If you’ve been involved in a car accident, you generally need to use your PIP coverage for medical bills, disability benefits, or death benefits.
What Expenses Does PIP Insurance Pay For?
PIP plans must cover a minimum of certain expenses by law. The plan must cover these expenses regardless of who was at fault for an accident.
At least $10,000 of medical bills and disability benefits must be covered under a PIP plan.
This covers many types of medical expenses, such as:
- Dental services
- Ambulance services
- Nursing services
- Rehabilitative services, including prosthetic devices
PIP plans must cover 80% of these medical costs up to the policy limit. These expenses must be reasonable and medically necessary.
Disability benefits must cover 60% of the following expenses, up to the policy limit:
- Lost wages or loss of income
- Loss of earning capacity
- Reasonable expenses for obtaining ordinary and necessary services for household duties (childcare, housekeeping, etc.)
These expenses must be directly caused by your injuries. For example, if you normally hire a housekeeper once a month, this wouldn’t be covered by a PIP plan. However, if you now need a housekeeper every week because of your injuries, this may be covered.
The minimum death benefit amount is $5,000 per individual. The benefit is paid to the deceased person’s estate or their surviving relatives.
Which Accidents Does PIP Cover?
PIP coverage is paid no matter who is at fault for an accident. The benefits may cover you, your passengers, and your relatives residing in the same household. PIP may also cover injuries from an accident that takes place while you are riding a bicycling or walking as a pedestrian.
There are some limited cases where PIP coverage may not apply to an accident. PIP may not cover you if you intentionally caused an accident or were injured while committing a felony.
What Isn’t Covered by PIP?
A lot of your expenses from an accident may not be covered by PIP. The minimum policy limit of $10,000 is quite low. You can easily exceed your limits with a single trip to a hospital for serious injuries. Any expenses that exceed the policy limits won’t be covered.
Non-economic losses are also not covered by PIP.
This can include any of the following damages:
- Pain and suffering
- Mental anguish
You can only seek a financial recovery for these damages in certain cases.
Florida statutes only permit a recovery if the injured person suffers from one of the following conditions due to the accident:
- Significant and important loss of an important bodily function
- Permanent injury other than scarring or disfigurement
- Significant and permanent scarring or disfigurement
Property damage–such as damage to your vehicle or other personal property–is also not covered by PIP. This can include damage to your vehicle or other personal property.
If your damages exceed your PIP policy limits, you’ll need to figure out how to seek compensation for your injuries. A Florida personal injury lawyer can help you with this process.
How to Seek Damages for Items Not Covered by PIP
Florida’s car accident laws are fairly complicated. You may need to deal with filing multiple claims with different insurance companies if you have a serious accident.
Your PIP plan is required to provide primary coverage, which means this plan has to pay all covered expenses first before any other insurance coverage will apply. After you exhaust your PIP benefits, you may need to file a claim under the at-fault driver’s liability policy.
For example, say you are injured in a car accident and the other driver is at fault. You’d first use your PIP plan, which will cover 80% of medical bills and 60% of disability benefits up to the policy limit of $10,000.
Next, you’d file a claim under the other driver’s liability policy.
You’d do this to seek compensation for any expenses that aren’t covered by PIP, such as:
- Medical bills exceeding the PIP policy limit
- Disability or death benefits exceeding the PIP policy limit
- Property damage (not covered by PIP)
Your damages may exceed the limits of the at-fault driver’s insurance policy. In this case, you could also pursue a claim under your own uninsured motorist policy, if you have one.
As you can see, Florida car accident laws are complex. You may have a hard time figuring out which claims to file and how to get your expenses covered.
Contact a Miami car accident lawyer – most offer free case evaluations. Find out what your legal rights are and get help seeking compensation for your injuries.