Norden Leacox Accident & Injury Law | July 25, 2024 | Car Accidents
Florida is one of around 12 states with a no-fault insurance system. This means in a car accident, drivers turn to their own insurance policy first to cover medical bills and lost wages regardless of fault.
All Florida drivers are required to carry personal injury protection (PIP) coverage to pay for these losses. Unless you suffer serious injuries or if another exception applies (there are many), you can’t sue the at-fault driver.
PIP coverage is confusing, especially for motorists who have moved to Florida from another state. Here are answers to some of the most frequently asked questions about this type of insurance.
What Is Personal Injury Protection (PIP)?
Personal Injury Protection, commonly known as PIP, is a form of auto insurance coverage mandatory for all drivers in Florida. A form of “no-fault insurance,” PIP coverage pays for some of the lost wages and medical bills after an accident, no matter who was at fault.
The purpose of PIP coverage is ensuring all drivers have coverage for essential medical treatment and lost earnings in an emergency. It was also intended to reduce car accident lawsuits and litigation costs.
What Does PIP Cover In Florida?
PIP coverage pays for the following losses up to the limit of $10,000 per person:
- 80% of medical bills
- 60% of lost earnings
- Death benefit for funeral expenses (up to $5,000)
PIP can cover emergency medical care and continuing treatment. This includes hospitalization, surgery, ambulance services, imaging tests, and prescriptions. Supplemental services like psychiatric therapy and rehabilitation may also be covered. However, only medically necessary expenses will be covered.
PIP insurance does not cover pain and suffering or other non-economic damages.
One of the most important limitations of PIP coverage is the cap on benefits for non-emergency treatment. PIP insurance pays up to the full $10,000 benefit for an Emergency Medical Condition (EMC), but benefits are capped at $2,500 without an EMC diagnosis.
What Is an Emergency Medical Condition (EMC)?
Only an Emergency Medical Condition (EMC) qualifies for full PIP coverage. According to Florida law, an EMC is a condition that causes acute, severe symptoms that seriously hurt or jeopardize your health. To qualify, the injury could reasonably cause any of the following without prompt care:
- Serious dysfunction of a bodily organ or body part
- Serious impairment of a bodily function
- Serious jeopardy to your health
To receive full PIP coverage, a medical provider must determine you have an EMC caused by your car accident. Otherwise, your benefits are capped at $2,500.
While this seems straightforward, it can become complicated in practice. Sometimes, providers don’t say one way or the other whether a condition is an emergency, or they use vague language.
The insurance adjuster may doubt the severity of your injury and require an Independent Medical Examination (IME) or peer review. An attorney can help you respond to these issues as they arise.
What Is the Deadline To File a Claim for PIP Benefits?
A recent change to Florida’s PIP statute requires accident victims to get medical care within 14 days from the date of the accident. You may not be eligible for PIP coverage if you do not receive medical treatment within 14 days.
Check the terms of your policy in terms of how long you have to file a claim from there. You can also ask an attorney for help during a free initial consultation.
Who Is Covered By Florida PIP Insurance?
Because all drivers in Florida are required to carry PIP coverage, accident victims are typically covered by their own PIP insurance policy. In an accident, your PIP insurance policy usually covers you and:
- Family members living in the same household,
- Passengers, and
- Someone else driving your vehicle with permission
Other people in your vehicle who were injured can be covered by your policy if they do not own a vehicle and have their own PIP coverage. If you are injured as a pedestrian or bicyclist, your PIP insurance covers you, even though you were not driving.
What If PIP Coverage Isn’t Enough To Cover My Losses?
The standard PIP coverage may not always be sufficient, especially in the case of more serious injuries that require expensive medical attention. It’s easy to exceed the $10,000 limit considering the average hospital stay is $2,826 per day and an ambulance ride can cost $500 to $1,000.
Fortunately, there are various exceptions to Florida’s “no-fault” system that can allow you to file a claim for compensation. For example, if your losses exceed your policy limits or if you’ve sustained a “serious injury” as laid out by state law, you may be able to take legal action against the other driver.
In this type of claim, you can get much more money than what PIP can offer you. Set up a free case review with an attorney after a crash to learn about your rights and options.
Contact a Personal Injury lawyer at Norden Leacox Accident & Injury Law Today
For more information, please contact Norden Leacox Accident & Injury Law to schedule a free consultation. We have five convenient locations in Florida, including Orlando, Palm Bay, Melbourne, Cocoa, and Titusville.
Orlando, FL Office
964 Lake Baldwin Ln Ste. 200, Orlando, FL 32814, United States
407-801-3000
Palm Bay, FL Office
4620 Lipscomb Street N.E Suite #3K, Palm Bay, FL 32905, United States
321-677-5964
Melbourne, FL Office
1600 W Eau Gallie Blvd #205j, Melbourne, FL 32935, United States
321-450-7134
Cocoa, FL Office
717 S Cocoa Blvd STE 203, Cocoa, FL 32922, United States
321-449-8042
Titusville, FL Office
4527 S Hopkins Ave Suite B, Titusville, FL 32780, United States
407-801-3000