Personal Injury Protection, or PIP, is a branch of car insurance offered by a handful of U.S. states including Florida, which has mandatory PIP coverage. The idea of PIP is to cover any medical expenses (and occasionally funeral expenses, lost wages, and/or other damages) as the result of an accident. PIP is also called “no-fault” coverage as no legal liability should be regarded in the case, and the plaintiff’s insurance premiums are not to be penalized in any way, however; in the event that coverage exceeds your PIP limits and there is someone to hold liable for the accident, their liability insurance may cover the excess costs.
If a patient has been in an accident and is curious about whether or not they qualify for PIP coverage, there are a few things to first take into consideration.
1.) Did the patient seek and receive medical treatment within 14 days of the accident?
If treatment was received within 14 days of the accident, they may be eligible for coverage.
If treatment was not received within 14 days of the accident, no PIP coverage applies and the patient will not have an eligible claim.
(Note: ‘Treatment’ is vague, but here are a few actions you may have taken that are considered legitimate methods of treatment: Followed up with a Primary Care Provider, Hospital, or Walk-In Clinic, received roadside emergency services after the accident, traveled in an EMS who provided medical attention, or was examined/treated by someone who is qualified to provide emergency transportation and treatment.)
2.) Does the patient own an insured motor vehicle?
If they do, then they are eligible for PIP coverage and should file a claim with their insurance provider, however; in some states, certain motor vehicles are not covered by PIP coverage, most commonly motorcycles.
If they do not, they may be eligible for coverage under the policy of a relative whom they must live with.
3.) Does the patient reside with a relative (blood or spouse) who owns an insured motor vehicle?
If they do, then they are eligible for PIP coverage and should file a claim with their relative’s insurance provider.
If they do not, they may still be eligible if they were a passenger of a vehicle involved in the accident through the driver’s policy and should file a claim with the driver’s insurance provider.
With eligibility comes questions, you must next figure out what exactly you are eligible for. By default, you are entitled to a minimum of $2,500.00 in coverage. The varying factor in coverage allowance is an EMC, or Emergency Medical Condition. Simply put, this is quite literally an emergency medical condition obtained or a pre-existing condition activated due to the trauma of the accident. While you must seek and receive treatment within 14 days after the accident to be eligible for the minimum $2,500.00 in coverage, there is no time restrictions on when an EMC must be noted, however; when an EMC is diagnosed by either an MD, DO, PA, ARNP or Dentist, your PIP Coverage may be increased to an upwards of $10,000.00. Some providers, including Allstate and Esurance, offer greater allowances and allow additional titles to provide eligible EMC diagnosis, possibly increasing your chances of coverage for more obscure conditions.
Per Florida Statute, an EMC is a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate attention would be reasonably expected to result in any of the following:
EMC is an arbitrary standard put in place by the Republican leaning Florida legislature in an effort to satisfy the desires of the Florida auto insurance industry (the strongest lobbyists for the Republican party). EMC is not a term that physicians are trained to understand and is merely an arbitrary process meant to limit the number of claims brought each year and cap a strong majority of such claims at $2500.00 in medical benefits. Thus, many physicians will fail to specifically state that a patient has manifested with an EMC, even when the symptoms meet the above referenced criteria set out by Florida Statue. The EMC term is foreign to most physicians unless they routinely treat auto accident victims. Even the physicians, who consistently treat auto accident victims, are unsure whether they must specifically state the tem “emergency medical condition” in their reports. In fact, this is a clear ambiguity in the amended PIP statute.
If upon first examination, no EMC is discovered or diagnosed by one of the qualified professionals, it is still possible that a condition could appear in the future and would therefore enable you to receive the rest of the coverage allowance. This is important to note, because a medical condition you suffer in the future after the accident may have been received in delayed form significantly later and you could be eligible to receive the other $7,500.00 entitled to you.
If you have been diagnosed with a clear cut Emergency Medical Condition and were treated for it or are currently being treated for it, but your insurance provider is refusing to supply your coverage in its entirety, you have great grounds for a case. If you have tangible proof that a qualified physician diagnosed you with an EMC, it is, by law in the state of Florida, to be paid by the insurance providers to the organizations to be used towards medical expenses, lost wages (due to forced time out from work), funeral expenses, and other miscellaneous losses. If for any reason at all, money that the insurance provider owes is denied to these organizations and you’re feeling lost, get in touch with Dolman Law Group as soon as possible. We can provide you with the necessary information, tips, and legal ammunition to bring these insurance providers to justice.
Occasionally, insurance providers will wrongfully refuse to provide coverage to victims of accidents and leave medical expensive in a state of limbo. Doctors are still expected to provide medical care, but the money to pay for it is often absent, forcing doctors to sue the providers in order to recover their losses. This puts patients in a stressful position. We maintain a division of our law practice that handles Florida PIP cases just like these in an effort to ease the pressure put on the patient, but also to help put a stop to the wrongful doing of these greedy insurance providers.
You may have been in an accident recently that left you hurt, but not critically. You may feel like your losses are steeper than they’re being treated and you’re not getting the coverage allowance you’re entitled to. You could be missing out on a substantial amount of money that you deserve to cover your losses. Don’t sit back and take a hit like that; it could leave you in a regrettable situation where you’re losing more than you’d ever imagined. Step up and pick a fight; we’re here to help.
Dolman Law Group has had amazing success in the past and we only plan on adding to our list of impressive achievements. We’re proud to represent anyone who is a victim of unfair treatment, ignorance or simply don’t know what steps to take to make your claim. Our proud and respected team will stand with you in your battle and ensure a victorious result.
The Dolman Law Group represents physicians throughout Florida on PIP claims. In fact, we actively litigate PIP suits on behalf of MRI facilities, Chiropractors, Physiatrists, Orthopedic Surgeons, Anesthesiologists, Neurologists, among others. We presently litigate PIP suits in Pinellas County, Hillsborough County, Pasco County, Manatee County and Sarasota County.
Our team is happy to come directly to your office to review and scan files in order to pursue PIP claims. We perform PIP audits free of charge and work around your convenience. Finally, we have a long list of references we are happy to share with you concerning medical providers who are extremely satisfied with our services.
The Dolman Law Group is comprised of seven attorneys. Christian Myer and Matthew Dolman head the litigation department and oversee all cases in which a lawsuit has been drafted. Both Matthew and Christian attended Stetson University focusing on trial advocacy; Stetson has one of the highest rated trial advocacy programs in the nation. And has been ranked among the top three by U.S. News & World Report for the past decade. They were both also selected as Florida Rising Stars in 2013 – 2014, a prestigious title given by Super Lawyers rating service to outstanding young candidates. Not only was Matthew selected as a “National Top 100 Trial Lawyer”, but also as a “Top 40 Under 40” by NTL (National Trial Lawyers Organization), and scores a perfect 10.0 rating on Avvo.com, a respected online legal directory.
Our firm operates in the Tampa Bay Area but serves the entire state of Florida. Focusing on personal injury law, Dolman Law Group represents many practice areas including those who have been injured in car and motorcycle accidents, wrongful death, traumatic brain injury, slip and fall accidents, distracted or drunk driving, and more. At our firm, we’re on your side, and being home to seven experienced, successful and professional attorneys makes having Dolman Law fight for you a wise choice. We provide an important gateway for success as well by providing our clients with the personal cell phone number of the attorney dealing with their case, enabling the creation of real relationships and connections. We’ve been ‘in it to win it’ since 2009 and we hope you are as well.
Dolman Law Group
800 North Belcher Road
Clearwater, FL 33756
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