WHAT IS P.I.P. AND WHAT DOES IT COVER?
P.I.P. stands for personal injury protection or no-fault insurance. Florida is one of ten States that have personal injury protection (no fault) auto insurance as mandatory minimum.
The intention was to provide injured drivers up to $10,000 in immediate medical coverage in lieu of establishing fault through the court system. The goal was to reduce payment delay for injured drivers, as well as limit the utilization of the court system.
In Florida, PIP coverage is required to be purchased by all owners of motor vehicles registered in this state. PIP coverage makes the individual responsible for their own injuries in an accident regardless of fault.
Florida’s PIP or no-fault coverage covers up to 80% of medical expenses, paid up to $10,000. It also covers lost wages, mileage, and death benefits.
WHAT IS THE 14-DAY RULE?
In the 2012 Florida Legislative Sessions, the P.I.P. statue was amended (House Bill 119.) and on 2013, the laws officially went into effect. Before the amendment, there was no limit to the amount of time you had to seek treatment after a car accident. You are now required to seek treatment within 14 days of the accident date from a licensed hospital facility, emergency transport, medical doctor, doctor of osteopathy, chiropractor, or a dentist.
“You must obtain medical care within 14 days if you suffer injuries in a traffic accident in Florida, or else run the risk of your insurance company denying your claim. Florida Statute 627.736, the no-fault insurance law, is the law that requires medical attention within 14 days.”
If you fail to seek care within the first two weeks after an accident, your insurer will likely deny your claim.
We recommend you seek medical care even if you are unsure whether you suffered injuries. Many injuries take hours or even days to appear.
WHAT IS AN EMERGENCY MEDICAL CONDITION?
Florida Statute §627.732 defines an Emergency Medical Condition (EMC) as a medical condition manifesting itself acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention would reasonably be expected to result in any of the following:
Serious jeopardy to patient health
Serious impairment of bodily function
Serious dysfunction of any bodily organ or part
The Statue expressly states that the finding of an EMC must take place in order for the claimant (injured party-ies) to have access to the full $10,000 in P.I.P benefits. If a medical provider determines that the injured party does not meet the level of an EMC, then they are only entitled to just $2500 in PIP benefits. (75% reduction).
DENIED P.I.P. BENEFITS ??
If an insurance company has denied or underpaid your P.I.P. claim, contact our Boynton Beach personal injury attorneys for a free consultation at 561-810-8448 or submit a contact request form. Attorney Michael Fischetti has over 15 years of experience in personal injury, civil litigation, and insurance law.