Roads in Florida]]>https://www.licznerskilaw.com/?p=470532026-10-16T19:50:08Z2026-10-17T12:00:28ZA pothole that jolts a car can throw a rider. Loose gravel at the edge of a turn, an uneven pavement seam in a construction zone, or a missing warning sign can take a motorcycle down with no other vehicle involved. With the amount of road construction across Tampa Bay and the growing counties to the north, roadway hazards are a real risk for riders.
When a road defect causes a crash, the responsible party may be a government entity, a private contractor, or both. The rules for each are different.
Claims Against Government Entities
Cities, counties, and the state are responsible for maintaining many roads. Under section 768.28 of the Florida Statutes, Florida has waived sovereign immunity for certain negligence claims against government entities, but with significant limits.
Damages Caps
Recovery from a government entity is capped at $200,000 per person and $300,000 per incident. The Legislature passed a 2026 bill that would have raised those caps, but it was vetoed in June 2026, so the existing caps remain. A judgment above the cap generally can only be collected through a claims bill passed by the Legislature.
Pre-Suit Notice
Before suing, the injured person must give written notice of the claim to the agency and, in many cases, to the Department of Financial Services within the statutory period. The agency then has time to investigate before a lawsuit may be filed. Missing these steps can defeat the claim.
Operational Versus Planning Decisions
Government entities are generally not liable for basic planning decisions, such as whether to build or widen a road. They can be liable for operational failures, such as failing to repair a known hazard or failing to warn of a dangerous condition they knew or should have known about. Proving knowledge often requires maintenance records, prior complaints, and work orders.
Claims Against Contractors
Road construction is often performed by private contractors. A contractor that leaves loose gravel, an unmarked drop-off, uneven lanes, or inadequate signage may be liable under ordinary negligence rules, without the government caps. Construction contracts and traffic control plans can show who was responsible for a particular hazard.
Evidence in Road Defect Cases
Road conditions change fast. A pothole may be patched within days, and gravel swept away. Photograph and measure the defect as soon as possible, note the exact location, and look for nearby construction signs or company names on equipment. Damage to the bike's wheels and suspension can help show the defect caused the crash.
Frequently Asked Questions
Can I sue the county for a pothole that caused my motorcycle crash?
Possibly. Florida allows certain negligence claims against government entities, but they require pre-suit notice and are subject to damages caps.
What are Florida's sovereign immunity caps in 2026?
$200,000 per person and $300,000 per incident. A 2026 bill to raise them was vetoed.
What if a construction company caused the hazard?
A private contractor may be liable under ordinary negligence rules, and its insurance is not subject to the government damages caps.
How quickly should I document a road defect?
Immediately. Hazards are often repaired within days, and photographs and measurements taken right away can be critical evidence.
Working With [nap_names id="FIRM-NAME-3"]
[nap_names id="FIRM-NAME-1"] is a boutique personal injury and insurance law firm based in Oldsmar, serving riders throughout Hillsborough, Pinellas, Pasco, Hernando, Citrus, Sumter, and surrounding counties, and statewide. When you hire the firm, Alexander Licznerski handles your case personally. Your calls and questions go to your attorney, not a rotating case manager, and the firm keeps a selective caseload so each case gets real attention.Motorcycle cases also draw on the firm's insurance coverage and PIP litigation practice. Because riders have no PIP, finding every available source of coverage, including UM, medical payments, household policies, and responsible third parties, is often what determines whether a serious injury is fully compensated.Motorcycle injury cases are handled on a contingency fee. The written fee agreement explains the percentage and how case costs are handled, including whether you could be responsible for any costs, before you sign anything.A candid note on HB 837: The 2023 tort reform law changed several rules that matter to injured riders. It shortened the general negligence deadline to two years, adopted the rule that bars recovery for a plaintiff found more than 50% at fault, changed how medical expenses are proven at trial, and eliminated the automatic attorney's fee award that once applied when an insured successfully sued their own auto insurer. Those changes make early investigation and realistic case evaluation more important, and the firm will tell you plainly how they apply to your situation.
