Florida is one of the ten states that offer personal injury protection (no-fault) insurance policies for automobiles. Rather than establishing fault through the court system, injured drivers could receive immediate medical coverage of up to $10,000. The goal was to limit the amount of money spent on the court system and reduce the payment delay for injured drivers. Every owner of a motor vehicle registered in Florida is required to purchase personal injury protection insurance. An individual covered by PIP is responsible for their own injuries in an accident regardless of who is at fault.
There hasn’t been much of a change in the number of drivers in auto accidents, but that hasn’t stopped the amount of PIP claims and PIP payments from skyrocketing. Florida has several cities that report the highest number of questionable claims, according to the National Insurance Crime Bureau. Nearly 50 percent of Florida’s insurance fraud referrals are related to PIP premiums, which represent roughly two percent of the state’s total premiums.
In 2021, lawmakers proposed repealing Florida’s no-fault insurance law. They failed in their efforts, with Governor Ron DeSantis issuing a veto for the bill that would have changed auto accident liability in Florida drastically. A driver should be aware of what the requirements are before getting behind the wheel.
What is Personal Injury Protection PIP Insurance in Florida?
Personal Injury Protection (PIP) covers injuries sustained in an accident. As part of the legislation establishing PIP, the goal was to provide medical coverage to injured drivers. Accident victims have immediate access to these funds. As a result, accident victims do not have to go through the legal system to establish fault, which can potentially take a long time to accomplish. They can receive funds to cover their medical expenses without having to go through that process. Regardless of fault, personal injury protection covers insured individuals. Children, household members, and certain passengers are also covered by personal injury protection. Passengers in an accident-involved vehicle can rely on their own personal injury protection for coverage.
In Florida, prior to mandating personal injury protection (PIP), injured drivers faced significant delays in obtaining funds to cover their medical expenses. As a result of personal injury protection, injured motorists no longer have to wait long periods of time to recover medical costs and other costs following a road traffic accident. Due to no-fault insurance, injured parties are typically able to recover their medical expenses and costs regardless of who is at fault for the accident. As long as the driver of the car who caused the accident holds the necessary level of PIP insurance coverage, they should also be entitled to compensation for their medical expenses.
What is Covered by PIP Insurance in Florida?
According to Florida PIP, medical costs, lost wages, and death benefits are covered.
Medical Costs
In general, PIP will cover the majority of medical costs. The personal injury protection (PIP) coverage in other states generally covers anyone living in your household, but in Florida, you have the choice of whether you want your PIP to cover only yourself or other family members as well. PIP claims can be made for the following:
- The provision of medical services and medication
- The cost of surgical services and hospitalization
- Costs of rehabilitation
- Diagnostic services
- Emergency medical services such as the ambulance
Unlike other states, Florida only covers 80% of your medical expenses through PIP insurance. For example, if you have an injury that costs $10,000, PIP will only pay for $8,000 of that. You will also only be entitled to $2,500 if your injury is not considered an emergency. Your health insurance policy might cover the rest, but you should make sure it covers injuries sustained in a car accident. If benefits are not paid within 30 days of notice, they are overdue. The insurance company must provide an itemized explanation of benefits if benefits are denied or only partially paid.
Other Limitations of Personal Injury Protection in Florida
Despite its many benefits, PIP is also considered to have limitations. The following are some limitations of no-fault laws and personal injury protection:
Harder to Sue for Non-Medical Injuries
Florida’s no-fault law severely restricts a victim’s right to sue the other driver for non-medical injuries. As a result of the no-fault law, it became much harder to sue the driver who caused the accident for emotional and mental distress. The consequence of this is the reduction in the amount of compensation available for non-physical conditions, such as stress, anxiety, pain, and suffering following a road traffic accident.
Massage Therapy & Acupuncture Not Covered by PIP
Treatments that were previously covered by personal injury protection now cannot be claimed by injured parties. Due to changes to the law in 2012, massage therapy and acupuncture are no longer covered by personal injury protection insurance, so the costs associated with these treatments can no longer be claimed back by injured drivers.
No-Fault Accident Fraud
It is possible for drivers to exploit the no-fault legislation by making fraudulent claims. From staged accidents to unethical medical providers assisting with claims for treatment that was never delivered, fraudulent claims take many forms. In recent years, no-fault accident fraud has caused a significant number of questionable claims to be filed by drivers.
Difficult to Make a Successful Insurance Claim
It can be difficult to make a successful claim on your PIP insurance, as any oversight in your paperwork could result in your claim being rejected. In order to improve their chances of making a successful claim and receiving reimbursement for their medical bills, many injured drivers retain an attorney to assist them with the process and ensure they receive the compensation that they are entitled to.
Increased Waiting Times for Claim Decisions
Even though the no-fault system is designed to provide compensation for medical costs quickly, there can be situations when your claim is delayed. In the event that your claim is found to be fraudulent, you will have to wait longer for a decision regarding your compensation. It will take the insurance company some time to investigate your claim before it can decide whether to compensate you. It can lead to a stressful wait and increased worry for injured parties making legitimate claims.
What You Should Do After a Car Accident in Riverview?
- If you have not already reported the car accident to the police, you should do so right away.
- You should identify any witnesses and gather their names, addresses, and telephone numbers. Take photos or videos from as many angles as possible of the scene and the vehicles. You can assist your personal injury lawyer in maximizing your compensation by taking photographs of the damage to your vehicle.
- When describing how the accident happened, be clear and accurate. You should also tell your doctor how the accident occurred in a complete, honest, and truthful manner. Make sure you mention any problems you are experiencing as a result of the accident. You should also let your doctor know about any prior similar injuries you may have suffered.
- In Florida, you have a duty to cooperate with your insurance company. However, there is no obligation on your part to cooperate or provide a recorded statement to the insurance company of the driver who caused the accident.
- Photograph your injuries if you have suffered lacerations, burns, or bruising. Including any bandages or braces that were applied. Once your injuries have healed, such photographs will be invaluable in establishing the extent of your injuries.
- Make a list of all the automobile insurance policies in your household. To determine the full extent of your insurance coverage, you should consult an experienced car accident lawyer.
When and How to File a PIP Insurance Claim in Florida?
The rules for filing a PIP claim in Florida are rather strict. To be eligible for PIP reimbursement, treatment for any injuries must take place within two weeks of the accident. Claims submitted after two weeks will not be accepted. In Riverview, there is a high incidence of insurance fraud, so your insurer has up to sixty days to investigate any false information you provide, but must pay your damages within thirty days even if there is suspicion. According to Florida law, the statute of limitations for typical car accidents caused by driver negligence is four years from the date of the accident. If you file a lawsuit against another driver or vehicle owner, you must do so within four years of the accident. Failure to do so may forever bar your claim. Consult an accident attorney regarding the specific facts of your case, as this is a complicated area of the law.
If your case is complex or your insurer is being difficult, you may want to hire a personal injury lawyer to ensure you get your settlement. Meanwhile, you should keep track of all medical expenses incurred after the accident. To receive work loss benefits, you will need to submit a “Wage and Salary” verification that needs to be completed by your employer. This document shows how much you earned during the thirteen weeks prior to the accident. You may need a lawyer to make sure your employer completes the verification in a timely manner. Additionally, you may need a note from your doctor explaining the details of how you became disabled.
Our Personal Injury Lawyers Are Experts When It Comes to PIP Claims
Our experienced personal injury attorneys in Riverview can help you if you have been injured in a car accident. With our experience handling PIP claims, our attorneys can assist you in getting fair compensation. Contact Calandro Law today for your free legal consultation about your injuries and PIP claim.
