When the Victim of a Car Accident Has Medical Bills That Exceed the Defendant’s Auto Policy Limits

June 6, 2019
When the Victim of a Car Accident Has Medical Bills That Exceed the Defendant’s Auto Policy Limits Traffic is part of life in the United States. More than 143 million people commute every day, and car accidents are inevitable. The National Highway Traffic Safety Administration reports that in 2017, 37,133 people died in motor vehicle crashes. Many of those accidents were caused by driving under the influence, distracted driving, and other irresponsible driving behaviors. During 2017 in Florida, motor vehicle crashes accounted for 3,116 deaths and 254,310 injuries. After an accident, medical care is usually everyone's top priority. But even in the midst of the shock and trauma, a question haunts many victims: “Who is going to pay for all of this?”

Who Pays the Medical Bills?

For many Americans, a household financial crisis often results from unexpected medical bills. Medical costs are always on the rise, and even the smallest injury can run up huge expenses. The meter runs with every ride in the ambulance, visit to the emergency room, diagnostic test, treatment, and follow-up care appointment. And that's just for minor injuries. More serious injuries may mean a stay in the hospital, surgery, rehabilitation costs or even long-term care or special adaptive equipment, all costing tens of thousands of dollars, at least. What's worse, the extreme cost of healthcare sometimes inhibits people from seeing a doctor after a car accident, which only makes their situations worse. It's extremely important to seek medical care after a car accident. But, people have a tendency to convince themselves car accident injuries are minor when they're more severe, especially when they're worried about the cost of care. Sometimes accident victims don't even realize they're injured at all. Our bodies generate adrenaline and endorphins in stressful situations like car accidents, blocking or blunting some pain. But, later, those stress chemicals wear off and accident victims begin to feel pain they didn't expect. Which is why, even if you think you have not been injured in a car accident, you should still always seek medical attention immediately.

Insurance That May Cover Your Expenses

How and to what extent your medical bills get paid depends on what kind of insurance coverage you have and, potentially, who was at fault in the accident. Insurance plans are often hard to decipher, so it can be a challenge to understand your coverage and policy limits. Here are five types of insurance that could cover your medical expenses.

Florida No-Fault/Personal Injury Protection (PIP)

To begin with, it's important to understand that Florida has a no-fault auto insurance system. What that means is, regardless of fault, each driver's medical bills and certain other related expenses are paid by his or her own insurance first, before any other insurance coverage kicks in. Every Florida driver is required to carry at least $10,000 in personal injury protection (PIP) insurance. PIP covers medical expenses for bodily injury, sickness, disease, or death arising out of a car accident. PIP covers maintenance, at 80 percent up to $10,000 with a $1,000 copayment for qualifying injuries and $5,000 in death benefits. PIP also covers 60 percent of lost wages due to injury but is still subject to the maximum benefits of $10,000. The medical benefits provide reimbursement exclusively for the following: chiropractic care, EMS transport, hospital care, dental care, treatment provided by an advanced registered nurse practitioner, and physical therapy. If you were at fault in the accident, then you may have to pay medical bills in excess of your PIP limits yourself. If the other driver was at fault, he or she might have to pay your unpaid medical bills. To qualify for the full $10,000 in medical coverage under a PIP policy, a claimant must receive initial medical services and care within 14 days after the motor vehicle accident and be certified to have an emergency medical condition resulting from the accident. Failure to obtain treatment within 14 days waives the right to these benefits and could make it difficult to obtain other insurance benefits also. Failure to be diagnosed with an emergency medical condition limits a claimant to only $2,500 in benefits. Standard PIP policies have a $1,000 deductible, but insurers are also required to offer lesser deductible options, for an additional premium, in amounts of $250 and $500. The deductible amount must be applied to medical expenses.

The Other Driver's Liability Coverage

If the other driver is at fault in an accident, and you meet certain thresholds under Florida law for the severity of your injury and amount of your damages, you may have the right to seek compensation from the other driver and his liability insurance carrier. Speak with an attorney to help you figure out if this option is open to you.

Underinsured/Uninsured Motorist Coverage (UM)

UM coverage is an optional insurance policy. Unlike PIP, Florida law does not require you to buy this type of coverage. Nevertheless, UM coverage provides important benefits. It protects you in the event the other driver is at fault and you get severely injured, but the other driver does not have enough (or any) liability insurance coverage to pay for your medical expenses and other losses. Wf the person who is at fault does not have enough liability insurance, you can turn to your UM policy to pay the extra amount, up to the limits of the UM policy you purchased. A standard UM policy generally covers a spouse and any relatives who live with the policyholder, as well as passengers who were in the vehicle when the accident happened. In addition to medical bills, UM coverage may pay for such losses as lost wages, long-term care, medical devices, remodeling to make your house accessible, the cost of house cleaning, yard work, etc., pain and suffering and death. UM coverage can be valuable, but it can sometimes also be difficult to obtain its benefits. You may need the help of an experienced personal injury attorney to obtain the compensation you deserve. Your UM insurance carrier may dispute the meaning of the term “fair compensation” or of facts triggering its obligation to pay you. Even if the insurance company honors the contract, you will only be able to collect up to your policy limits. Therefore, you may want to consider purchasing as much UM coverage as you can afford. A rule of thumb is to purchase at least enough to provide two year's worth of income, because it usually takes about two years for Social Security Disability approval.

