Key Takeaway
Florida's demanding pre-suit requirements for PIP claims now require precision in demand letters, moving beyond substantial compliance to exact amounts.
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The pre-suit demands. When the State of Florida engages in “lawsuit reform”, the pre-suit demand requirement enters the equation. We saw in 2020 and 2021 with the first-party homeowners cases, which in my estimation represent pure abuse and have made getting HO polices in Fla impossible. But on the PIP side, it is a tool to allow the carriers to close their eyes initially and then, when the pre-suit comes rolling in, pay out the policy to avoid the PIP suit.
The law as to the pre-suit demands on average usually spoke of substantial compliance and were not an effective weapon by the carriers to have county court PIP cases dismissed. These were the findings in published county court and Appellate Division decisions. Times are a changing.
“We have written that section 627.736(10)(b) requires precision in a presuit demand letter to encourage resolution of PIP claims before the filing of a lawsuit: The language of subsection 627.736(10)(b)3. requires precision in a demand letter by its requirement of an “itemized statement specifying each exact amount” … The statute mandates that the amount at issue for a bill be specified early in the claims process. This requirement of precision in medical bills discourages gamesmanship on the part of those
who might benefit from confusion and delay. The statutory requirements surrounding a demand letter are significant, substantive preconditions to bringing a cause of action for PIP benefits. MRI Assocs. of Am., LLC v. State Farm Fire & Cas. Co., 61 So. 3d 462, 465 (Fla. 4th DCA 2011); see also Rivera v. State Farm Mut. Auto. Ins. Co., 317 So. 3d 197, 205 (Fla. 3d DCA 2021).
The demand letter in this case was hardly precise in the amount claimed to be due. It sought $2,978.88 or $4,524.28, not the amount less than $100 sought in the lawsuit. “he purpose of the demand letter is
not just notice of intent to sue. The demand letter also notifies the insurer as to the exact amount for which it will be sued if the insurer does not pay the claim.” Rivera, 317 So. 3d at 204. A demand letter that complies with the statute permits the insurer to accurately evaluate its decision to pay the claim or litigate. See, e.g., Venus Health Ctr. a/a/o Joally Rojas v. State Farm Fire & Cas. Co., 21 Fla. L. Weekly Supp. 496a (Fla. 11th Cir. Ct. Mar. 13, 2014).
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We have fully considered the other issues raised by appellant. We see nothing in the language of section 627.736 that requires an insurer to give notice to the insured or an assignee that a demand letter is defective. The trial court did not abuse its discretion in allowing Geico to amend its affirmative defenses or in ruling on the offer of judgment.”
The letter stated PIP benefits were owed in a certain amount and, if the policy has Med Pay, another amount. Not how I would draft a pre-suit letter, but the carrier knew what was in controversy. Many of you want to know why the heck you’d sue foe less than $100 if $2500 or $5000 was owed. LOL.
At the end of the day, if payments were made, the provider is searching for some small FS difference of unpaid interest. That triggers an attorney fee that starts at $3000 and can go to $100,000. These Fla PIP lawsuits are generally more about attorney fees then benefits. But that does not answer the question: why sue for less than $100.
The filing fee for a lawsuit under $100 is $55. For an amount between $500-$2500 it is $175. From $2500 to $15,000, it is $300. After $15,000, it is $400, which is the Circuit Court filing fee.
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Legal Context
Why This Matters for Your Case
New York's no-fault insurance system, established under Insurance Law Article 51, is one of the most complex insurance frameworks in the country. Every motorist must carry Personal Injury Protection coverage that pays medical expenses and lost wages regardless of fault, up to $50,000 per person.
But insurers routinely deny valid claims using peer reviews, EUO scheduling tactics, fee schedule reductions, and coverage defenses. The Law Office of Jason Tenenbaum has handled over 100,000 no-fault cases since 2002 — from initial claim submissions through arbitration before the American Arbitration Association, trials in Civil Court and Supreme Court, and appeals to the Appellate Term and Appellate Division. Jason Tenenbaum is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
His 2,353+ published legal articles on no-fault practice are cited by attorneys throughout New York. Whether you are dealing with a medical necessity denial, an EUO no-show defense, a fee schedule dispute, or a coverage question, this article provides the kind of detailed case-law analysis that helps practitioners and claimants understand exactly where the law stands.
About This Topic
New York No-Fault Insurance Law
New York's no-fault insurance system requires every driver to carry Personal Injury Protection (PIP) coverage that pays medical expenses and lost wages regardless of who caused the accident. But insurers routinely deny, delay, and underpay valid claims — using peer reviews, IME no-shows, and fee schedule defenses to avoid paying providers and injured claimants. Attorney Jason Tenenbaum has litigated thousands of no-fault arbitrations and court cases since 2002.
271 published articles in No-Fault
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Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
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