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Reimbursement Limitations

Payor of Last Resort

As the payor of last resort, it is important to know that s. 960.13(3) of the Florida Statutes, precludes the Bureau of Victim Compensation from considering any/all benefits until all collateral sources are exhausted. Those sources include, but are not limited to, Medicare/Medicaid, health insurance, automobile insurance, hospitalization insurance, or workers compensation. It is helpful when vendors note their bill to identify that all collateral sources are exhausted, that no collateral sources exist, or when the victim’s collateral source is not accepted.

Payment in Full

The Bureau of Victim Compensation’s payment is “payment in full” pursuant to s. 960.14(4) of the Florida Statutes, and the victim/applicant cannot be balance billed for the same account or dates of service. If the provider rejects payment in full from the department, the funds may be paid to the victim/applicant, who is then responsible for the bill.

Benefit Maximums

Benefit maximums are applicable to the Schedule of Benefits in effect on the date of crime and may be reduced or denied without prior notice or appeal rights. Total benefits paid on a single claim cannot exceed $15,000 when the victim is not deceased, or catastrophically injured, $25,000 when the victim is deceased, $50,000 when the victim has sustained a catastrophic injury as defined in s. 960.03(1 ) of the Florida Statutes, as a direct result of the crime, or $50,000 when an emergency responder is killed in the line of duty while answering a call for service. Please refer to the Schedule of Benefits for benefit caps within those claim maximums. Note that treatment expenses for medical, dental, and mental health are collectively calculated. The current benefit rate for payments to treatment providers is 50% or less depending on the availability of funds. All awards made are in accordance with the discretion and direction of the department.

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