Talk to Your Attorney Directly
If you or someone in your family was hurt in a motorcycle crash anywhere in the Tampa Bay area, you can speak directly with attorney Alexander Licznerski about what happened and what options may be available.[nap_names id="FIRM-NAME-1"] | Oldsmar, FloridaPhone: [nap_phone id="LOCAL-CT-NUMBER-1"] | Web: licznerskilaw.com | Email: alicznerski@licznerskilaw.comBoutique Representation. Real Results. Your Attorney, Not a Case Number.This article provides general information about Florida law and is not legal advice. Reading it does not create an attorney-client relationship. Every case depends on its own facts, and past results do not guarantee a similar outcome.]]>On Behalf of Licznerski Law, PLLC<![CDATA[Anti-Motorcycle Bias: How Insurers and Juries View Riders, and How Strong Cases Overcome It]]>https://www.licznerskilaw.com/?p=470512026-10-15T21:18:54Z2026-10-16T12:00:33ZAsk experienced riders and they will tell you: some people assume a motorcyclist in a crash must have been doing something reckless. That assumption does not come from the facts of a particular crash. It comes from stereotypes, and it can follow a rider into the claims process and the courtroom. Recognizing it is the first step to making sure a case is decided on evidence.
How Bias Shows Up in Claims
Rider bias rarely announces itself. It appears in subtler ways:
An adjuster assigns the rider a share of fault before reviewing video or witness statements.
A "speeding" accusation appears in the claim notes with nothing to support it.
Helmet use or licensing status is raised even where neither had anything to do with the crash.
Settlement offers are discounted on the assumption that a jury will not like the rider.
Under Florida's 51% rule, these assumptions matter more than ever. Pushing a rider's fault above 50% eliminates the claim entirely.
How Bias Shows Up at Trial
Prospective jurors bring their own experiences. Some have been startled by a loud bike on the highway or watched a rider weave through traffic. Those experiences can color how they view a rider who did nothing wrong. Jury selection is where these attitudes can be identified, discussed openly, and addressed. Lawyers can ask potential jurors about their views of motorcyclists, and jurors who cannot set aside their assumptions can be challenged.
What Overcomes Bias
Bias loses to specifics. The cases that overcome it share common features:
Objective evidence of the crash: video, reconstruction, and physical evidence that show what actually happened.
The other driver's conduct: distraction, failure to yield, or impairment brought out in deposition.
The rider as a person: work history, family, safety training, gear, and riding experience.
Credible, consistent medical evidence connecting the crash to the injuries.
In our experience with vulnerable road user cases, including a bicycle case the firm recently resolved for $500,000 after the defense initially blamed the cyclist, the early narrative often changes once the evidence is developed. Past results do not guarantee future outcomes, but they show why the first story an insurer tells should not be accepted as the final one.
Frequently Asked Questions
Why does the insurer seem to assume I was at fault?
Some adjusters start from assumptions about riders. Those assumptions can be challenged with evidence such as video, witness statements, and reconstruction.
Will a jury be biased against me because I ride?
Some jurors may hold negative views of motorcyclists. Jury selection allows those views to be explored, and jurors who cannot be fair can be challenged.
Does my appearance or my bike affect my case?
Insurers sometimes try to use appearance or bike type to suggest recklessness. Those details are rarely relevant to what caused the crash, and the focus should stay on the evidence.
How can I counter a lowball offer based on rider bias?
By building a factual record: crash evidence, the other driver's conduct, and thorough medical documentation. Strong evidence changes how a claim is valued.
