In Florida, every automobile owner is required to carry auto insurance which includes Personal Injury Protection (PIP) coverage. PIP covers up to 80% of all necessary and reasonable medical expenses up to $10,000 resulting from a covered injury, regardless of who caused the crash. If a person’s injuries result in a loss in wages, PIP can cover up to 60% of these lost wages, up to $10,000. PIP also provides death benefits of $5,000 to surviving family members for each person killed due to an accident.
PIP covers insurance to the named insured person, relatives living in the same household, anyone operating the insured vehicle with the owner’s permission, passengers in the insured vehicle, and anyone struck and injured by the insured vehicle while not an occupant of another vehicle.
There are requirements to receive this coverage, however. In order to qualify for PIP coverage, you must be examined by an approved medical provider within 14 days of the accident. If you delay, you will not be eligible for PIP benefits. You must also contact your insurance company within the timeframe that is required by your insurance policy, or they will have grounds to deny your claim.
You are also required to cover a minimum of $10,000 in Property Damage Liability (PDL) in order to be eligible for PIP claims. PDL covers property damage to someone else’s car or property caused by you or someone else driving your insured vehicle.
Interpreting the statute
Florida Statute 627.736 regarding “Required personal injury protection benefits; exclusions; priority; claims” defines the limitations of what kinds of medical expenses are covered and what constitutes coverage for disability. The language of the law is obscure, however, and could be open to interpretation in a legal dispute. For instance, the disability benefits section states:
Sixty percent of any loss of gross income and loss of earning capacity per individual from inability to work proximately caused by the injury sustained by the injured person, plus all expenses reasonably incurred in obtaining from others 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.
Your insurance company may quibble with the definition of “loss of earning capacity” or may deny that it is caused by the injuries from the accident. The insurance company may also argue that the services you incurred because of your injury were not necessary (for instance, if you were unable to mow your lawn and you needed to hire a service). This is one reason why you should consult an experienced attorney who can advocate for you and help you receive maximum compensation for your claim.
PIP options
When you purchase an auto insurance policy in Florida, you are given various PIP options. These options could include paying a deductible before PIP begins to pay (which could decrease the cost of your insurance). You may also choose PIP that offers more than $10,000 coverage, which is the legal minimum. These options are called “extended PIP” or “added PIP” and are slightly different in coverage.
Furthermore, you can purchase Medical Payments Coverage (MEDPAY), which will cover the remaining 20% of medical bills that aren’t covered by PIP. This may not be necessary if you have health insurance, but if you have high healthcare deductibles, you may still have to make significant payments to cover the remaining expenses, so extended coverage or MEDPAY may be a good option.
When you may need a lawyer
Unfortunately, it is not uncommon for a person who has incurred significant medical bills to find that he or she cannot pay the balance after PIP and/or health insurance has been maxed out. Medical providers could send your bill to a collections agency, which could make your life even more difficult after all you’ve been through. Not only does this cause significant stress, it can destroy your credit rating.
Even if you maximize your PIP and health insurance coverage, they are limited, and neither considers pain and suffering, future lost earnings, and ongoing disabilities. They do not cover mental health injury, necessary changes to your home or accommodations after an injury, or loss of companionship.
Making a PIP claim can be difficult enough. Dealing with the aftermath and getting fair compensation for your injuries is even more challenging, especially when you have experienced significant injury.
You don’t have to walk alone. As a Florida personal injury lawyer, I am committed to helping Florida residents throughout the state receive just and fair compensation to help them cope with the injuries they have sustained due to someone else’s negligence. Contact me from anywhere in Florida at (954) 448-7288, any time 24/7, for a free consultation to see how I can help you.