When you’re hurt in a vehicle crash, you may need medical attention immediately. You don’t have time to wait for a legal claim and a lengthy court process to get access to funds. The State of Florida has a law meant to provide just that. It is Florida’s personal injury protection (PIP) law.
In Florida, the owner of a registered vehicle is required to carry PIP insurance. It covers them, and usually vehicle passengers and household relatives, in the event of a crash. These benefits provide minimum medical benefits and disability income – even if the driver is at fault for the accident.
Whether you are purchasing insurance for the first time, have been involved in a crash, or simply want to be an informed driver, it is important to understand PIP insurance. Our Pensacola injury lawyers explain PIP insurance in Florida.
PIP Insurance – the Basics
What is PIP insurance in Florida?
Personal injury protection (PIP) insurance in Florida pays medical and disability benefits without regard to fault for the accident. Covered individuals may receive benefits up to policy limits if injured in a motor vehicle accident.
What is the PIP law in Florida?
Florida Statutes §627.736 – Required personal injury protection benefits; exclusions; priority; claims – is the PIP law. It requires certain individuals to get PIP insurance. The law defines covered benefits and exclusions. It creates requirements for the claims process.
Is PIP insurance required in Florida?
Yes. Each person registering a vehicle in Florida must have PIP insurance to a limit of $10,000 in medical and disability benefits and $5,000 in death benefits.
What does PIP insurance pay?
PIP insurance pays for:
that arises from the use, ownership, or maintenance of a motor vehicle.
A policy pays:
- 80% of medically necessary treatment up to policy limits
- Up to a maximum of $2,500 if injuries are non-emergency (Based on the definition in Florida Statutes § 395.002).
- 60% of lost wages
- 60% of needed personal services that the injured party cannot do because of their injuries
- Up to $5,000 in death benefits
PIP Coverages and Benefits
What medical care is covered under PIP benefits?
Some of the services that are covered by PIP benefits include:
- Emergency medical care
- Dental services
- prosthetic devices
- Hospital care
- Nursing services
Services must be provided by a licensed physician, dentist, chiropractor, advanced practice registered nurse, hospital or hospital-owned facility, or emergency transportation and treatment provider. Follow-up services may be covered with a referral by a qualified provider and consistent with the underlying medical diagnosis to a variety of medical professionals, including a physical therapist.
See Florida Statutes § 627.736(1)(a).
Is massage therapy covered by PIP benefits in Florida?
No. Florida Statutes § 627.736(1)(a)(5) excludes massage therapy from benefits covered under PIP insurance.
Is acupuncture covered by PIP benefits in Florida?
No. Florida Statutes § 627.736(1)(a)(5) excludes acupuncture from benefits covered under PIP insurance.
Getting PIP Coverage
Who must get PIP coverage in Florida?
In Florida, PIP insurance coverage is tied to the vehicle and its registration. It is a requirement to register a vehicle in the state of Florida.
Can I just avoid registering my vehicle in Florida?
No. You must register your vehicle in Florida within 10 days of establishing residency, enrolling children in school, or beginning employment in the state.
Who Is Covered Under Florida PIP Benefits?
PIP benefits cover the named insured. But that’s not all. A single policy may cover a number of people, including:
- The named insured
- Relatives residing in the same household as the named insured
- Persons operating the vehicle
- Passengers in the vehicle
- Others struck while not in a vehicle themselves (pedestrians and bicyclists)
Some people may be excluded from PIP benefits, including:
- The named insured and household relatives when riding in a different vehicle that is not insured under the policy
- Someone who causes intentional harm
- Injuries that occur while committing a felony
- Specific exclusions
The person who is hurt uses their policy coverage first. Then, the vehicle owner’s coverage may apply.
Claiming Your Benefits
How does a person make a PIP benefit claim?
Making a PIP benefit claim begins with receiving medical care within 14 days of the accident. The person must receive medical care from a qualified professional or healthcare group. Then, the person must contact the insurance company to make a claim.
The insurance company will need information – usually an itemized statement of medical care and costs.
If the person misses work and claims wage benefits, there is a form for the employer to fill out. The form establishes their average wage in the weeks leading up to the accident.
Once the claim is filed, the person can expect payment within 30 days.
Is there a deductible in PIP insurance?
Yes, there may be a deductible for a PIP benefits claim. A typical amount is $500-$2,000. Check your policy to see if you have a deductible. Each policy is different.
What if a passenger in a vehicle has their own coverage?
If a passenger in a vehicle has their own PIP coverage, they should make a claim through their policy.
About PIP Insurance in Florida
Florida is one of 12 states that use a no-fault insurance scheme. Florida’s law took effect in 1972. It was the second state to pass no-fault laws.
Interestingly, Florida does not require drivers to carry bodily injury liability coverage. Taxi drivers must have it, but it is optional for private drivers. Vehicle owners need only $10,000 in personal injury protection coverage and $10,000 in property damage liability.
Legal claims are still possible for serious accidents in Florida. A victim may go outside the no-fault system and bring a traditional claim in tort for compensation if they suffer:
- Significant and permanent loss of an important bodily function
- Permanent injury, to a reasonable degree of medical probability
Florida Statutes § 627.737(2). Unless the victim meets the exception for the type or severity of injury, they suffer, if the vehicle owner, operator, or occupant of a motor vehicle has the required insurance, they are exempted from tort liability arising out of the ownership, operation, maintenance, or use of the vehicle.
Critics of PIP insurance say that it raises rates. Proponents say that the higher rates are worth faster access to benefits and a decrease in litigation.
Understanding Florida PIP Insurance and Benefits
PIP insurance is required for vehicle owners in Florida. If you are injured in an accident, it can be a way to access medical and disability benefits. These benefits are one way that you may receive financial relief following an accident.
Stevenson Klotz Injury Lawyers can help you look at all the avenues for accessing benefits and compensation when you are hurt in a crash. In addition, if you are not receiving the PIP benefits that you deserve, you should talk to a lawyer. We may be able to help.
Contact us for a personalized consultation about your situation.