Working With [nap_names id="FIRM-NAME-3"]
[nap_names id="FIRM-NAME-1"] is a boutique personal injury and insurance law firm based in Oldsmar, serving riders throughout Hillsborough, Pinellas, Pasco, Hernando, Citrus, Sumter, and surrounding counties, and statewide. When you hire the firm, Alexander Licznerski handles your case personally. Your calls and questions go to your attorney, not a rotating case manager, and the firm keeps a selective caseload so each case gets real attention.Motorcycle cases also draw on the firm's insurance coverage and PIP litigation practice. Because riders have no PIP, finding every available source of coverage, including UM, medical payments, household policies, and responsible third parties, is often what determines whether a serious injury is fully compensated.Motorcycle injury cases are handled on a contingency fee. The written fee agreement explains the percentage and how case costs are handled, including whether you could be responsible for any costs, before you sign anything.A candid note on HB 837: The 2023 tort reform law changed several rules that matter to injured riders. It shortened the general negligence deadline to two years, adopted the rule that bars recovery for a plaintiff found more than 50% at fault, changed how medical expenses are proven at trial, and eliminated the automatic attorney's fee award that once applied when an insured successfully sued their own auto insurer. Those changes make early investigation and realistic case evaluation more important, and the firm will tell you plainly how they apply to your situation.
Talk to Your Attorney Directly
If you or someone in your family was hurt in a motorcycle crash anywhere in the Tampa Bay area, you can speak directly with attorney Alexander Licznerski about what happened and what options may be available.[nap_names id="FIRM-NAME-1"] | Oldsmar, FloridaPhone: [nap_phone id="LOCAL-CT-NUMBER-1"] | Web: licznerskilaw.com | Email: alicznerski@licznerskilaw.comBoutique Representation. Real Results. Your Attorney, Not a Case Number.This article provides general information about Florida law and is not legal advice. Reading it does not create an attorney-client relationship. Every case depends on its own facts, and past results do not guarantee a similar outcome.]]>On Behalf of Licznerski Law, PLLC<![CDATA[Florida Motorcycle Accident Statute of Limitations: The Two-Year Deadline and Its Exceptions]]>https://www.licznerskilaw.com/?p=470492026-10-15T21:16:35Z2026-10-15T21:16:11ZFor decades, Florida gave injured people four years to file a negligence lawsuit. Many riders still believe that is the rule. It is not. HB 837 cut the deadline in half for claims arising after March 24, 2023. Missing the deadline generally means losing the claim entirely, no matter how strong it is.
The General Rule: Two Years
Under section 95.11(4)(a) of the Florida Statutes, as amended by HB 837, a negligence action must generally be filed within two years. For a motorcycle crash, the clock usually starts on the date of the crash. Crashes that happened before March 24, 2023, remain subject to the prior four-year period.Two years passes quickly. Medical treatment, recovery, and settlement negotiations can consume much of it. A lawsuit often needs to be prepared months before the deadline, not days.
Claims That Follow Different Rules
Claims Against Government Entities
When a city, county, or state agency is responsible, whether through a government vehicle or a dangerous road condition, section 768.28 applies. These claims require written pre-suit notice to the agency, and in many cases to the Department of Financial Services, before a lawsuit can be filed. Notice requirements and deadlines are strict, and the procedures differ from ordinary claims. A 2026 bill that would have changed these procedures and raised damages caps was vetoed, so the existing framework remains in place.
Wrongful Death
When a rider is killed, the personal representative of the estate brings the claim under Florida's Wrongful Death Act. The limitations period is generally two years from the date of death.
UM Claims Against Your Own Insurer
A claim for uninsured motorist benefits arises under your insurance contract. Contract claims and UM claims have their own limitations rules, and your policy may contain notice requirements that apply much sooner. Do not assume the UM deadline matches the deadline for suing the driver.
Why Waiting Hurts Even Before the Deadline
The statute of limitations is the outer limit. Evidence disappears well before it. Business video is overwritten, vehicles are repaired or salvaged, and witnesses move or forget. In motorcycle cases, where fault is often disputed, early investigation can matter as much as the filing deadline itself.
Frequently Asked Questions
How long do I have to sue after a motorcycle accident in Florida?
For most negligence claims arising after March 24, 2023, two years from the date of the crash.
My crash happened in 2022. Which deadline applies?
Crashes before March 24, 2023, are generally governed by the prior four-year period, though any claim that old should be reviewed promptly.
Is the deadline different if a government vehicle hit me?
Yes. Claims against government entities require written pre-suit notice under section 768.28 and follow specific procedures and time limits.
