How Does Florida’s Personal Injury Protection (PIP) Coverage Work and Pitfalls to Avoid

The events during and after a motor vehicle accident can be chaotic and traumatic. You are entitled to medical benefits coverage in Florida, even if you do not have health insurance and regardless of who was at-fault for causing the accident.  This coverage is known as Personal Injury Protection (PIP). It is a required coverage under every car insurance policy in Florida. Although things may seem like a blur, it’s important to understand the steps one needs to take after an accident. One of the more important steps to take after a motor vehicle accident is to make sure you get the necessary medical attention that you need. This is important especially if the accident caused injury to a part of your body.

What is Personal Injury Protection?

Personal Injury Protection (PIP), or no-fault automobile insurance, is mandatory in the state of Florida. It is even stated in the Florida Statutes that an “insurance policy must provide personal injury protection to the named insured”. This is because, Florida is considered a “no-fault” state. No matter who is at fault for an accident, all parties can seek medical attention for any injuries sustained. PIP insurance covers the medical bills of you and your immediate family members that reside with you. It also covers passengers that do not own a vehicle of their own or live with a relative that has their own insurance policy.
Personal Injury Protection on your automobile insurance will cover up to $10,000 of medical expense following an accident.  With Florida’s “no-fault” system, the PIP policies help to make sure anyone injured in a car accident could seek medical attention and have the majority of their medical expenses covered without waiting for a court or insurance to determine whose fault the accident was. PIP insurance coverage will pay 80% of the amount allowed under the PIP reimbursement fee schedule to your medical providers. This leaves a 20% balance. If you have private health insurance, Medicare, or Medicaid, you can then submit your medical bills through your insurance. If you do this, there is a good chance that the remaining 20% balance will be written off completely or greatly reduced.

The Fourteen-Day PIP Window

There is a limited amount of time, only fourteen days, after an accident to go seek medical treatment to make sure it will be covered by your PIP benefits. If you fail to seek initial treatment within the fourteen-day window, then you may lose out on the $10,000 in PIP benefits that you are entitled to receive. That’s why there is such an emphasis on seeking medical diagnoses and treatments within this window. This fourteen-day time limit is one of the things that makes going to seek medical services so important following a motor vehicle accident.
One thing we commonly hear at Hunter Law is that people are too busy or do not want to be bothered with seeking medical care. They do not think that they are that injured or think that their injuries seem minor and will get better on their own with time. This mindset can turn out to be a devastating mistake. Far too often, we see clients who did not think they were that injured. Through the course of treatment they find out that they suffered significant injuries that require procedures such as spinal injection therapy and even surgery. It is important to get yourself medically examined if you are suffering any discomfort or suspected injuries following a care accident.

Seeking Medical Assistance Decisions

Determining whether to go to an emergency room, urgent care, or your primary care physician can be a troubling decision. At Hunter Law, we always encourage our clients to listen to their bodies and respond accordingly. If you experience physical symptoms immediately after an accident, we recommend to err on the side of caution and present immediately to an urgent care center or emergency room. Have your car insurance policy information handy, as the facility will need this so they can begin to process your PIP insurance claim. If you decide to wait a day or two to seek medical attention, it may be best to go to a medical provider that specializes in treating car accident victims. Too often we see primary care physicians unwilling or unable to properly treat our clients. Ultimately, wherever you decide to treat, it is always best to do so as soon as possible.

Understanding Florida’s Automobile PIP and Fourteen-day Rule Together:

Understanding the importance of Florida’s fourteen-day PIP policies helps determine you first steps following a car accident. Seeking medical attention after an accident is always important. But having a basic understanding of Florida’s PIP law is also very helpful. PIP insurance can help to ensure that an injured person does not have to wait for their insurance or the insurance from the other party involved to accept responsibility before being able to seek medical attention.
Although insurance policies can vary from person to person, there are requirements under Florida law. Florida’s “no-fault” and personal injury protection policies can get a little confusing. Tt is there for the benefit of those who are be involved in an accident. The lawyers at Hunter Law are always available to assist our clients in navigating the rough and murky waters following a motor vehicle accident. If you ever have any questions or concerns, we are always here. We will provide our insight and advice based upon our years of experience. We hope that you never need us but if you do, we are here for you.

Resources/References:

§627.736 Required Personal Injury Protection Benefits; Exclusions; Priority; Claims, Fla. Stat. (2019)
Diederich, S. Why You Should Go to the Doctor After a Car Accident in Florida. Retrieved August 04, 2020, from https://www.hg.org/legal-articles/why-you-should-go-to-the-doctor-after-a-car-accident-in-florida-37104
Florida Office of Insurance Regulation. Personal Injury Protection (PIP) for Auto Insurance. Retrieved August 05, 2020, from https://www.floir.com/Sections/PandC/ProductReview/PIPInfo.aspx
Florida Physical Medicine. (2018, August 15). Should I See a Doctor After a Car Wreck Even If I Don’t Have Symptoms? Retrieved August 05, 2020, from https://floridaphysicalmedicine.com/doctor-after-wreck-no-symptoms/
Florida Physical Medicine. (2018, October 30). Florida is a No-Fault State. What Does That Mean for You? Retrieved August 05, 2020, from https://floridaphysicalmedicine.com/florida-no-fault-state/