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What is Personal Injury Protection in Florida?

on  Car Accidents

Personal Injury Protection (PIP) is a critical component of auto insurance policies in Florida. Commonly known as “no-fault” coverage, PIP is designed to provide immediate financial support for medical expenses and other losses, irrespective of who caused the accident. This coverage is especially important in Florida due to the state’s unique auto insurance laws.

In Florida, PIP ensures that individuals can access medical care and cover lost wages quickly after a car accident without establishing fault. This allows accident victims to recover money for medical bills and lost wages quickly and reduces the number of lawsuits filed. However, car accident victims must understand how to use their benefits and what isn’t covered by PIP after a crash. 

Understanding Personal Injury Protection Insurance in Florida

Personal Injury Protection (PIP) is unique and only available in no-fault states like Florida. It differs from other car insurance types because you don’t need to establish fault to collect money. However, unlike personal injury lawsuits, PIP doesn’t cover everything. 

PIP is designed to provide immediate financial assistance for medical expenses, lost wages, and even death benefits in the event of a car accident, regardless of who is at fault. In at-fault states, car accident victims only collect compensation when the policyholder is at fault for causing injury or damage to property. 

The coverage under PIP covers a significant portion of medical costs resulting from a car accident (typically 80%). This can include expenses for hospitalization, surgical procedures, and rehabilitation services, and in some cases, even extends to dental and optometry costs. 

In addition to medical expenses, PIP provides compensation for lost wages, addressing the financial gap caused by an inability to work due to accident-related injuries. Furthermore, in the unfortunate event of a death resulting from an accident, PIP offers a death benefit, which provides financial support to the deceased’s family, helping to mitigate the sudden financial strain. 

PIP’s no-fault feature is what sets it apart from other types of car insurance. Unlike liability coverage, which is contingent on establishing who is at fault in an accident, PIP ensures that the policyholder receives immediate coverage for their own injuries or losses, independent of fault. This characteristic accelerates the compensation process and simplifies it, as it eliminates the often lengthy and complicated procedure of determining fault before any claims can be settled.

Is PIP Insurance Required in Florida?

Yes! In Florida, Personal Injury Protection (PIP) coverage is not just an option – it’s a legal requirement for all drivers. Florida law requires every driver to carry a minimum PIP coverage amount. Typically, this amount is set at $10,000. This coverage is essential for registering and maintaining a vehicle’s legal status on Florida roads. Failing to carry this minimum PIP coverage can result in severe legal consequences, including fines and suspension of driving privileges.

What Does PIP Cover?

In Florida, PIP insurance offers policyholders up to $10,000 in coverage. This amount can assist in paying for various expenses such as prescription costs, surgical procedures, and ambulance services. Additionally, it can compensate for lost income, expenses for home care, pet care, or even funeral costs in the event of a fatality. 

PIP typically covers 80% of medical expenses and 60% of lost wages. For example, if you have medical bills totaling $10,000, your PIP insurance would contribute $8,000 towards these costs. The remaining $2,000 is considered your copay. 

It’s important to note that even if your total damages do not exceed $10,000, you still have the option to pursue the at-fault driver for any expenses that exceed your PIP coverage. This allows you to seek further compensation from the responsible party for additional costs incurred.

For some car accident cases, $10,000 in PIP coverage is sufficient to cover their medical expenses and a few missed weeks of work. However, for more serious collisions, PIP limits will get exhausted quickly. When this happens, injured accident victims may be able to file a personal injury lawsuit against the at-fault driver to collect further compensation.

If someone you love dies in a car accident, their PIP policy will also cover up to $5,000 of funeral and burial costs. 

What Isn’t Covered by PIP?

While PIP provides broad coverage, it’s important to note that there are limitations and exclusions. For instance, PIP only covers a percentage of medical bills and lost wages up to the policy’s limit, typically $10,000. Expenses exceeding this cap might need to be covered by other insurance policies (such as health insurance) or out-of-pocket payments. Certain injuries or circumstances may also be excluded from PIP coverage, so policyholders must understand the specifics of their policy.

Here are some key situations not covered by PIP:

  • Injuries Sustained Outside of a Vehicle: PIP is designed for auto accidents. Therefore, injuries outside of a vehicular context, such as pedestrian or bicycle accidents not involving a vehicle, are typically not covered.
  • Damages Exceeding Policy Limits: PIP has a coverage limit, commonly $10,000, in Florida. PIP will not cover costs exceeding this amount and must be addressed through other insurance policies or personal funds.
  • Intentional Acts: Injuries resulting from intentional acts, such as self-inflicted harm or actions intended to cause injury to oneself or others, are not covered under PIP.
  • Injuries While Committing a Felony: If injuries are sustained while committing a felony, PIP coverage does not apply. This exclusion underscores the legal and ethical framework within which PIP operates.
  • Injuries Sustained Under the Influence: Injuries sustained while the policyholder is under the influence of drugs or alcohol may not be covered by PIP.
  • Work-Related Auto Accidents: PIP may not cover accidents during employment for those who use their vehicles for commercial purposes, such as truck drivers. These situations are often covered under workers’ compensation insurance.

