Personal Injury Protection (PIP)

Florida is a no-fault insurance state when it comes to car accidents. That means motor vehicle owners are responsible for securing their own personal injury protection (PIP) coverage that will cover damages regardless of who was to blame. The general idea is to drive down legal costs and ease congestion in the courts.

But as the Fort Lauderdale car accident attorneys at The Ansara Law Firm can explain, recovering the full among of your damages usually isn’t quite so simple.

The Basics of Florida Auto Insurance Coverage

PIP coverage, even under the best of circumstances, is only likely to cover up to $10,000 (unless you purchase extended PIP coverage). Per F.S. 627.736, PIP is available to cover medical costs and up to 60 percent of your lost wages – but that’s only if you seek treatment within 14 days and only if a medical professional has diagnosed you with an emergency medical condition requiring treatment. Absent that, you’re only entitled to $2,500.

As anyone who has made a trip to the emergency room knows, you’re lucky if $2,500 will cover that single trip, let alone any follow-up visits.

If your injuries are deemed severe and disabling, our Fort Lauderdale lawyers can help you step outside of Florida’s no-fault system to take legal action against the tortfeasor (at-fault driver). However, keep in mind that Florida law does not require drivers or vehicle owners to carry bodily injury insurance coverage. The state’s Financial Responsibility Act does require at-fault drivers whose negligence causes injuries to be financially responsible for at least $10,000 per person and $20,000 per accident. So many people go ahead and purchase bodily injury liability so they won’t be personally stuck with a $20,000 bill. Of course, there are many people who do not.

According to the Florida Insurance Council, nearly 1 in 4 Florida drivers lacks auto insurance. That means motorists must often rely on their own PIP, as well as their own uninsured/ underinsured motorist coverage. UM/ UIM coverage will fill in the gap when your damages exceed PIP limits and the other driver either lacks insurance or fled the scene or doesn’t have enough insurance to cover your damages.

Who – and What – Does PIP Cover, Exactly?

Not all states require personal injury protection, but all registered vehicles in Florida must have it. That means even if you live out-of-state part of the year, if your vehicle is registered in Florida, you must have PIP.

The exact details of Florida PIP coverage are outlined in F.S. 627.736, and our attorneys can explain them to you further.

All PIP policies will cover the named insured, as well as any resident family members of that insured. Resident relatives do not need to be listed as drivers in order for the coverage to apply.

All cars owned by the insured and listed in the policy and not used for commercial purposes are covered under PIP. If you are in a crash but are not in your vehicle (i.e., you are a passenger in someone else’s car or you are a pedestrian), you could be eligible to collect the driver’s PIP benefits or your own, depending on the circumstances.

Personal injury protection benefits will offer:

  • Up to $5,000 in death benefits;
  • Up to $10,00 in medical expenses (80 percent of what is deemed “reasonable,” generally including ambulance and hospital, x-rays, dental, surgery, etc.) and lost wages (up to 60 percent). The total payable for any one crash will be the policy limit.

Keep in mind: Some PIP policies have deductibles, though Florida law does not allow deductibles of more than $1,000 for PIP. You can still collect PIP benefits even if you have health insurance.

A few years ago, lawmakers with the stated purpose of driving down insurance premiums raised the criteria for collecting more than $2,500 in PIP benefits. (Of course, there was no requirement in the law to lower premiums, and most insurance companies did not.) Nonetheless, to collect on that full $10,000 limit, you MUST:

  • Seek medical treatment within 14 days of the crash;
  • Be diagnosed with an emergency medical condition by a licensed medical doctor, dentist or physician’s assistant;
  • Obtain care from an approved provider (i.e. no massage therapy, acupuncture, etc.).
  • The law does allow insurers to stipulate certain exclusions, including:
  • Injuries to insured/ resident relative in a vehicle owned by insured but not covered under the policy;
  • To any person operating the vehicle without express or implied consent of insured;
  • To anyone who injured themselves intentionally;
  • To anyone who was injured in a car accident while committing a felony.

It should be noted that any ambiguous language in the insurance policy will automatically be construed in favor of the insured/ injured person.

In cases where more than one PIP policy is applicable, you will still only be eligible for the policy maximum, with each company responsible for their pro-rata share.

Extended PIP Coverage

Given that the current limits of PIP coverage are generally not sufficient to cover injuries following a serious accident, drivers are encouraged to obtain not just UM/UIM coverage, but also extended PIP (also sometimes referred to as “additional PIP).

For an additional premium, vehicle owners can opt to increase the total payable under PIP. They may also choose to increase the percentages payable (i.e., more than 80 percent of medical expenses and 60 percent of lost wages). Usually, that means covering 100 percent of medical expenses and 80 percent of lost wages.

Obtaining PIP benefits – extended or otherwise – is supposed to be a simple and straightforward process. However, it’s not uncommon to run into problems. Our car accident attorneys advising Fort Lauderdale are here to help answer your questions. We can help reduce your burdens by taking over negotiations for a settlement or, if necessary, pursuing claims for further damages in court.

If you or a loved one has been injured in a Fort Lauderdale car accident, contact the personal injury attorneys at The Ansara Law Firm by calling (954) 761-4011 or toll-free at (888) ANSARA-8.

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