Does settling with an insurer stop the clock?
Negotiations do not extend the statute of limitations. If a case is not resolved, a lawsuit must be filed before the deadline.
Working With [nap_names id="FIRM-NAME-3"]
[nap_names id="FIRM-NAME-1"] is a boutique personal injury and insurance law firm based in Oldsmar, serving riders throughout Hillsborough, Pinellas, Pasco, Hernando, Citrus, Sumter, and surrounding counties, and statewide. When you hire the firm, Alexander Licznerski handles your case personally. Your calls and questions go to your attorney, not a rotating case manager, and the firm keeps a selective caseload so each case gets real attention.Motorcycle cases also draw on the firm's insurance coverage and PIP litigation practice. Because riders have no PIP, finding every available source of coverage, including UM, medical payments, household policies, and responsible third parties, is often what determines whether a serious injury is fully compensated.Motorcycle injury cases are handled on a contingency fee. The written fee agreement explains the percentage and how case costs are handled, including whether you could be responsible for any costs, before you sign anything.A candid note on HB 837: The 2023 tort reform law changed several rules that matter to injured riders. It shortened the general negligence deadline to two years, adopted the rule that bars recovery for a plaintiff found more than 50% at fault, changed how medical expenses are proven at trial, and eliminated the automatic attorney's fee award that once applied when an insured successfully sued their own auto insurer. Those changes make early investigation and realistic case evaluation more important, and the firm will tell you plainly how they apply to your situation.
Talk to Your Attorney Directly
If you or someone in your family was hurt in a motorcycle crash anywhere in the Tampa Bay area, you can speak directly with attorney Alexander Licznerski about what happened and what options may be available.[nap_names id="FIRM-NAME-1"] | Oldsmar, FloridaPhone: [nap_phone id="LOCAL-CT-NUMBER-1"] | Web: licznerskilaw.com | Email: alicznerski@licznerskilaw.comBoutique Representation. Real Results. Your Attorney, Not a Case Number.This article provides general information about Florida law and is not legal advice. Reading it does not create an attorney-client relationship. Every case depends on its own facts, and past results do not guarantee a similar outcome.]]>On Behalf of Licznerski Law, PLLC<![CDATA[Fighting for Your Patients: How Florida PIP Providers Can Recover the Benefits They’re Owed]]>https://www.licznerskilaw.com/?p=467732026-10-14T15:05:24Z2026-10-14T15:05:24ZIf you're a healthcare provider treating auto accident patients in Florida, you already know the frustration. You deliver the care. You submit the bills. And then the insurance company finds every reason not to pay.
Coverage denials, lowball reimbursements, and procedural roadblocks have become standard operating procedure for many auto insurers in Florida. But you don't have to accept it. [nap_names id="FIRM-NAME-1"] fights alongside medical providers across Florida to recover Personal Injury Protection (PIP) benefits that insurers wrongfully withhold.
The PIP System Was Designed to Help — Insurers Have Learned to Exploit It
Florida's PIP law requires auto insurance policies to cover 80% of reasonable and necessary medical expenses up to $10,000 for injuries sustained in a car accident — regardless of who was at fault. In theory, this means your patients' treatment should be reimbursed promptly and fairly.In practice, insurers have developed a sophisticated playbook to deny, delay, and reduce payments to providers like you.
