Maximizing Personal Injury Claims in Florida: A Comprehensive Guide Personal Injury Protection (PIP) insurance is crucial to Florida’s no-fault auto insurance system. Each driver’s insurance policy is designed to cover their own injuries and damages so that medical expenses and lost wages can be dealt with promptly. In other words, PIP provides financial relief regardless of who caused the accident.
In theory, this sounds great. However, navigating the complexities of PIP can be challenging, especially when injuries and damages exceed the coverage limits. This post aims to explain PIP insurance in Florida, its benefits, limitations, and the steps you need to take when you are injured due to another’s negligence and costs surpass PIP coverage.
Understanding PIP Insurance in Florida
PIP insurance, often referred to as “no-fault insurance,” is mandatory for all Florida drivers. The state requires a minimum of $10,000 in PIP, which covers:
Medical Expenses. PIP covers 80% of necessary and reasonable medical expenses resulting from an auto accident, including hospital bills, surgery, rehabilitation, and medication.
Lost Wages. PIP covers 60% of lost wages if injuries from the accident prevent the insured from working. It also covers the costs of hiring someone to perform household tasks the injured person cannot do.
Death Benefits. In the event of a fatal accident, PIP provides a $5,000 death benefit in addition to the $10,000 in medical and disability benefits.
Other Expenses. PIP may cover other reasonable expenses incurred due to the accident, such as transportation to and from medical appointments.
Filing a PIP Claim in Florida
Here are the steps you should take to file a PIP claim:
- Notify Your Insurance Company. Immediately inform your insurance company about the accident. Timely notification is critical as there are deadlines to meet.
- Seek Medical Attention. To be eligible for PIP benefits, you must seek medical attention within 14 days of the accident. Ensure that the healthcare provider documents all injuries and treatments accurately.
- Submit Required Documentation. Provide your insurance company with all necessary documentation, including medical records, receipts, and proof of lost wages. Proper documentation is crucial for a smooth claims process.
- Learn the Ins and Outs of Your Policy: Review your PIP policy thoroughly to understand the extent of your coverage, including any exclusions or limitations.
Floridians Take Note: Limitations of PIP Insurance
While PIP insurance offers substantial benefits, it has notable limitations.
The standard PIP coverage limit is $10,000. In severe accidents, medical expenses and lost wages can quickly exceed this amount, leaving significant out-of-pocket costs.
Also, you might have noticed above that we said PIP covers 80% of medical expenses and 60% of lost wages up to a certain maximum amount. That means, even in the best case scenario, you’ll still be responsible for a portion of these costs. Moreover, as mentioned, if you fail to seek medical attention within 14 days, your claim may be denied outright, meaning you will be on the hook for everything.
Beyond this, certain treatments and expenses, such as massage therapy or acupuncture, may not be covered under PIP.
Finally, PIP is no-fault insurance. That means it does not consider who caused the accident. So if another driver is at fault and your costs exceed what PIP will cover, it does nothing for those expenses. You need to pursue additional compensation through other means.
What are those means?
When Florida Accident Costs Exceed PIP Coverage
When injuries and damages from an accident exceed the PIP coverage limits, exploring other compensation options is essential. There are a few potential options out there for people, including:
MedPay (Medical Payments Coverage). Consider adding MedPay to your auto insurance policy. MedPay covers medical expenses regardless of fault and can supplement PIP benefits.
Health Insurance. After exhausting PIP and MedPay, your health insurance may be able to cover additional medical expenses. Be aware of co-pays, deductibles, and limits.
Uninsured/Underinsured Motorist Coverage (UM/UIM). If the at-fault driver is uninsured or underinsured, UM/UIM coverage can provide compensation for medical expenses, lost wages, and other damages.
Bodily Injury Liability Insurance. If someone else is at fault, you can file a claim against their bodily injury liability insurance to cover medical expenses, lost wages, etc.
Personal Injury Lawsuit. In cases of severe injuries, you may need to file a personal injury lawsuit against the at-fault driver. A successful lawsuit can provide compensation for medical expenses, lost wages, pain and suffering, and other damages.
Steps Floridians Should Take After Exceeding PIP Coverage
If you are considering filing a personal injury claim, you first want to consult a Florida injury attorney. They will be able to help you navigate the complexities of your case, determine liability, and pursue additional compensation if they believe your case has merit.
If you do decide to proceed with a claim, collect all relevant evidence, including medical records, police reports, witness statements, and photographs of the accident scene and injuries. While this is something you can do on your own, an experienced lawyer will be able to assist you and guide you to ensure all pertinent evidence is obtained.
You’re also going to want to file any claims promptly. That includes claims with your health insurance, UM/UIM coverage, and the at-fault driver’s insurance. Adhering to deadlines is crucial for successful claims. This is particularly true for legal deadlines related to your personal injury lawsuit.
Your attorney will guide you through this entire process, from filing the complaint to negotiating settlements to going to trial.
Don’t Be Afraid to Ask for Professional Legal Guidance
Navigating Florida’s PIP insurance can be challenging, especially when injuries and damages exceed coverage limits. Understanding the benefits and limitations of PIP and seeking legal advice are crucial steps in ensuring you receive the compensation you need.
