Understanding PIP in Florida

April 17, 2024 | Jarrett Blakeley
Understanding PIP in Florida
Notebook labeled "Personal Injury Protection" with two wooden figurines representing insured individuals.

In Florida, Personal Injury Protection (PIP) coverage is a crucial aspect of car insurance that every driver needs to understand. PIP coverage provides benefits for medical expenses and lost income in the event of an accident, regardless of who is at fault.

However, understanding how PIP coverage works in Florida can be challenging. That's why you should never wait to consult a Florida car accident attorney who can help navigate the intricacies of PIP and ensure you receive the compensation you deserve. If you or a loved one has been involved in a car accident in Florida, contact an experienced car accident attorney for a free consultation. They can assist you in protecting your rights and obtaining the compensation you need.

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The Basics of PIP Coverage

Florida is one of only twelve states that strictly hold drivers to PIP coverage. Another seven states offer elective PIP coverage. Florida has had Personal Injury Protection coverage requirements since 1979.

PIP coverage is a no-fault insurance system that legally requires all drivers in Florida to carry a minimum of $10,000 in coverage. Unlike traditional liability insurance, PIP coverage provides benefits regardless of who caused the accident. It means that even if you were at fault, you can still receive benefits under your PIP policy.

The primary purpose of PIP coverage is to provide immediate medical and income loss benefits after an accident. It is particularly important in Florida, where there is a large number of uninsured drivers. PIP coverage ensures that accident victims can receive essential medical treatment without having to rely solely on the other party's insurance.

The Benefits of PIP Coverage

Medical Expenses

Under PIP coverage, you are entitled to have your reasonable and necessary medical expenses covered up to the policy limit. It can include ambulance rides, hospital bills, doctor visits, specialist consultations, diagnostic tests, and even rehabilitation services. PIP coverage only pays a percentage of these expenses, typically 80 percent of the total amount, after deductibles and copays up to the policy limit.

Lost Income and Services

If your car accident injury causes you to miss work, PIP coverage can help compensate for your lost income. However, PIP coverage only covers a portion of your lost income, typically up to 60 percent of your average weekly earnings. It also pays for services you can't do because of an accident, like cleaning the house or caring for your children.

Death Benefits

In unfortunate cases where a car accident results in fatalities, PIP coverage provides death benefits to the deceased person's estate, survivors, or next of kin. These benefits may cover funeral expenses, medical expenses incurred prior to death, and lost income. PIP pays $5,000 for each covered individual who dies as a result of a car accident. However, Death benefits don't count toward the $10,000 PIP limit.

Some Florida insurance companies give drivers the option to adjust their PIP coverage. For instance, they can pay for "extended PIP coverage," where 100 percent of medical expenses and 80 percent of lost income and services are paid. You can also reduce your coverage by excluding the part coverage for lost income.

PIP Coverage Limitations

While PIP coverage can provide immediate benefits after a car accident, it has limitations that accident victims need to be aware of. Understanding these limitations can help ensure you are fully compensated for your injuries and other damages.

Time Limitations

One important limitation of PIP coverage in Florida is the time limit for seeking medical treatment. To be eligible for PIP benefits, you must seek medical treatment within 14 days of the accident. Failure to do so may result in a denial of your PIP claim. Seek medical attention as soon as possible after a car accident to preserve your right to PIP benefits. Outside of PIP coverage, it is still important to seek timely medical care for your own health and to help substantiate any legal claim you might have from the accident.

Policy Limitations

The minimum PIP coverage required in Florida is $10,000. However, this may not be sufficient to cover all your medical expenses and lost income in the event of a severe injury. Suppose your medical bills exceed the policy limit. In that case, you will have to rely on other sources of compensation to cover the remaining expenses. That's why you should consider additional insurance coverage options or consult a Florida car accident attorney to explore your legal options for additional compensation.

Non-Medical Expenses

An important fact is that PIP coverage in Florida does not cover non-medical expenses such as property damage or pain and suffering. If you want to seek compensation for these damages, you may need to file a separate claim against the at-fault party's insurance or consider pursuing a personal injury lawsuit.

Who is Covered Under Florida PIP Insurance?

Gavel, calculator, money, and heart-shaped objects symbolizing the costs and emotions in personal injury cases.

PIP covers the insured and the following individuals (unless they have their own PIP insurance policy):

  • Relatives living with the insured
  • Passengers in the insured's vehicle
  • Pedestrians the insured hits
  • Anyone driving the insured's vehicle with their permission

PIP insurance may also cover you and family members living with you when:

  • You drive another individual's vehicle with their permission
  • You are riding in another party's vehicle
  • You suffered an injury as a pedestrian in a car accident

Is PIP Insurance All You Need to Drive in Florida?

PIP insurance is just one of two requirements you must meet before registering a vehicle in this state. The other is property damage liability insurance, which pays for damage to other people's property you might cause in an accident. Drivers must carry a minimum of $10,000 in property damage liability insurance on top of PIP coverage.

PIP Insurance vs. Health Insurance

Both PIP and typical health insurance may pay for many of the exact medical car accident expenses. However, remember that health insurance probably won't cover other losses such as lost income, services you can no longer perform(such as grocery shopping, house cleaning, or cooking), and death benefits. As such, PIP insurance is somewhat more flexible than most health insurance policies.