Common Tactics Used to Deny Your PIP Claims
Independent Medical Examinations (IMEs)Don't let the name fool you. An IME is ordered by the insurance company and performed by a physician of the insurer's choosing. The purpose, more often than not, is to generate a report concluding that your patient has reached maximum medical improvement or that further treatment is not medically necessary — cutting off your reimbursement. These examinations are frequently brief, superficial, and completely at odds with the clinical picture you've documented over weeks or months of treatment. [nap_names id="FIRM-NAME-1"] knows how to challenge IME findings and hold insurers accountable when they use them improperly.Peer ReviewsA peer review is another insurer-favored tool where a reviewing physician — who has never examined your patient — evaluates your billing and determines that some or all of the treatment was not reasonable or necessary. These paper reviews are often used to justify partial or full denials of your claims. We know how to scrutinize peer review reports and expose the flaws in their reasoning.Examinations Under Oath (EUOs)Insurance companies may require your patients to submit to an Examination Under Oath as a condition of receiving benefits. These are formal, recorded proceedings conducted by the insurer's attorney. When a patient fails to appear or is not properly prepared, the insurer may use it as grounds to deny the entire claim — and your bills go unpaid as a result. We help ensure your patients' obligations are met and that EUOs are not weaponized against legitimate claims.Coverage DenialsInsurers deny PIP claims on a wide variety of grounds — policy lapses, alleged fraud, late notice, failure to attend an IME, and more. Many of these denials are legally questionable or outright improper. A denial letter is not the end of the road. It is often the beginning of a fight we are prepared to win.
You Provided the Care. You Deserve to Be Paid.
Providers who treat PIP patients take on real financial risk every time they accept an assignment of benefits. You invest your time, your staff, and your resources in treating injured patients — often before you know whether the insurer will honor the claim. When insurers act in bad faith or misapply the law, it's not just an inconvenience. It threatens the viability of your practice.[nap_names id="FIRM-NAME-1"] represents healthcare providers in PIP litigation and pre-suit negotiations. We understand the statutes, the case law, and the tactics insurers use. We work to recover what you are owed — and in successful cases, Florida law provides for the recovery of attorney's fees, meaning you can pursue your claim without worrying about legal costs eating into your recovery.
Serving Providers Across Florida
[nap_names id="FIRM-NAME-1"] proudly serves PIP providers throughout Florida, including:Hillsborough County, Pinellas County, Pasco County, Hernando County, Citrus County, Polk County, Manatee County, Sarasota County, Charlotte County, Lee County, Collier County, Miami-Dade County, Broward County, Palm Beach County, Orange County, Osceola County, Seminole County, Brevard County, Volusia County, Duval County, and surrounding areas.
Don't Leave Money on the Table
Insurance companies count on providers giving up after a denial. They rely on the fact that chasing down unpaid PIP claims is time-consuming and complex. That's exactly why having an experienced legal team in your corner matters.If your PIP claims are being denied due to IMEs, peer reviews, EUOs, or other coverage disputes, contact [nap_names id="FIRM-NAME-1"] today for a consultation. We'll review your situation and help you understand your options.Your patients trusted you with their care. Trust us to fight for your payment.
[nap_phone id="LOCAL-CT-NUMBER-1"]
alicznerski@licznerskilaw.comwww.licznerskilaw.com]]>On Behalf of Licznerski Law, PLLC<![CDATA[IME, Peer Review, Bill Review, or Something Else? Reading a Florida PIP Denial and Knowing What You Are Actually Fighting]]>https://www.licznerskilaw.com/?p=468702026-10-14T15:06:46Z2026-10-14T15:05:22ZA practice manager in Wesley Chapel called us about what she described as a peer review denial. When the file arrived, it was not a peer review. It was a code audit — a vendor product that had rebundled two CPT codes and paid the difference. There was no physician opinion anywhere in it. Nobody had reviewed a chart. The letter used clinical-sounding language because the vendor's template used clinical-sounding language, and the practice had spent three weeks preparing a medical necessity response to a denial that had nothing to do with medical necessity.
This happens constantly. Florida PIP insurers have at least five distinct tools for reducing or stopping payment, each governed by a different provision of Florida Statute § 627.736, each imposing different obligations on the carrier, and each vulnerable to a different response. Carrier correspondence blurs them, sometimes carelessly and sometimes not.If your office is going to respond to these letters effectively — or hand them to counsel in usable shape — the threshold skill is identifying which of the five you received. This article is the field guide.
