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Do you know how PIP (Personal Injury Protection) works in Florida?

| Jan 13, 2020 | Uncategorized |

If you have ever been in a car accident, you probably know that you cannot always count on the other driver to carry auto insurance, let alone enough to cover all your losses. Medical costs and lost wages can add up quickly, and it is important to get a full financial recovery if you are to move on without financial difficulties.

PIP (personal injury protection) coverage is required for every driver in Florida. This type of insurance is Florida’s version of “no-fault” auto coverage. To understand this coverage and use it to your benefit if needed, you need to know how it works.

How does PIP coverage work?

Whether you lived in another state that also required PIP coverage or you are purchasing it for the first time, it can be beneficial to understand that Florida’s version has unique terms and requirements, such as the following:

  • You must seek medical treatment within 14 days of the accident in order to file a claim under your PIP coverage.
  • Your PIP insurance will only cover 80% of your qualifying medical expenses. The theory is that other insurance should cover the other 20%.
  • You could receive 60% of your lost wages and household services if your injuries disable you. However, PIP coverage is usually capped at $10,000. Also, this benefit is only available if you opted to purchase “work loss” coverage.
  • A death benefit of $5,000 is available to cover funeral and burial costs in the event of death.
  • If you suffer an injury not considered “emergent” in nature (as determined by your doctor), your insurance company may reduce your coverage to $2,500 in benefits under your PIP coverage.
  • You can choose whether you want your PIP to cover just you or other household residents as well, at the time of purchase.
  • PIP benefits cover many medical treatment options, but not all. For instance, acupuncture is not covered.

What happens if my expenses exceed PIP coverage?

In most cases, where post-accident expenses significantly exceed PIP coverage. When your losses from the accident exceed your auto coverage, you have other options. 

If you have Med-Pay coverage, it will cover medical bills up to the medical payments coverage limit. If you have health insurance, it will usually pay for your medical bills as long as the physician treating you is on your health insurance plan.

Unfortunately, many physicians are currently refusing to send bills to a patient’s health insurance company if the loss or injury is accident-related. Most policies do not offer this right to your doctor within the policy’s terms and conditions. However, if you call your doctor out for it, you will likely have a very antagonistic doctor that you may wish to have testify on your behalf. This is not necessarily the result you are looking for…  

Despite all this, or in addition to it, you still have the right to file a lawsuit against an at-fault party. Remember, that your claim for injuries caused by the negligence of another is not limited to the cost of medical care and treatment you received. You can recover for past and future wage loss, past and future medical expenses, past and future pain and suffering and any other economic loss you have suffered. You may also have a claim for loss of use of your vehicle or diminished value of your vehicle. And, your spouse may have a claim for loss of consortium. 

PIP coverage gets eaten up very quickly after an accident, and if you go to the emergency room, is quite likely that your PIP insurance coverage will be exhausted before you leave the hospital. There are times when a person will want to try to coordinate their insurance benefits. For instance, if you know you’re going to be facing a long rehabilitation and you can’t work because of your injury, you will want to try to keep your PIP insurance intact to pay for your lost wages, rather than your medical expenses, which could be covered under your health insurance coverage. 

In the aftermath of a serious accident, you don’t have to face insurance companies alone. Learn about your options from an experienced personal injury attorney.