Florida PIP Coverage Explained

Florida PIP Coverage Explained

What is Florida PIP

Florida is one of several states to enact no-fault auto insurance laws. Under Florida’s no-fault insurance laws, every vehicle owner is required to purchase Personal Injury Protection insurance, also known as PIP. PIP is used to compensate the policyholder and their passengers in the event of an auto accident, regardless of who is at fault. The minimum PIP policy allowed under Florida law is $10,000.

What PIP Covers

Florida PIP compensates for accident related medical expenses and lost wages for the policyholder or their passengers. After deductibles and up to the policy limits, PIP will pay for:

• 80% of Medical Expenses
• 60% of Lost Wages
• $5,000 in Death Benefits

What PIP Doesn’t Cover

Florida PIP policies will not pay for:

• Any Vehicle or Property Damage
• The Other Driver’s Medical Bills
• The Other Driver’s Lost Wages
• Theft of Your Vehicle

Limitations of PIP

In order to collect the full $10,000 in Florida PIP benefits, certain criteria must be met. Failure to meet these criteria results in an automatic reduction of PIP benefits to $2,500. The mandatory criteria is as follows:

14 Day Rule – The PIP claimant must have received medical treatment within 14 days of the accident. The “initial medical treatment” must have been provided by one of the following:

• Hospital Facility
• Emergency Transport
• Licensed Physician
• Licensed Chiropractor

Emergency Medical Condition – To qualify for full Florida PIP benefits, the claimant must be diagnosed with an Emergency Medical Condition, related to the auto accident. Florida statute 627.732 defines an Emergency Medical Condition as:

A medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:

• Serious jeopardy to patient health.
• Serious impairment to bodily functions.
• Serious dysfunction of any bodily organ or part.

The statute doesn’t specify that the Emergency Medical Condition must be diagnosed during the first 14 days. Despite this, insurance adjusters will often deny PIP benefits for Emergency Medical Conditions not diagnosed within the 14-day window. If you have found yourself in this situation, contact our law firm today. We’re waiting to help you.

Talk to a Florida PIP Attorney Today

If you have questions about your PIP policy or feel your PIP claim has been unjustly denied, the lawyers of Lutz, Bobo & Telfair, P.A. offer free case reviews for auto accident victims. Call 941-951-1800 to get started.