One: The Compulsory Medical Examination (the "IME")
What it is. A physical or mental examination of your patient by a physician the insurer selects. Section 627.736(7)(a) provides that whenever the injured person's mental or physical condition is material to a PIP claim, that person must submit to examination by a physician upon the insurer's request.What the insurer owes. More than most people realize.The costs of any examination requested by an insurer are borne entirely by the insurer.The location is regulated. The examination must be conducted within the municipality where the insured is receiving treatment, or in a location reasonably accessible to the insured. The statute defines reasonably accessible as any location within the municipality where the insured resides, or any location within ten miles by road of the insured's residence, provided that location is within the county in which the insured resides. If no qualified physician is available within that radius, the examination must be conducted in the area of closest proximity to the insured's residence.That is a concrete, checkable rule, and it gets violated. A patient living in Brooksville sent to a Tampa examiner, or a patient in Bradenton scheduled in Pinellas County, is worth a hard look at the geography.The patient is entitled to the report. Under § 627.736(7)(b), if requested by the person examined, the party causing the examination shall deliver a copy of every written report concerning the examination, and at least one of those reports must set out the examining physician's findings and conclusions in detail. Note the word every. Note also that requesting the report or deposing the examiner waives certain privileges regarding testimony of other examining physicians, so that request is a decision, not a reflex.What it can accomplish. An IME report can serve as the valid report supporting a withdrawal of a treating physician's payment under § 627.736(7)(a) — but only if it satisfies every element of the valid-report definition, including that the examining physician be licensed under the same chapter as the treating physician whose authorization is being withdrawn.The separate no-show mechanism. Section 627.736(7)(b) also provides that if a person unreasonably refuses to submit to or fails to appear at an examination, the carrier is no longer liable for subsequent PIP benefits. Two things about that sentence deserve attention. It says subsequent — it is forward-looking. And the statute provides that refusal or failure to appear at two examinations raises a rebuttable presumption that the refusal or failure was unreasonable, which means the presumption attaches at two, not one, and it is rebuttable even then.How to spot it. Correspondence scheduling an appointment for the patient. An address and a time. A report describing a physical examination with range-of-motion findings, orthopedic testing, and observations of the patient in person.
Two: The Peer Review
What it is. A physician's opinion based on reviewing the treatment records, with no examination of the patient. The term does not appear in the statute; the statutory concept is a report by a physician reviewing the treatment records of the injured person.What the insurer owes. If the report is being used to withdraw payment of a treating physician, it must satisfy the valid-report requirements in § 627.736(7)(a): prepared and signed by the physician reviewing the records, factually supported by the treatment records reviewed, not modified by anyone other than the physician, authored by a Florida physician licensed under the same chapter as the treating physician, who is in active practice as the statute defines that term.The reviewing physician must also keep copies of all examination reports as medical records for at least three years, and records of all payments for those examinations and reports for at least three years.And the insurer — or anyone acting at its direction or on its behalf — may not materially change an opinion in the report or direct the physician to change one. The statute permits only calling errors of fact to the physician's attention based on information in the claim file.What it can accomplish. Where the carrier was paying and stopped, this is the document that has to hold up. Where the carrier never paid at all, the controlling appellate authority treats the claim as a denial under § 627.736(4)(b) rather than a withdrawal, and the report functions as evidence rather than as a statutory precondition. We cover that distinction in detail in a separate article in this series, and it is the single most consequential question in a peer review dispute.How to spot it. No appointment was ever scheduled. The report recites a list of documents reviewed. The physician's conclusions reference chart entries, not personal observations. The patient has never met this doctor.
