“PIP” stands for Personal Injury Protection. It is a form of auto insurance offered in Florida and several other states and is an integral part of Florida’s no-fault auto insurance system. However, every state’s PIP insurance rules are different, and Florida is no exception.
What PIP Covers
PIP covers the two main forms of economic losses you might suffer as a consequence of a car accident — medical care and lost earnings. It also offers death benefits in the event of wrongful death. Remember: PIP pays for your own losses, not the other driver’s losses.
PIP auto insurance policies offer meager benefits compared to what you would get by filing a personal injury lawsuit. PIP will cover 80% of your medical bills up to a total award of $2,500. If your condition qualifies as an “Emergency Medical Condition,” your maximum coverage rises to $10,000. PIP covers the following expenses to the extent that they are reasonable and necessary:
- Ambulance charges;
- Lab tests and other diagnostic services;
- Ongoing professional care;
- General medical services;
- Diagnostic services
- Ambulatory services
- Home care expenses such as childcare and house cleaning, if your injuries prevent you from fulfilling these duties on your own; and
- Other medical expenses.
PIP covers injuries to you, family members residing in your household, passengers in your car, people driving your car with your permission, and pedestrians or bicycle riders injured by your vehicle.
PIP will only cover 60% of your lost earnings, up to a maximum of $10,000.
PIP death benefits include funeral and burial expenses, plus accidental death benefits. The maximum death benefit is $5,000.
Although PIP premiums vary, you can lower your monthly premium by increasing your deductible. The maximum deductible (and therefore the minimum monthly premium) is based on a $1,000 deductible.
Since PIP only pays for 80% of your medical expenses, selecting the maximum deduction will require you to pay $1,000 + 20% of your medical expenses out of your pocket.
Filing a Claim
To qualify for PIP coverage, you must receive medical treatment within 14 days of your accident. It works like a statute of limitations deadline—Florida will reject your claim if you don’t get treatment within two weeks.
Your insurer has 60 days to investigate your claim to make sure it isn’t fraudulent. Nevertheless, it must pay your claim within 30 days, even if it still suspects fraud.
Proving Your Medical Expenses
Proving your medical expenses is not difficult. Keep a copy of all your medical bills, and keep a personal log detailing all your treatments. Submit all of this documentation with your claim. Don’t be surprised if PIP refuses to pay for unconventional medical treatments such as acupuncture.
Proving Lost Earnings
Your employer must complete a “Wage and Salary” verification, which verifies your earnings during the 13 weeks immediately prior to your accident. You must submit it with your claim. You should also submit a statement from your employer detailing how much work time you lost.
Also, submit documentation such as W-2 statements, tax returns, and pay stubs. Finally, Florida might also require you to submit a doctor’s statement verifying any disability you claim.
Filing a Lawsuit
Because PIP is a no-fault system, under ordinary circumstances, you cannot file a lawsuit against an at-fault driver or their liability insurance policy (even if they have one). Since you lack the ability to file a lawsuit, you lack the bargaining leverage to negotiate with the at-fault driver’s liability insurance carrier.
Florida law does, however, allow you to exit the no-fault system and file a lawsuit if your injuries are “serious.” For your injuries to be “serious,” you must have suffered:
- Permanent loss of a bodily function,
- A serious permanent injury,
- Significant and permanent scarring and disfigurement, or
The main advantages of filing a lawsuit are that you can claim 100% of your medical expenses and lost wages, and you can also claim damages for pain and suffering. Pain and suffering damages often amount to several times the amount awarded for medical expenses.
Supplementing Your PIP Insurance
Although PIP insurance is mandatory, you can choose other, optional insurance plans to supplement your PIP insurance.
You can use Florida MedPay to supplement your PIP insurance coverage. MedPay is optional, but it covers 20% of your PIP medical deductible up to its coverage limits.
With just the minimum PIP insurance, you enjoy $10,000 in coverage after paying the 20% deductible. With $5,000 in MedPay insurance, you enjoy $15,000 in coverage with no deductible. MedPay doesn’t cover lost earnings.
Under Florida law, you must file a PIP claim before you can file a claim against your health insurance policy. In other words, you can only use health insurance if PIP benefits are not enough to pay for your claim.
Are You an Accident Victim? Schedule a Free Initial Consultation With a Jacksonville Personal Injury Lawyer
Florida is a difficult state in which to resolve a significant auto accident claim, and for more than one reason. In addition to low PIP insurance limits, Florida is one of only two states that do not require their drivers to carry liability insurance.
Even if the other driver is loaded with optional insurance, you will face significant legal barriers trying to file a lawsuit. Under these circumstances, you have little to lose by scheduling a free initial consultation with a Jacksonville auto accident lawyer from Bagget Law Personal Injury Lawyers; contact us at (904) 396-1100.