Florida PIP (Personal Injury Protection)
April 13, 2023 | Sagi Shaked | Personal Injury
Florida is one of about a dozen “no-fault states” for car insurance coverage. No-fault states require drivers to purchase Personal Injury Protection or PIP insurance. Florida requires drivers to have $10,000 in PIP coverage.
Understanding PIP insurance and claims is essential if you are involved in a car accident in Miami. Even though PIP is no-fault insurance coverage, there are rules you must follow to receive benefits. Furthermore, some victims could be entitled to additional compensation beyond no-fault insurance benefits.
Let’s review Florida PIP insurance coverage and when you have the right to pursue a claim against the driver who caused your car accident.
What Is Florida PIP Insurance?
Personal Injury Protection insurance coverage is a type of no-fault insurance for drivers. No-fault car insurance pays benefits for:
- Lost wages
- Medical bills
- Funeral expenses
- Hospital expenses
- Physical therapy
- Diagnostic services
- Ambulatory services
- Nursing services
- Expenses to cover necessary household help during recovery
The insurance coverage pays benefits regardless of how the car accident occurred. Even if you cause a car crash, you can receive benefits under your PIP insurance policy. PIP insurance is a factor in most Florida car accidents.
Important Information About PIP Insurance Explained
When and how you can receive PIP benefits is set by Florida Statute §627.736. Some of the important things you need to know about receiving PIP benefits in Florida include:
You Must Receive Medical Treatment Within 14 Days of the Accident Date
Receiving prompt medical treatment for injuries can help reduce the risk that your injuries worsen or that you develop complications from your injuries. Immediate treatment of injuries is also essential if you have a claim against the other driver.
For PIP benefits, you must receive medical treatment within 14 days after a motor vehicle accident from a healthcare professional. Ensure that the medical provider notes in your medical records that you are being treated for car accident injuries.
PIP requires that you receive medical treatment from EMS services, medical doctors, dentists, hospitals, or doctors of osteopathic medicine. Chiropractors are also usually covered by PIP benefits.
PIP Benefits Are Limited Unless You Sustain an Emergency Medical Condition (EMC)
Typically, you have up to $10,000 in PIP benefits for a covered accident. However, if you do not sustain an emergency medical condition, your benefits are limited to $2,500. An EMC would include:
- Serious impairment of a bodily function
- Significant jeopardy to a person’s health
- Severe dysfunction of any body part or organ
A medical provider should determine whether a car accident injury meets these definitions after a medical exam and diagnostic testing. The injured person might need to consult a specialist to determine the severity of the injury.
Sometimes, a doctor might not determine whether a person sustained an EMC within the first 14 days after the car crash. For example, a patient could have delayed symptoms, or a condition could progressively become worse, even with medical intervention.
Problems can arise when a doctor does not use detailed language to communicate the patient suffered an injury that meets the definition of an emergency medical condition. Doctors are encouraged to use wording from the statute to avoid confusion.
If an insurance adjuster states your injury does not meet the EMC requirements for full PIP coverage, talk with a Miami PIP claims lawyer as soon as possible. PIP laws are complex, so you should always seek an opinion from an experienced car accident lawyer in Miami.
Does PIP Cover All Medical Bills and Lost Wages?
No, Personal Injury Protection coverage does not pay you for all your medical expenses and loss of income. PIP benefits do not cover all other economic damages from a car accident.
PIP benefits are limited to 80% of your medical costs and 60% of your lost income. The benefits are up to $2,500 for non-emergency injuries and $10,000 for emergency medical conditions.
Does No-Fault Insurance Compensate a Victim for Non-Economic Damages?
Non-economic damages or “pain and suffering” damages are not covered by PIP insurance. Therefore, you cannot receive money for your emotional distress, physical agony, or mental anguish. However, you might be entitled to compensation for these damages if you sustained a serious injury and file a liability claim against the at-fault driver.
Who Does Personal Injury Protection Cover?
PIP covers the insured driver and passengers in the vehicle. However, your PIP policy covers more people. It also covers anyone driving your vehicle.
Your PIP insurance can cover your family members living in your home if you include them in your policy. Then, even if they are involved in an accident that did not involve your vehicle, they can file a claim with your PIP provider. In addition, bicyclists and pedestrians hit by your vehicle are also covered by your PIP policy.
What Is the Difference Between a PIP Claim and a Personal Injury Claim?
A PIP claim does not require you to prove fault for the cause of the accident. Your PIP insurance pays benefits regardless of who causes the accident. Furthermore, the damages and compensation you can receive are limited for a no-fault insurance claim.
However, the injured victim must prove causation and fault for a personal injury claim. You must prove how the accident occurred and that the other driver’s conduct caused the accident. Only then can you recover compensation for your damages.
You must also prove that you sustained damages and how much the damages are worth. An injured victim could receive compensation for all damages caused by the car accident. However, contributory fault could receive the amount received.
If a victim is partially to blame for causing a car accident, Florida’s modified comparative fault law reduces the amount of compensation by the percentage of fault. Therefore, if you were 25% to blame, you would only receive an amount equal to 75% of your damages. And if you were 51% or more to blame, you cannot recover compensation under Florida law.
Do I Need a Lawyer for a PIP Claim in Miami, FL?
No, you are not required to hire a Miami injury lawyer to file a PIP claim. However, seeking legal advice after a car accident can protect your best interests.
An attorney reviews your case during a free consultation and explains your legal options. Understanding your legal options can help you receive the money you deserve for a car accident claim.