Do I need an Attorney for a PIP Claim in Florida?

October 24, 2016
Do I need an Attorney for a PIP Claim in Florida?

There are a variety of rules and requirements surrounding PIP coverage and your ability to recover under a PIP policy. PIP policies also come with limits and restrictions on the amounts you can recover. Navigating the ins and outs of the PIP insurance process alone can be challenging and missing a step could result in your inability to recover. Hiring a Florida personal injury attorney would be beneficial as they can help you navigate your policy and ensure you receive all of the compensation you are entitled to. A Florida accident attorney can also help you if you are able to take legal action against the other driver involved in your accident.

What is PIP?

PIP stands for personal injury protection and it is required by Florida law.1 Each driver is required to carry a minimum of $10,000 in PIP coverage.

In Florida, assuming both drivers have proper insurance coverage, the fault of the parties does not matter to obtain PIP coverage. This means that if you are in an accident caused by someone else, it is not necessary to file a lawsuit or deal with the other person's insurance to get payment for the damage done. Instead, you would contact your own insurance company to get coverage for your bills and lost wages. This greatly expedites the process of getting reimbursed and allows injured people to get the treatment they need without the hassle of the more traditional methods. In addition, PIP coverage allows the driver who caused the accident to recover for their own injuries.

Limits of PIP Coverage

Even if your injury qualifies under your PIP insurance, you will still not be entitled to receive 100% of your medical costs. PIP policies only cover 80% of your medical expenses and 60% of your lost wages, up to the $10,000 threshold. If you are entitled to any costs beyond that $10,000 mark, you will need to bring a lawsuit. Your personal injury attorney will be able to guide you through your claim and any subsequent lawsuit.

In addition to the limits on recovery, there are several other specific requirements that you must meet in order to be entitled to your full benefits. PIP policies require you to seek treatment within 14 days of the accident. If you do not treat your injuries in that time frame, your PIP policy will not cover your medical costs.

The amount you are able to recover under your PIP policy is determined by your initial assessment. If your injury doesn't qualify as an “emergency medical condition,” you will only be entitled to $2,500 in PIP benefits. Florida law defines an emergency medical condition as a medical condition that requires immediate medical attention and that could reasonably be expected to result in serious jeopardy to the patient's health. If you believe that your condition qualified as an emergency medical condition but you are being denied the coverage you are entitled to, contact a Florida personal injury attorney right away.

Getting Your Benefits

Your PIP insurance policyholder owes you payment of your benefits within 30 days of receiving written notice of the loss and the amount of that loss. Your insurer may be entitled to an additional 60 days to investigate your claims if there are reasonable grounds to believe that there is insurance fraud being committed. If you are entitled to benefits that are overdue, contact a Florida attorney right away to ensure you receive payment. If you choose to work with an attorney from the time of your initial injury, your lawyer will ensure that you receive the full amount of your benefits in a timely manner.

Filing a Lawsuit

In some serious accidents, you may be able to file a personal injury lawsuit against the at-fault driver. Because the benefits available to you under your PIP coverage are capped at $10,000, drivers who are more seriously injured will have to seek full reimbursement through other means than their own insurance company. The PIP coverage certainly will help offset some of the outstanding expenses, but usually, a lawsuit is necessary to ensure that you are compensated fully for your outstanding medical expenses, lost wages, and pain and suffering.

Because of the complexities involved with dealing with your PIP coverage and recovering the amounts not covered by PIP, you should make sure to contact an experienced Florida auto accident and personal injury attorney to make sure that you are fully compensated for your injuries.

Contact a Clearwater Accident Attorney Today for a Free Consultation

If you or a loved one has been involved in an accident, contact a Clearwater auto accident attorney right away. Florida law allows victims to recover compensation for injuries and other losses that they may experience as a result of a collision. A lawyer familiar with litigating Florida accident cases can often help victims recover substantially more compensation than they would be able to retain on their own, so it is highly advisable for anyone injured in an auto accident to discuss their options with an experienced lawyer.

To schedule a free consultation with the Dolman Law Group Accident Injury Lawyers, PA, call our office today at 727-451-6900 or send us an email through our online contact form.

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


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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