FAQs About PIP Insurance Claims

October 5, 2017 | Attorney, Matthew Dolman
FAQs About PIP Insurance Claims

Florida is one of only ten states to require drivers to carry no-fault personal injury protection (“PIP”) coverage. This compensates a driver for her own injuries, regardless of who was at fault for causing an accident. If you or a loved one has been injured in a car accident caused by another driver's negligence, you have legal rights that must be vigorously defended. Don't fight an insurance company alone. Contact the Dolman Law Group Accident Injury Lawyers, PA today to schedule your free consultation with an experienced Florida auto accident attorney. Our professional team will ensure that you are fairly compensated for all injuries and losses you sustain in an auto accident.

PIP coverage is controversial and there have been several efforts by the state legislature to repeal the mandate. One bill filed by State Senator Tom Lee would repeal the PIP coverage mandate. It would, however, replace it with a $5,000 medical payments coverage, and this has caused other state lawmakers to claim that the Senate bill does not adequately address the PIP problem. State Representative Erin Grall of Vero Beach plans to introduce a bill that would eliminate both PIP and medical payments coverage altogether. The Palm Beach Post reports that Florida drivers could save $1 billion dollars per year in insurance premiums by not being forced to purchase PIP coverage.

Regardless of the arguments for and against PIP coverage, it is currently required by Florida law. Personal Injury Protection makes it possible for drivers to receive injury compensation more quickly, and without the need for establishing liability through the courts. Learn more about how PIP coverage can work to the benefit of Florida accident victims:

2.Why should my insurance pay for another person's negligence?

Even with PIP mandates, negligent drivers are still held accountable for their conduct. The advantage of PIP coverage is that it allows injury victims to immediately file medical claims, receive payment, and get the treatment they need. In order to be compensated through a negligent driver's liability insurance coverage, an injury victim must first prove the other driver was responsible for causing the accident. This can be a lengthy process. It can involve expert witnesses, traffic light data, subpoenaed records, and other extensive investigations. Injury victims should not wait for that process to be completed before they begin receiving payment for property and treatment.

3.What if I do not have PIP coverage, or my PIP coverage is not sufficient to cover all of my injuries?

Negligent drivers are still legally responsible (“liable”) for compensating injuries when the victim has no personal injury protection coverage (or when the coverage limit does not cover the full extent of the victim's medical bills). An injury victim can, therefore, still file a claim with the negligent driver's insurance company, or file a civil lawsuit against that driver in order to recover those losses that were not compensated by PIP insurance. Chapter 768 of the Florida Statutes protects an injury victim's cause of action and right to sue for the negligence that caused her losses.

4.Will a PIP claim raise my insurance rates?

PIP coverage is a no-fault insurance, much like health insurance. Your premiums do not, therefore, increase as a result of filing claims. However, when renewing a policy, carriers can consider the risk of a claim when offering a policy premium. This is a part of how health insurers calculate premiums. So while filing a claim will not immediately raise your premiums, it might potentially increase your risk rating, which can indirectly affect your future premiums.

5.How much PIP coverage must I carry?

Currently, Florida drivers must carry $10,000 in PIP insurance coverage.

6.What does PIP cover?

PIP coverage will compensate 80% of medical bills; 60% of lost wages; $5,000 in death benefits; and mileage reimbursement for medical appointments. There are important caveats to PIP benefits, however. If medical treatment is not rendered within 14 days of the accident, an injury victim may be wholly ineligible for PIP benefits. PIP coverage only extends to specific services enumerated in Section 627.736 of the Florida Statutes. These services must be provided by a hospital or ambulatory surgical center; a physician practice; a licensed physical therapist; or a licensed health care clinic.

Note that alternative medicine services or those that have not been generally accepted by the mainstream allopathic medical community, will not be covered by PIP. Acupuncture and massage are two common treatments not subject to PIP coverage. While chiropractic services are subject to coverage, they are the frequent target of insurance company challenges.

7.What if I was not driving a vehicle when I was injured?

PIP coverage is available for injuries sustained as a result of an auto accident. Thus, regardless of whether you were a driver or passenger, or even if you were a pedestrian or bicyclist, PIP benefits are available to you.

8.What is an “emergency medical condition” and how does it affect PIP coverage?

Section 395.002 of the Florida Statutes provides that, unless an emergency medical condition exists, PIP coverage is limited to $2,500. An emergency medical condition is defined as “a medical condition manifesting itself by acute symptoms of sufficient severity” such that the absence of immediate medical attention could result in serious jeopardy to the patient's health, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.

It may seem confusing that the law requires drivers to carry $10,000 in PIP coverage but only $2,500 can be accessed unless an emergency medical condition exists. The reason for this rule is to contain insurance costs. By reducing the number and amount of claims insurers are legally obligated to pay, they can offer lower premiums to drivers for their mandatory PIP coverage.

Fighting Hard to Protect Your Legal Rights

The Dolman Law Group Accident Injury Lawyers, PA has decades of experience in protecting the rights of car accident victims in and around the Clearwater area. Regardless of the types of injuries you have sustained, our experienced, aggressive attorneys will ensure you are fairly compensated for your losses. Call (727) 451-6900 or contact us online to schedule your free consultation with an experienced auto accident attorney today.

Dolman Law Group Accident Injury Lawyers, PA 800 North Belcher Road Clearwater, FL 33765 (727) 451-6900


Matthew Dolman

Personal Injury Lawyer

This article was written and reviewed by Matthew Dolman. Matt has been a practicing civil trial, personal injury, products liability, and mass tort lawyer since 2004. He has successfully fought for more than 11,000 injured clients and acted as lead counsel in more than 1,000 lawsuits. Always on the cutting edge of personal injury law, Matt is actively engaged in complex legal matters, including Suboxone, AFFF, and Ozempic lawsuits.  Matt is a lifetime member of the Million Dollar Advocates Forum and Multi-Million Dollar Advocates Forum for resolving individual cases in excess of $1 million and $2 million, respectively. He has also been selected by his colleagues as a Florida Superlawyer and as a member of Florida’s Legal Elite on multiple occasions. Further, Matt has been quoted in the media numerous times and is a sought-after speaker on a variety of legal issues and topics.

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