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What is not covered? |
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First, NICA will only cover what it determines to be "medically necessary," so right from the beginning families often have disputes with NICA over what is really medically needed for the child and what is not. Another serious flaw with this program is that NICA does not pay for what might otherwise be covered by insurance or any similar private or governmental programs. Since most severely injured children in Florida are either insured or covered by other programs like Medicaid or Children's Medical Services, in reality, while the statutory description of NICA benefits sounds great, the program frequently offers very little to families because the NICA representatives often assert that the families are already getting practically everything they seem to need from these other programs. And there are other very significant elements of damages that NICA never covers under any circumstances and the child and family just forfeit by the loss of the ability to file a malpractice claim. These forfeited elements of damages include things like compensation for pain, mental anguish, disfigurement, loss of ability to enjoy life, and the economic losses from the inability of the injured child to ever be able to work for a living. These damages (that NICA will never cover) can run into the millions of dollars for a catastrophically injured child. Every case should be considered on its own facts, but in the end, NICA usually pays relatively little to most families who qualify for the program.
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