At The Law Place, our personal injury lawyers have a lot of dealings with road accident claims in Florida. Therefore, we understand the intricacies of Florida’s no-fault law and the requirements of your Personal Injury Protection (PIP).
PIP is provided through your automobile insurance company. We work to recover compensation for any medical bills, lost wages, or other expenses as a result of your car accident. We can inform you of your rights and help to guide you through the system.
We are always informing our clients and their medical providers of the law that applies to them. It is essential to have a basic understanding to ensure that you are adequately covered and so that if you are in an accident, you know what help you are entitled to.
However, Florida laws can be confusing, and the system can be difficult to navigate, therefore if you are in an accident, then you should contact us on 941-444-4444 for a free, no-obligation consultation so that we can advise you on your next steps.
What is Personal Injury Protection (PIP)?
According to Florida Statute 627.7407, Florida is a no-fault state, which means that vehicle owners must have Personal Injury Protection (PIP), a type of no-fault insurance coverage that covers expenses whether or not you were at fault. PIP should be provided by your insurance company and is the first point of call when paying for medical bills or lost wages after a road accident in Florida.
You need to know that PIP will only cover expenses if someone seeks medical treatment with an approved first 14 days following a car accident.
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Who Does Pip Insurance Cover in Florida?
If you are insured then, PIP will pay towards your injuries following a car accident. If you are covered by PIP insurance on your vehicle, then this will cover you even if you are a passenger in a different car or are hit by a car when you were not in your vehicle.
Your insurance can also cover anyone else who is injured, including your passengers or someone else driving your car with your permission. However, if your passenger owns a car in Florida and has their PIP policy, then their insurance will pay even if they were driving your car.
What Is the Minimum Pip Coverage in Florida?
In Florida, there is a minimum amount of coverage required for your PIP insurance. In varies between states but in Florida, the minimum requirement is:
- $10,000 in PIP to cover medical expenses, lost wages, or car repair.
- $10,00 in property damage.
- If the policyholder is killed, then the next of kin is also entitled to $5000 towards funeral expenses.
Your insurance should cover $10,000 or more to cover medical treatment, hospital expenses, rehab costs, ambulance services and diagnostic services as well as any car repairs, and any other damages such as lost wages or funeral expenses.
If you are then in another car accident, then your PIP coverage should restart, and you will get another $10,000 worth of coverage.
The History of Florida PIP
In the past, PIP was susceptible to fraud by doctors, attorneys, or individuals exaggerating or fabricating their injuries. The insurance company could then struggle to prove either way if their claim was genuine.
In 2012 Florida lawmakers approved new policies, which has reduced fraud by placing limitations on insurance coverage.
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The Financial Limitations of PIP Coverage?
- PIP will only cover 80 percent of your medical expenses up to the amount specified on your policy (at least $10,000). Or 60 percent of your lost wages up to the amount specified on your policy (at least 10,000). This includes compensation for any services you cannot do due to your injuries, such as gardening, laundry, pet care, etc.
- Your deductible.
- If a medical expert classifies your injuries as non-emergency, then your PIP coverage is limited to $2,500.
- Certain treatments are not covered, such as massage therapy or acupuncture.
- If you occur more then $10,000 of losses, then you may be required to meet the rest of the cost, although some insurance policies will have to pay more.
How Does a Deductible Work With Personal Injury Protection (PIP)?
Your personal injury protection will set out a deductible, and this is an amount of money you have to cover before your insurance can pay anything out. Your deductible amount will be specified in your insurance policy. For example, if your medical bills amount to $6000 and your deductible is $1000, you will need to pay the $1000, and then PIP will pay 80 percent of what is left. ($6000 – $1000) x 80 percent will be the settlement amount. In this scenario, your PIP insurance would be required to pay out $4000.
What Is Classified as an Emergency Medical Condition?
In order to be covered for the full 10,000 from your personal injury protection following a car accident, then your injuries must constitute an emergency medical condition. If not, you are only entitled to up to $2,500. According to Florida Statute 395.002, an emergency medical condition is defined as:
- Serious risk to patient health.
- Serious dysfunction of any organ or body part.
- Severe impairment to bodily functions.
In regards to pregnant women:
- Serious risk to the health of mother or fetus.
- Inadequate time to transfer the mother to the hospital for delivery, or where it is unsafe to do so.
Who Is Required to Have Florida PIP Insurance?
Generally speaking, most people are required to have Personal Injury Protection (PIP) in Florida if they are using a motor vehicle. However, there are some exceptions, including:
- Vehicles that cannot move without assistance, such as mobile homes or inoperable vehicles.
- Vehicles with less than four wheels, such as motorcycles.
That does not mean that these types of vehicles have no coverage, but the kind of coverage they have will differ. For example, a taxi must have a motor vehicle liability policy which has a much higher coverage then PIP. Furthermore, because they are not covered by the no-fault law, a claimant does not have to meet the same requirements to claim for any injuries caused.
When and How to File a Florida PIP Claim
There are strict rules to follow when filing a PIP claim in Florida. The first and most important is that you must seek medical treatment for your injuries within two weeks of the accident.
Your insurer then has 60 days to investigate your claim for falsehood but must pay within 30 days, even if they have suspicions. If your case is not straightforward and you are struggling to have your insurance pay for your damages, then you should speak to a personal injury lawyer.
For any lost income, you need to submit a “Wage and Salary” verification that is completed by your employer. This will verify your wages in the 13 weeks leading up to the accident. You may also need a note from your doctor to explain why you lost time at work.
Can You Still Sue After Claiming Florida PIP?
States like Florida introduce a no-fault system to reduce the number of people suing. Most no-fault states, such as Florida, only allow drivers to sue when injuries are considered severe or permanent. However, in Florida, you can sue even if your injury is not severe if medical costs exceed $10,000.
If, for example, your accident results in $15,000 of medical bills, you could sue the other driver for the amount not covered by your PIP, in this case, $5000. You could also sue for any emotional suffering as a result of the accident.
If you are filing a lawsuit against a negligent driver in Florida, then your injuries must be serious and not entirely covered by your PIP insurance. Some examples include:
- Back and spinal cord injuries.
- Broken bones.
- Disfigurement or permanent scarring.
- Traumatic brain injuries.
Under Florida law, car insurance companies have a right to request an independent medical examination to confirm your injuries. If this happens to you, then you should always speak to your attorney first. You should also not sign any paperwork until you have spoken to your attorney.
The average cost for a hospital stay is $60,000. Therefore, it is a good idea to have bodily injury liability coverage included in your policy. This is not mandatory; however, if you do get sued by another driver for their medical costs, then this could cover it.
Recovering Unpaid PIP Benefits
If you have PIP insurance, then they are required to pay out towards any expenses following a car accident, whether or not it was your fault. If you have any trouble recovering unpaid or underpaid benefits, then you should speak to an attorney. Don’t navigate the system alone; get the right help.
When to Speak to an Attorney
It is always a good idea to speak to a personal injury lawyer following a car accident. They will be able to explain PIP to you and might be able to assist you with the process. Following an accident, dealing with insurance companies as well as your injury can be overwhelming. Especially because insurance laws in Florida are confusing, complex, and constantly changing.
At The Law Place, we deal with PIP insurance claims in Florida all the time. We can support you in getting the compensation that you deserve. Get in touch on 941-444-4444 any time, day or night, for a free and no-obligation consultation.