Medical Payments Coverage

Medical payment coverage is just what it sounds like. It pays medical expenses from a motor vehicle accident. This coverage, also called MedPay, is an elective provision on your insurance policy that may entitle you to full payment of your medical bills up to a certain coverage limit. Think of it as supplemental PIP insurance. If you recover damages for your injury from a third party (such as through a lawsuit), you must pay back the money paid by Medical Payments coverage.

Comprehensive Coverage for Property Damage Only

Comprehensive Coverage only covers your own property if it gets damaged in an accident and exceeds the other driver's property damage liability coverage. It has a maximum that the insurance carrier will pay and also contains time restrictions. It is important to understand exactly what is covered before you buy this coverage. Does it include the contents of your car, such as a computer, or purse? Some policies include a car rental while your car is being repaired.

What Is a Bodily Injury Claim?

A bodily injury claim is a claim for pain and suffering after an accident. Because Florida has “no-fault” car insurance and accident compensation laws, if you are injured in an accident, you must first file a claim with your own insurance. In certain circumstances, the injured party may be able to pursue the at-fault driver for damages. To do this, your injuries must be greater than Florida's “Personal Injury Threshold.” To meet this threshold, the victim must have sustained a serious injury is defined under Florida law:
  • A permanent injury
  • Significant and permanent scarring or disfigurement
  • Significant and permanent loss of a bodily function
  • Death
Permanent injuries can be anything from back and neck injuries, fractures, bad scars, and more. A qualified doctor must testify as to the percentage of permanency. In court, if the treating doctor declares the injury permanent and the doctor for the defense declares there is no permanent injury, the jury would have to decide the issue. Pain and suffering can only be awarded if the injury is found to be permanent. In determining fault, Florida is a comparative negligence state. This means that damage awards would be adjusted based upon the percentage of fault of each driver. It is important to consult an attorney promptly because the statute of limitations is four years from the date of the car accident.


In personal injury cases, the victim may be awarded damages to compensate him or her for losses caused by the injury. You may be entitled to compensation for many types of losses you suffered as a result of the car accident. Damages may include:
  • Past, present and future medical expenses
  • Lost wages
  • Loss of future earning capacity
  • Damages for permanent disfigurement
  • Property damage
  • Cost of hiring someone to perform tasks that you can no longer accomplish because of your injuries, such as housecleaning, yard work, or pet care
  • Pain, suffering and emotional distress
  • Loss of consortium
  • Loss of enjoyment, which means that your injuries prevent you from enjoying day-to-day pursuits like athletic pursuits, hobbies, and other recreational activities
  • Other damages caused by the accident

What Should I Do After an Accident?

  • Check yourself for injuries. Also check on the well-being of your passengers, and others involved in the accident. If anyone is injured, call emergency services.
  • Get to safety. If possible, move to the side of the road or a safe area.
  • Call 911. Even if it is a minor accident, it is important to call the police. In some states, it is required. The police can document the scene and file an accident report, which may be useful later.
  • Exchange information. If possible, exchange contact and insurance information with the other driver. Information collected should include the full name and contact information, insurance company and policy number, driver's license and license plate number, type, color and model of vehicle, and location of the accident
  • Document the accident. Most people have cell phone cameras, so it is relatively easy to take pictures from several angles, showing the damage to both cars, the other car's license plate, the area of the accident and surrounding debris.
  • If there are witnesses, obtain their contact information.
  • Contact a personal injury lawyer for advice and assistance or if you are asked to provide a statement to an insurance company representative. Try to avoid discussing the question of fault with anyone until you have had an opportunity to speak with a lawyer.
  • Contact your insurer

How Can an Attorney Help?

The legal ramifications of a Florida car accident can be complicated and difficult to understand. A personal injury attorney who is experienced in car accident claims can review your situation and advise you on your options. If you have been involved in a car accident, you probably have many pressing questions. Who is at fault? How am I going to get my car fixed? What about my injured passenger? What other losses will I face? Should I accept a settlement offer from an insurance company? And, most of all, how am I going to pay for all of my medical bills? With offices across both Florida coasts, you can easily reach Dolman Law Group Accident Injury Lawyers, PA, and Dolman Law Group Accident Injury Lawyers, PA, at 833-552-7274 (833-55-CRASH) or through email. Our dedicated, skilled, and compassionate attorneys can help car accident victims answer the questions they have about their legal rights to recover compensation during our free consultation and case evaluation. Dolman Law Group Accident Injury Lawyers, PA 800 North Belcher Road Clearwater, FL 33765 (727) 451-6900 https://www.dolmanlaw.com/florida-car-accident-lawyer/

Matthew Dolman

Clearwater Personal Injury and Insurance Attorney

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 represented over 11,000 injury victims and has served as lead counsel in over 1000 lawsuits. Matt is a lifetime member of the Million Dollar Advocates Forum and Multi-Million Dollar Advocates Forum for resolving individual cases in excess or $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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