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Personal Injury Protection (PIP)
Florida automobile insurance laws require vehicle owners to have a minimum of $10,000 in personal injury protection (PIP) coverage. PIP provides compensation to drivers in an accident regardless of who was at fault in causing the collision. Florida’s PIP rules and regulations may also bar lawsuits in certain circumstances against the at-fault party.
A car accident attorney can help you navigate the PIP insurance process and ensure that you receive all available PIP benefits, as well as determine whether you can take legal action following a crash.
What You Need to Know
For car accident victims, it is important to remember that PIP benefits may be provided to you only if you receive medical treatment for your injuries within two weeks of the accident. Otherwise, you might be ineligible to receive benefits under the program.
Limits on No-Fault Insurance: No-fault insurance pays benefits, after any applicable deductibles, in the amount of:
- 80% of medical bills, including out-of-pocket prescription costs, dental expenses, and rehabilitative services
- 60% of lost wages
- $5,000 worth of death benefits, which are in addition to the medical and disability benefits provided under the policy
- Mileage reimbursement to and from your doctor
Emergency Medical Condition: In addition, if you do not have an “emergency medical condition,” you will not be able to receive more than $2,500 in benefits. Florida law defines emergency medical condition as an ailment that requires immediate medical attention and could reasonably be expected to result in serious jeopardy to the patient’s health.
If you have been seriously injured, $2,500 may not fully cover the cost of medical treatments. After PIP benefits have been exhausted, our Florida car accident attorneys may be able to help you seek additional compensation from the at-fault driver through a personal injury lawsuit.
With regard to emergency medical conditions, Florida law imposes the following limits on PIP insurance claims:
- PIP will not cover any medical bills if you do not get treatment within 14 days of the accident.
- If the initial treatment is for a medical condition diagnosed as an emergency medical condition, PIP will provide coverage only for follow-up services that are related to the diagnosed conditions.
- PIP does not cover massage and acupuncture therapy.
Generally, PIP insurance benefits are overdue if they are not paid within 30 days after the insurer is furnished with written notice of the covered loss and the amount of the loss. An insurance company may have an additional 60 days to investigate the claim if the insurer has a reasonable belief that a fraudulent insurance act has been committed. Your car accident attorney will work to make sure the insurance company pays all benefits due to you in a timely fashion.
While waiting for your case to settle, your treating physician may request a letter of protection. This document is a contract that the unpaid expenses will be paid out of the settlement of your claim. Your car accident attorney should review any request for letters of protection before you sign them.
Following an accident, you should retain proof of all of your out-of-pocket expenses. For example, to receive reimbursement for out-of-pocket prescription expenses, you will need to submit to the insurance provider the original receipt for the prescription as well as the prescription label that is attached to the outside of the prescription bag.
PIP Reimbursement for Lost Wages: To receive compensation for lost wages, you must submit a wage and salary verification, which your employer completes and then submits to the insurance provider. The document shows your gross wages for the 13 weeks preceding the accident.
Your personal injury attorney may deal directly with your employer in ensuring the verification is filed with the insurance company in a timely manner. The 40% of your wages not covered by PIP may become part of your damages claim against the at-fault party’s insurance carrier.
To receive PIP reimbursement for lost wages, your treating doctor may also need to complete a disability form if you will be out of work for an extended period of time.
Filing a Lawsuit Against a Negligent Driver for Damages Not Covered by PIP: Generally, you must have sustained serious, permanent injuries to file a personal injury lawsuit against the at-fault driver in an accident. Examples of serious and permanent injuries may include:
- Traumatic brain injuries
- Back and spinal cord injuries
- Disfigurement or permanent scarring
- Broken bones
The insurance company representing the at-fault driver may try to categorize your injury as temporary and nonserious in nature. Your car accident attorney will collect supporting medical evidence to establish that your injuries are serious enough to qualify you for damages through a personal injury lawsuit.
Independent Medical Examinations: Under Florida law, car insurance companies have a right to request that you undergo an independent medical examination performed by a doctor of their choosing. Because this doctor is paid by the insurance company, they may not necessarily render an unbiased medical opinion in assessing your injuries.
During this medical exam, it is important that you do not sign any paperwork other than a sign-in sheet without first speaking to your attorney. It is also important that you do not speak to the doctor about insurance companies, settlements, or any other legal matters during the course of the independent medical examination.
If you or a loved one has been injured in a car accident, our attorneys may be able to assist you in recovering PIP benefits and monetary damages. For more information, please complete our free case review form today.
Medical Providers: Having Trouble Getting Paid?
What happens when medical providers have problems recovering payment from a patient's motor vehicle insurance company? Just as drivers can have trouble getting compensation to cover medical costs, so too can the people providing the medical services. They provide treatment for a person injured in a car accident, but they do not get paid for their services until the insurance company sends them a check.
All too often, insurance companies deny payment for treatments that were already conducted, leaving the medical provider hanging out to dry. Sometimes there is a valid reason for this, but often the insurance company is trying to get away with paying medical providers less than it should.
Billing for PIP is complicated, and insurance providers will use every trick they can to find a mistake. Whether they alter the coding to pay you less, claim they never received the bills, or try some other way to avoid paying you the full amount you are due, you don’t have to stand for it.
Because of these denials and more, your medical bills could mount, especially if there are complications. This and the accident itself mean you need to seek out legal expertise you can count on. At Morgan & Morgan, our attorneys have more than 50 years of combined legal experience, many having directly worked for insurance carriers either as adjusters or attorneys handling PIP and other personal injury claims.
We frequently take on insurance companies that don’t pay personal-injury victims their fare share, and we know what to expect from those companies. Find out how we might be able to help you.
Fill out this free, no-obligation case evaluation. Our attorneys handle a variety of personal injury cases in many different practice areas. Visit the rest of our website to learn more or contact us today.