PIP insurance can also benefit those with a high-deductible health plan, as $1,000 is the most you'll pay for a PIP insurance deductible in Florida. If you reach the $10,000 PIP limit, your health insurance can help cover any additional medical expenses beyond that amount.

Why You Need a Florida Car Accident Attorney

Understanding the ins and outs of PIP coverage and ensuring you receive the full compensation you deserve can be challenging. That's where a Florida car accident attorney can help. By consulting with an experienced attorney, you can:

Understand Your Rights and Options

A skilled attorney can explain the intricacies of PIP coverage and help you understand your rights and options. They can review your case, assess the extent of your injuries and damages, and advise you on the best course of action to pursue maximum compensation.

Gather Evidence

Building a solid case requires gathering evidence to support your claim. An attorney can help collect medical records, police reports, witness statements, and other crucial evidence to strengthen your case and increase your chances of receiving fair compensation.

Negotiate with Insurance Companies

Dealing with insurance companies can be intimidating, especially when they try to undervalue or deny your claim. An attorney can negotiate on your behalf, ensuring the insurance company considers all your damages and pays you a fair settlement.

Litigation Support

If negotiations fail to result in a fair resolution, your attorney can provide litigation support and take your case to court if necessary. They will fight for your rights and advocate for your best interests, presenting a compelling case to the judge and jury.

PIP Insurance and At-fault Accidents

If you are involved in a car accident in Florida and you are found to be at fault, your PIP insurance will still provide coverage for your medical expenses and lost income. However, in this scenario, you may also be liable for damages caused to the other party involved in the accident. PIP coverage does not extend to cover these additional damages, which is why you need to have additional liability coverage on your insurance policy.

Common Misunderstandings About PIP Insurance

There are several common misunderstandings about PIP insurance in Florida. One of the biggest misconceptions is that PIP insurance will cover all medical expenses and lost income in the event of a car accident. However, PIP coverage is subject to limits, and you must understand the specifics of your policy. Another misunderstanding is that PIP insurance is only applicable to car accidents. In fact, PIP coverage also extends to pedestrian and bicycle accidents and accidents involving other motorized vehicles.

How to File a PIP Insurance Claim in Florida

The process is relatively straightforward if you suffered an injury in a car accident in Florida and wish to make a PIP insurance claim. First, you should seek immediate medical attention for your injuries. Then, you should notify your insurance company as soon as possible and provide them with the necessary details of the accident and your injuries. Your insurance company will guide you through the claim process, including any required documentation and deadlines. You should also consult an attorney who handles car accident cases to ensure you receive fair compensation for your injuries.

Understanding PIP insurance in Florida is crucial for car accident victims and their families. By clearly understanding how PIP insurance works, what it covers, and how to file a claim, you can confidently navigate the aftermath of a car accident and ensure that you receive the proper medical care and financial support you need. If you have suffered an injury in a car accident in Florida, seek legal assistance to protect your rights and maximize your chances of receiving fair compensation.

What Is an Emergency Medical Condition?

Doctor examining a patient's injured elbow, assessing mobility and pain in a clinical setting.

To receive full PIP benefits, your doctor must determine that you have an emergency medical condition (EMC). An EMC is legally defined as "A medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain or other acute symptoms, such that the absence of immediate medical attention can reasonably be expected to result in any of the following:

  • Serious jeopardy to the health of a patient, including a pregnant woman or a fetus.
  • Serious impairment to bodily functions.
  • Serious dysfunction of any bodily organ or part."

In essence, EMC is a medical condition that puts you in serious danger if you don't receive medical attention immediately.

Get a Fair Settlement in Your Car Accident Injury Case

PIP coverage can help to cover some of your expenses after an accident. Unfortunately, with today's medical system, $10,000 isn't enough to cover medical costs. You can get a liability settlement if you exhaust your PIP benefits and need extra coverage. If your PIP benefits aren't covering your expenses and someone else is responsible for your injuries, you can be entitled to additional injury compensation. An experienced car accident attorney can stand up to the insurance companies and ensure you get the money you deserve. It is especially important if your injuries are severe or will impact your life permanently or for some time to come.

Meet with a Florida Car Accident Attorney Today

The PIP system in Florida is intended to make the claim process easier, but it can complicate matters for car accident victims. They often find they have insufficient compensation for their losses from their PIP coverage, especially without legal help.

If you or a loved one has suffered an injury in a car accident in Florida, you need to understand the limitations of PIP coverage and explore your legal options for additional compensation. Contact a skilled personal injury attorney for a free consultation. They are dedicated to helping Florida car accident victims and their families manage car accident claims and obtain the compensation they deserve. Don't face the aftermath of a car accident alone - let a qualified car accident attorney fight for your rights and protect your future.

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Jarrett Blakeley

Firm founder Jarrett Blakeley fights to get maximum compensation for all of Blakeley Law Firm’s clients. He has been practicing law since 2006 and takes great pride in representing the rights of injured individuals against the insurance companies and the law firms that represent them. He has successfully represented thousands of clients and recovered tens of millions of dollars on their behalf. Mr. Blakeley strives to give all of his clients personal attention and maximum effort and seeks to instill a firm culture that prioritizes customer service and compassion for the injured over all else. Fighting for the injured is Jarrett Blakeley’s greatest passion and he looks forward to fighting for the injured for the rest of his career.

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