Three: Bill Review, Code Audits, and Fee Schedule Reductions
What it is. Not a medical opinion at all. These are billing-side products — software-driven or analyst-driven reviews that recode, rebundle, or reprice your charges. They live in subsection (5) of the statute, not subsection (7).What the insurer owes. Several things worth knowing.On fee schedule limits: § 627.736(5)(a)1 permits an insurer to limit reimbursement to eighty percent of a schedule of maximum charges, generally two hundred percent of the applicable Medicare Part B allowable for most services, with separate treatment for emergency transport, hospital services, ambulatory surgical centers, clinical laboratories, and durable medical equipment. Critically, § 627.736(5)(a)5 permits an insurer to limit payment under that schedule only if the policy includes notice at issuance or renewal that the insurer may do so. A carrier applying fee schedule limits under a policy without that notice has a problem.Also under § 627.736(5)(a)3: an insurer applying those payment limitations must reimburse a provider who lawfully provided care within the scope of his or her license, regardless of whether that provider would be entitled to reimbursement under Medicare due to restrictions on which disciplines may bill particular codes. The statute permits use of Medicare coding policies and payment methodologies, including modifiers, but not utilization limits.On upcoding and unbundling: § 627.736(5)(b)1.e permits an insurer to change codes it determines were improperly upcoded or unbundled and pay on the changed codes. But before doing so, the insurer must contact the health care provider and discuss the reasons for the insurer's change and the provider's reason for the coding — or make a reasonable good faith effort to do so, documented in the insurer's file. That is an affirmative obligation. If nobody from the carrier ever called your office before recoding your bills, ask what is in that file.On downcoding: § 627.736(5)(g) provides that an insurer may not systematically downcode with the intent to deny reimbursement otherwise due, and that such action constitutes a material misrepresentation under § 626.9541(1)(i)2.What it cannot accomplish. A bill review product is not a physician's report. It cannot satisfy § 627.736(7)(a) and cannot support a withdrawal of a treating physician's treatment authorization on reasonableness, relatedness, or necessity grounds.How to spot it. Line-item math. CPT codes with modifiers. Language about allowable amounts, multiple procedure reductions, bundling edits, or usual and customary charges. No physician signature, or a signature from someone with no stated clinical relationship to the review.
Four: The § 627.736(6)(b) Records and Sworn Statement Request
What it is. Not a denial at all, which is why practices misread it. Section 627.736(6)(b) permits an insurer to require a provider to furnish a written report of the history, condition, treatment, dates, and costs of treatment, and why the items the insurer identified were reasonable in amount and medically necessary — together with a sworn statement that the treatment or services were reasonable and necessary, in the specific form the statute prescribes, and to allow inspection and copying of records.What the insurer owes. The person requesting the records and sworn statement must pay all reasonable costs connected with it.There is also a timing consequence that runs in the provider's favor. If the insurer makes a written request under this paragraph within thirty days after receiving notice of the amount of a covered loss, the amount subject to the inquiry is overdue if the insurer does not pay within the ordinary period or within ten days after receiving the requested documentation, whichever is later. The clock does not stop indefinitely.And § 627.736(6)(b) provides that an insurer that requests documentation or information pertaining to reasonableness of charges or medical necessity under that paragraph without a reasonable basis, as a general business practice, engages in an unfair trade practice under the insurance code.How to spot it. It asks you for something rather than telling you something. It references a sworn statement. It usually arrives before any denial and is frequently the prelude to one.
Five: The Examination Under Oath
What it is. A recorded, sworn examination of the insured. Section 627.736(6)(g) provides that an insured seeking benefits must comply with the terms of the policy, including submitting to an examination under oath, that the scope of questioning is limited to relevant information or information reasonably expected to lead to relevant information, and that compliance is a condition precedent to receiving benefits.What constrains it. The scope limitation is real and is written into the statute. And an insurer that, as a general business practice as determined by the Office of Insurance Regulation, requests an examination under oath without a reasonable basis is subject to § 626.9541.How to spot it. It involves the patient, not the records, and it involves a court reporter. We address EUO no-show denials in a separate article.
Telling Them Apart at a Glance
Was your patient examined in person by a doctor the insurer chose? IME.Did a doctor read the chart without examining the patient? Peer review.Is the dispute about codes, modifiers, bundling, or allowable amounts, with no physician opinion? Bill review or fee schedule reduction.Did the carrier ask your office for records and a sworn statement? A § 627.736(6)(b) request — not yet a denial.Did the carrier want the patient under oath with a court reporter? EUO.Received two or three of these at once? That is common, and each component needs its own response. A single letter frequently contains a fee schedule reduction on some codes and a medical necessity denial on others.
