Florida PIP coverage works by ensuring everyone covers their financial losses from an auto accident, regardless of who caused it. Each person must turn to their insurance company to cover their medical bills, lost income, and death benefits. Anyone who owns and/or drives a registered vehicle in Florida must have personal injury protection (PIP).
This coverage, also known as “no-fault insurance,” means also applies if a policyholder suffers an injury as a bicyclist, a pedestrian, or a passenger in their vehicle or someone else’s. If you get into an accident, you can start your PIP benefits promptly, even if you did not cause the accident.
Coverage Limits of a Florida PIP Policy
Florida is a “no-fault” state because it wanted to reduce the number of personal injury lawsuits injured motorists file to recover their damages.
Everyone’s PIP policy has limits, which they can find in Florida Statutes § 627.736. The minimum coverage requirements of a PIP policy are:
- $10,000 in personal injury protection (PIP)
- $10,000 in property damage liability coverage
PIP Coverage and Deductibles
A deductible is the money the insured pays out of pocket up front for a claim before their insurer covers their losses. How much someone pays will determine how high or low their PIP insurance costs will be. A deductible can be $250, $500, or $1,000. There’s also the option of not paying a deductible, but the upfront costs will be higher.
What Does a Florida PIP Policy Cover?
A Florida personal protection policy covers:
Basic PIP coverage will pay up to 80% of an accident victim’s medical expenses. According to Florida law, this includes medical, surgical, X-ray, dental, and rehabilitative services. A person must receive medical care within 14 days after the accident to use these benefits.
They must find a way to pay the 20% that their PIP policy does not cover. For some accidents, $10,000 is more than enough to cover the damages. However, for others seriously hurt in an accident, it might not be enough. Medical treatment for severe injuries could easily surpass the $10,000 limit.
There are various ways to cover auto accident costs. If someone has health insurance, they should use it to help cover their medical costs. If they have opted to carry MedPay (medical payment insurance coverage) in addition to their PIP policy, they might be able to fully cover the other 20% of their healthcare expenses. Other options include Medicare or Medicaid or workers’ compensation if a person was injured in an accident while working. Medical providers may offer flexible payment plans, as well.
Unpaid balances can end up in collections and cause more financial problems down the road. Consulting a personal injury attorney about the matter can also help determine other payment options.
A person with basic PIP coverage is also eligible to receive 60% of their income (limited to $10,000) if they cannot work after an accident. These income payments must be paid at least every two weeks, according to the law.
Death benefits are also available under a PIP policy. It will also pay $5,000 toward funeral and burial costs if someone dies from the accident. This benefit is in addition to the other benefits the policy covers.
Filing a PIP Claim After an Accident in Florida
As noted above, a person should seek medical treatment within 14 days (two weeks) of the accident. Doing so makes it easy to connect the injuries with the accident. If they do not file within this time, they forfeit their PIP benefits. If a medical provider determines that someone has an emergency medical condition (EMC), they will be eligible for benefits up to $10,000. However, PIP will pay only 20% of that.
An EMC is any untreated condition that can seriously harm someone’s health, bodily function, or the function of a specific part of the body. If they do not qualify for an EMC, then their benefits will be limited to $2,500. After they receive a diagnosis, they must file a claim with their PIP insurance provider. Also, they must file their PIP claim before filing a claim with their health insurance provider. However, they can call their health insurance provider and tell them who their PIP provider is as they receive treatment. This helps keep billing matters simpler and easier to track. They should also keep track of all their medical expenses.
Their auto insurer has 60 days to review the accident claim, but they must pay within 30 days of receiving it. An injury lawyer can help you if the insurer later denies their claim and requests that they pay the money back.
Logging Lost Income
To recover lost income, the injured must get a “wage and salary” verification from their employer that shows their earnings for the 13 weeks before the accident. Their employer must fill this out before they submit it. An attorney can help with this documentation request.
What If A PIP Policy Doesn’t Cover All Their Accident Losses?
If their auto accident losses have surpassed their Florida PIP coverage’s limits, the injured person can seek damages from the liable party that caused the crash. They can work with our auto accident lawyers, who can file a lawsuit on their behalf so they can recover compensation for:
- Medical expenses that you cannot pay
- Lost income and future lost earnings (if the accident has put you out of work)
- Pain and suffering and other intangible losses with no fixed dollar amount
Permanent Injuries Are Exceptions to Florida PIP Coverage Limits
An injury lawyer can investigate the accident, collect evidence proving the other party’s fault, and build a compensation case that shows why a person should recover damages. Part of establishing an injury lawsuit is showing that someone suffered accident wounds that meet the permanent injury threshold as Florida Statutes § 627.737 defines.
These are injuries that cause significant and permanent loss of an important bodily function, permanent scarring and disfigurement, permanent disability, and even death. The injured will need documentation to prove their injuries are severe and the ongoing medical and rehabilitation expenses they will have to treat them.
GED Lawyers Can Help
Our car accident team can help you understand how Florida PIP coverage works and how you can help someone recover compensation that can help them move forward after an accident. Florida PIP matters are not always easy to follow, so having an injury lawyer who knows Florida’s law is beneficial.
Call us for a free consultation to learn how our personal injury lawyer can help.