Personal Injury Protection – Insurance 101

Personal Injury Protection (PIP)
Insurance 101 Part 2

Personal Injury Protection insurance, commonly referred to as PIP, can get confusing. To understand PIP, first we must discuss the fact that Florida is a “No-Fault” state and what that means to you. The Florida legislature came up with the “No-Fault” plan in the early 1970s for the main purpose of ensuring that every motorist purchase PIP insurance. By doing so, the right to sue the at-fault party in an accident was removed and the intention was that injured parties could expect quick reimbursement for any lost wages and medical expenses that resulted from the accident, regardless of who was at fault. The added benefit was that the use of the court system.

Over the years, the items covered by PIP have been stretched to their limit and the reimbursements have become slower. And $10,000 is no longer enough. When the law was first initiated the coverage amount of $10,000 went a long way. Today that figure is far from adequate.

Recently there have been changes in the PIP laws regarding coverage. The law now requires you to seek medical treatment within 14 days of an accident. Failure to do so will result in your not being eligible to receive PIP benefits. Also of note is that the previously automatic amount of $10,000 no longer applies. You are still required by law to purchase a minimum of $10,000, but it your Doctor determines that you do not have an “emergency medical condition”, you then are only eligible for $2,500 for your medical bills and lost wages.

That’s a significant difference in compensation. What exactly is the official definition of “emergency medical condition”? Boiled down to the basics, an emergency medical condition requires two things – severe pain and medical attention that would result in seriously damaging your health if denied. Regardless, you must see your Doctor within 14 days of your accident in order to be eligible for any PIP compensation.

Following is a quick list of frequently asked questions.

  • Q: Are PIP benefits paid by my insurance company regardless of who is at fault for the accident?

A: Yes. That’s the prime reason you need to have adequate limits.

  • Q: Is it true that PIP covers only 80% of your medical bills and 60% of your lost wages for a grand total of $10,000?

A: Yes and No. If your Doctor determines that you have an emergency medical condition, the compensation can be as high as $10,000. Otherwise the ceiling will be $2,500.

  • Q: If PIP only pays 80% of my medical and 60% of my lost wages, who covers the remainder of the out-of-pocket expenses?

A: You have the option of trying to recover those expenses from the driver at fault.

  • Q: Does PIP cover all accidents involving a vehicle?

A: Yes. It doesn’t matter if you were a pedestrian or on a bicycle, if a vehicle injures you, PIP covers it.

  • Q: If my passenger(s) has their own PIP insurance, will they be covered by their policy or mine?

A: Their own PIP insurance will cover their expenses.

Don’t let PIP or any other type of insurance confuse you. Seek advice from your attorney and be sure you are fully covered…just in case.

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