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Florida Personal Injury Protection (PIP) Insurance

April 7, 2020

Personal Injury Protection coverage or “PIP” is mandatory insurance coverage that is required to be carried by Florida drivers pursuant to Fla. Stat. § 627.736(1), which covers the named insured (under an auto insurance policy), relatives of the insured who are residing in the same household as the insured, people driving the insured’s car and passengers in the insured’s car to a limit of $10,000.00 for any losses sustained by any of the aforementioned parties that results from bodily injuries, sickness, disease, or death arising out of the ownership, maintenance or use of the insured’s car. While the minimum amount of PIP coverage is $10,000.00, many Florida residents carry more PIP coverage than $10,000.00. This coverage applies regardless of who may be at fault for causing a particular accident. Further, because this is non-fault based coverage, an insured should not experience an increase in their insurance premium if they happen to use their PIP coverage at any time, regardless of whether such use is due to the insured causing a car accident. We always recommend that you seek the advice of a licensed car accident attorney if you have been involved in an accident.


What Type of Post-Accident Medical Costs Are Covered by PIP?


Pursuant to Fla. Stat. § 627.736(1)(a), PIP covers 80% of all reasonable expenses up to $10,000.00 (or more if a PIP policy has greater than $10,000.00 of coverage) for medically necessary medical, surgical, X-ray, dental and rehabilitative services, including prosthetic devices, and medically necessary ambulance, hospital, and nursing services that are obtained by insured parties within 14 days of any injury causing event. (Failure to obtain treatment within 14 days of an accident can result in the denial of a PIP claim as can failure to furnish any medical bills to a PIP carrier within 30 days of receipt of such bills). However, PIP medical cost benefits will be limited to $2,500.00 if an authorized healthcare provider, listed below determines that an injured person did not have an emergency medical condition, which is defined as a condition that demonstrates itself by severe acute symptoms including severe pain that in the lack of medical assistance could result in: (a) serious jeopardy to patient health, and or (b) serious impairment to bodily functions, and/or (c) serious dysfunction of any bodily organ or part. It is important to note that PIP carriers are only required to reimburse their insured for such care and services that are lawfully provided, supervised, ordered, or prescribed by a licensed doctor, licensed dentist, or licensed chiropractor or for care and services provided by a licensed hospital or ambulatory surgical center or a person or entity licensed to provide emergency transportation and treatment. Additionally, PIP covers mileage incurred to and from treatment. Treatment that is not covered by PIP coverage is treatment provided by massage therapists or acupuncture therapists. Other minutia apply in this statute as to what types of treatment are specifically covered by PIP carriers. Please review the aforementioned statute for more information. Damages in excess of your PIP coverage limits may be obtained from the driver who is at fault for causing your motor vehicle accident. Your accident lawyer should be able to assist you in determining what is eligible treatment under the Florida PIP laws.


Are Lost Wages Incurred As A Result of A Car Accident Covered By PIP?


Pursuant to Fla. Stat. § 627.736(1)(b), PIP covers 60% of any loss of gross income and loss of earning capacity per individual from any inability to work that is proximately caused by any injury sustained by any injured person, plus all expenses reasonably incurred in obtaining from other ordinary and necessary services in lieu of those that, but for the injury, the injured person would have performed without income for the benefit of his or her household. In order to receive compensation for lost wages, you must submit a wage and salary verification to your employer, which they will complete and submit to your PIP provider. You may pursue the remaining 40% of your lost wages from the at-fault party’s liability carrier. Additionally, your treating doctors may need to complete a disability form if you will be out of work for an extended period of time after an auto accident.


Does PIP Cover Any Costs Related to Fatalities Caused by Auto Accidents?


Pursuant to Fla. Stat. § 627.736(1)(c), PIP covers the lesser of $5,000.00 or the remainder of any unused PIP benefits per individual. The insurance carrier may pay such benefits to the executor or administrator of any deceased, to any of the deceased’s relatives by blood or legal adoption or connection by marriage, or to any person appearing to the insurer to be equitably entitled thereto. Damages in excess of your PIP coverage may be recovered from the driver who is at fault for causing an auto accident.


When Are PIP Payments Considered Overdue?


Pursuant to Fla. Stat. § 627.736(4)(b), PIP benefits are considered to be overdue if they are not paid within 30 days after the insurer is furnished with written notice of the fact of a covered loss and of the amount of the covered loss. However, if written notice of the entire claim is not furnished to the insurer, any partial amount supported by written notice is overdue if not paid within 30 days after written notice is furnished to the insurer. Any part or all of the remainder of the claim that is subsequently supported by written notice is overdue if not paid within 30 days after written notice is furnished to the insurer. However, more minutia applies. Please review the aforementioned statute for more information.


Get Your Case Evaluated


Pursuing PIP claims and motor vehicle accident claims in general can be a convoluted process that can be easily mishandled which can result in minimal or no recovery. We strongly encourage you to seek the advice of a licensed Florida Personal Injury Attorney if you have been injured in a car accident, motorcycle accident, boating accident, Jet Ski accident, pedestrian accident, bicycle accident, slip and fall accident, premises liability accident, bus accident or any other type of accident that is caused by another. You could potentially recover damages for medical expenses, pain and suffering, lost wages, property damage and other compensable damages and expenses. At Biazzo Law, we are prepared to negotiate a settlement for you or pursue your case through a jury verdict if warranted. Contact Biazzo Law, the best local injury lawyer today at (561) 939-6300 to schedule your free Personal Injury consultation. This blog is not to be construed as legal advice.

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