Steps to Filing a PIP Claim

Florida has strict laws and timelines in place for filing a PIP claim. You must adhere to these timelines to file a successful PIP claim.  If you want to file a PIP claim, take the following steps after a car accident: 

Step One: Seek Immediate Medical Attention

The first step after a car accident is to seek medical care. This is crucial for two reasons: ensuring your health and well-being and establishing a medical record of your injuries. These records serve as vital evidence for your PIP claim. 

It is also a rule in Florida if you want to file a PIP claim. One of the most critical aspects of filing a PIP claim in Florida is adhering to the 14-day rule. You must receive medical care within 14 days of the accident to qualify for PIP benefits. This rule is a statutory requirement, and failure to comply can result in your PIP claim getting denied.

Step Two: Notify the Insurance Company

As soon as possible, and ideally within a few days of the accident, inform your insurance provider about the incident. Provide a detailed account of the accident, including the time, location, and how it occurred. This notification is the formal start of your PIP claim process.

When you notify your insurance company, they’ll provide you with a claim form. Fill out this form with accurate and complete information regarding the accident and your injuries. This form will help the insurance company assess and process your claim.

Be prepared to provide additional information if your insurance company conducts an investigation into your claim. This may include giving a recorded statement about the accident, presenting additional medical records, or providing proof of lost wages.

Step Three: Document Medical Treatment

Submit all relevant medical records and bills to your insurance company. Medical records are concrete evidence of your injuries and the treatments you received. These records typically include doctor’s notes, diagnostic test results (like X-rays or MRIs), treatment plans, and hospital admission records. They paint a clear picture of the severity and scope of your injuries, which helps your insurance company understand the extent of your claim.

Alongside medical records, submitting detailed bills is necessary. These bills should itemize every aspect of your treatment, from consultation fees and diagnostic tests to medical procedures and medication costs. These bills help the insurance company determine the financial aspect of your claim, ensuring that you are reimbursed accurately for the expenses incurred due to the accident.

How Do Florida’s No-Fault Laws Affect Personal Injury Lawsuits?

In Florida’s no-fault system, PIP claims are processed without determining which party was at fault in the accident. This significantly streamlines the claims process and can make it easier for injured accident victims to collect money quickly. 

But what happens when you exhaust your PIP benefits and still have expenses from the accident? Can you file a personal injury lawsuit? Yes, you can.  Florida’s personal injury protection laws do not prohibit an individual from filing a lawsuit. 

However, a person who received personal injury protection benefits may only be entitled to recover damages for economic damages such as medical expenses and lost wages if they cannot prove that they suffered permanent injury or death. Non-economic damages such as pain and suffering and mental anguish may only be awarded by the court when permanent injury or death is proven. 

PIP Benefits Aren’t as Comprehensive as a Personal Injury Lawsuit

PIP coverage primarily covers economic losses, such as medical expenses and lost wages. However, it does not address non-economic damages like pain and suffering, emotional distress, loss of enjoyment of life, or loss of consortium. A personal injury lawsuit allows the victim to seek compensation for an accident’s intangible yet significant impacts. 

PIP also has a limit, typically $10,000 in Florida, which can be quickly exhausted by medical bills and lost wages, especially in serious accidents. A personal injury lawsuit does not have this predefined cap and can result in higher compensation, particularly in cases involving severe or long-term injuries.

While PIP only covers a portion of medical expenses (often 80%), a personal injury lawsuit can seek full reimbursement for all medical treatments related to the accident, including long-term care and rehabilitation costs.

Lastly, in cases of permanent injuries or disabilities, a personal injury lawsuit can seek compensation for future medical expenses, loss of earning capacity, and ongoing care costs. This is crucial for injuries that have a lasting impact on the victim’s life and financial stability.

If I Have a Personal Injury Protection Policy, Do I Need a Lawyer?

Hiring a Florida car accident lawyer can be beneficial even if you have Personal Injury Protection (PIP) coverage. Even in minor car accidents, filing a PIP claim can be challenging. A lawyer can help ensure that all necessary documentation is properly submitted and can deal with the insurance company on your behalf, ensuring you receive all the benefits you are entitled to under your policy.

If your insurance company disputes your claim or offers a settlement that does not fully cover your losses, you need a lawyer to negotiate with the insurer. They can advocate for your rights and seek fair compensation.

If your injuries are severe and your medical expenses exceed the limits of your PIP coverage, a car accident attorney can help you explore other avenues for compensation. This may include filing a lawsuit against the at-fault party to recover additional damages. To do this, they’ll need to investigate the accident and determine who is to blame for your accident and injuries. They’ll gather evidence, speak to eyewitnesses, and build a solid case to help you collect all the money you need to recover after a car accident. 

Contact Our Experienced Florida Car Accident Lawyers Today

If you’ve been involved in a significant car accident, call Prosper Shaked Accident Injury Attorneys, PA. While your insurance company or the other driver involved might suggest filing a claim through insurance or accepting a settlement offer, initiating a lawsuit could be more advantageous for securing the full compensation you deserve. 

For a comprehensive, no-cost legal consultation regarding your accident case, consider reaching out to personal injury lawyer Prosper Shaked Accident Injury Attorneys PA at (305) 694-2676.