Why This Matters More Than It Sounds
Misidentifying the denial type costs practices real money in three ways.Wrong response, wasted effort. Preparing a medical necessity narrative for a bundling edit accomplishes nothing. Neither does arguing coding to a peer review physician.Wrong demand letter. Section 627.736(10) sets out what a demand must contain, and it treats a withdrawal of payment for future treatment not yet rendered differently from an ordinary overdue claim — requiring the withdrawal notice and an itemized statement of the type, frequency, and duration of the future treatment claimed to be reasonable and medically necessary. A demand drafted for the wrong track may not satisfy the condition precedent for the relief actually sought.Missed defects. Each category carries its own statutory requirements, and each set of requirements is a set of potential failures. The policy-notice requirement for fee schedule limits, the pre-recoding contact obligation, the IME location rules, the same-chapter requirement — none of these can be found if the letter was filed under the wrong heading in the first place.
How [nap_names id="FIRM-NAME-3"] Approaches These Denials
We represent the injured patient — the named insured under the policy. Your practice is not our client, signs nothing, and pays us nothing at any stage. There is no cost to your office to send us a denial and have us tell you what it actually is.That structure follows from the fee law. HB 837, effective March 24, 2023, eliminated the one-way attorney fee provision that made provider-assignee PIP suits economically workable. The fee right remaining in declaratory judgment actions under § 86.121 belongs to the named insured and is not assignable, which is why the patient must be the plaintiff and why we revoke the assignment of benefits at the outset.We will also tell you plainly that Florida trial courts are divided on what "total coverage denial of a claim" means under § 86.121. We have obtained favorable rulings on that question and we have received adverse ones. No binding appellate decision has resolved the split on the merits.We handle these denials for patients treated at practices throughout Hillsborough, Pinellas, Pasco, Hernando, Citrus, Polk, Manatee, and Sarasota Counties, including Tampa, St. Petersburg, Clearwater, Brandon, Riverview, Plant City, Palm Harbor, Largo, Safety Harbor, Wesley Chapel, Land O' Lakes, New Port Richey, Spring Hill, Brooksville, Inverness, Lakeland, Bradenton, and Sarasota.
Frequently Asked Questions
Is a peer review the same thing as an IME?
No. An IME involves a physical examination of the patient by a physician the insurer selects. A peer review involves no examination — the physician reviews records only. Both can potentially serve as the report supporting a withdrawal of payment, but only if the statutory valid-report requirements are met.
How far can an insurer make our patient travel for an IME?
Section 627.736(7)(a) requires the examination to be within the municipality where the insured is receiving treatment, or in a location reasonably accessible to the insured — defined as within the municipality of the insured's residence, or within ten miles by road of the residence and inside the county of residence. If no qualified physician is available in that area, the exam must be in the closest available proximity to the residence.
Can a bill review company cut off our patient's treatment authorization?
A bill review product is not a physician's report and cannot satisfy § 627.736(7)(a). It can affect what gets paid on submitted charges under subsection (5), which is a different question.
The carrier recoded our bills without ever contacting us. Is that allowed?
Section 627.736(5)(b)1.e requires the insurer, before changing codes it deems upcoded or unbundled, to contact the provider and discuss the reasons for the change and the provider's reason for the coding — or to make a reasonable good faith effort to do so, documented in its file. Whether that was satisfied in a given case is a factual question worth asking about.
We got a letter asking for records and a sworn statement. Is that a denial?
No. That is a request under § 627.736(6)(b). The insurer must pay the reasonable costs connected with it, and the payment clock does not stop indefinitely while it is pending.
What does a review cost our practice?
Nothing. We are retained by the patient. Your office pays no fee at any point.
Contact [nap_names id="FIRM-NAME-3"] — Send Us the Letter Before You Draft a Response
If you are not certain what kind of denial you received, that is the most common and most expensive problem in Florida PIP. Send it over. We will tell you what it is, what the carrier was required to do before issuing it, and whether it holds up.Call [nap_names id="FIRM-NAME-3"] at [nap_phone id="LOCAL-CT-NUMBER-1"], email alicznerski@licznerskilaw.com, or visitwww.licznerskilaw.com.]]>