If you’ve been injured in a car accident in Florida, you probably have some questions regarding who will pay for your medical bills and what role each entity—your insurance, the other driver’s insurance, your health care provider, etc.—play in the process. This article will clarify who is responsible for paying for your damages and in what order each one is responsible to pay.
If you were injured in a car accident and you are one of the named insured on the car insurance policy, you will make what-is-called a “no-fault” injury claim under your (PIP) coverage that you are required to carry in Florida.
You may also make a claim for your MedPay to payout—if you elected this option when buying car insurance. In Florida, MedPay coverage is optional. MedPay will offer additional assistance when it comes time to pay your medical bills since it can cover deductibles and copays. MedPay—as the name does somewhat imply—can only be used for medical payments. Therefore, a combination of PIP and MedPay may be extremely beneficial.
MedPay, like PIP, covers medical bills without regard to fault. However, as previously stated, MedPay only covers medical expenses, so it can’t help with other costs like loss of income or expenses for services you now have to pay for (like cutting your lawn or child care). MedPay’s biggest advantage is that it never makes the insured person pay deductibles or coinsurance for medical care, and it can pay for the deductibles, coinsurance, and copays of other types of insurance, including your PIP coverage.
PIP and MedPay claims are considered something called: first-party claims. This means they are claims that you make against your own insurance company, rather than against another party’s insurance. This is similar to having your health insurance pay for a general checkup. When you make a claim against the negligent driver’s insurance carrier, it is called a third-party claim.
PIP and MedPay are also called because they pay benefits regardless of who is at fault in the accident, theoretically eliminating the need to prove liability. As you may already know, Florida is a “no-fault” state. PIP coverage pays for up to $10,000 in coverage, however, it does not cover all your bills. Instead, Florida PIP laws require your insurance to pay 80% of the medical bills which will max out at ten thousand dollars. You will still be responsible for the other 20%, which is where MedPay would be beneficial. Your PIP coverage may have a deductible of $1,000 or $2,000 dollars, which again, MedPay would cover.
Your health insurance may also help to pay what PIP will not and may also help to cover any additional medical bills over $10,000 you may incur. You also have the right to file a claim against the other driver’s insurance company for their Bodily Injury insurance to cover it. If they do not have Bodily Injury coverage, you will use your Uninsured or Underinsured coverage, if you elected to purchase it.
In the state of Florida, PIP is required to cover medical expenses and lost wages. This means that PIP will pay for your medical bills, within the parameters above, and also 60% of any loss wages due to your injury. PIP also covers your passengers or a pedestrian or bicyclists that were not in your vehicle but was struck by you. Motorcycles do not count in this category. PIP can also be used for relatives living in the same house or anyone driving the insured’s vehicle. See more details on PIP and what it covers.
Medical Payments Coverage, or MedPay, is optional in Florida. In fact, many drivers do not have MedPay coverage, but it may prove useful. This type of coverage is very beneficial as a supplement to your PIP coverage, as it will pay for the 20% co-pay that PIP does not pay and for medical expenses above the $10,000 cutoff.
Similar to PIP, MedPay will cover the insured (you), any of your passengers, and any pedestrians or bicyclist that you strike. It may also cover you when you’re injured as the passenger in someone else’s car.
Health Insurance and PIP
So what happens if you do not have MedPay and you need to pay the remaining 20% or costs that exceed $10,000?
Your health insurance will pay the remainder, but they may look for repayment of that money from the other driver or from your own Uninsured or Underinsured Motorist coverage. If you make a claim against the at-fault driver and recover a settlement or jury verdict at trial, then your health insurance company may have a right to reimbursement to be paid out of the settlement or verdict.
Finally, if you do not have health insurance and the accident was not your fault then you have the right to recover these medical costs from the at-fault driver, but this recovery will not happen right away. It may take months or years for the settlement and/or trial to go through. In the meantime, you will still be responsible for paying the medical bills.
So, the expenses associated with your medical care after a car accident will be split between your car insurance company through PIP, your health insurance (at least for now), and the other driver’s policy, if the accident was their fault and this is proved in litigation.
When you see a doctor or go to the hospital, make sure to let them know that you were involved in an auto accident. Most offices have specific checkbox exactly for this. Before using your health insurance to pay claims, contact an attorney who has experience with personal injury to clarify who should pay the bills associated with your injuries and let them advise you about using your medical insurance for your care.
The doctor’s office or the hospital should bill PIP and/or Med-Pay (if you opted to purchase it) for the medical expenses associated with your accident. They will then bill your health insurance company for the co-pays, the additional 20%, and any costs over $10,000.
Make sure to contact both your car insurance company and your health insurance company about the accident to make sure everything is billed and paid appropriately. Your health insurance company then has the option to seek reimbursement from the other party’s Bodily Injury coverage for what they paid out to cover your medical expenses.
Similarly, if you had to pay any out-of-pocket expenses while being treated for your injuries, you can also attempt to get reimbursed for that money by filing a claim against the other insurance company too. Your attorney will help file this claim to make sure you receive the compensation for your injuries that you deserve. This may include expenses you’ve paid out like deductibles or copays, future medical care you may need, compensation for time off work, and for pain and suffering you had to endure. Usually, you will not be involved when your health insurance or car insurance companies seek reimbursement from the other driver’s insurance company.
Uninsured and Underinsured Coverage
Uninsured motorist (UM) coverage, quite like the name implies, provides insurance coverage to you (the person with insurance) for damages caused by another driver who does not have insurance themselves. Underinsured motorist (UIM) coverage is similar, in that, should the other driver’s Bodily Injury coverage be insufficient to pay for the economic and non-economic losses damages of the policyholder, it can aid in making up for the deficiency. Uninsured and underinsured motorist coverage’s purpose is to protect the insured and provide the same coverage that would have been available to the insured had the negligent driver had a proper amount of coverage.
Uninsured and Underinsured Motorist covers medical bills that exceed the available PIP benefits, future medical expenses, lost wages not covered under PIP, pain and suffering, future loss of earning potential, and other non-economic damages. The cost of adding UM/UIM coverage to an insured’s monthly premium in order to purchase this coverage is small compared to the potentially disastrous situation created in the event of a car crash caused by an uninsured or underinsured driver.
Dolman Law Group
The attorneys at have years of experience dealing with the insurance companies, varying insurance policies, and those who are in need of filing insurance claims. From MedPay to PIP, health insurance to Bodily Injury, we can answer all your questions with the confidence of an award-winning, reputable law firm. If you or a loved one has been hurt in an automobile accident, call the St. Petersburg insurance lawyers at Dolman Law Group today. We can help you navigate this complex path in maximizing your insurance claim. Our phone number is 727-451-6900. Please feel free to contact us with any questions.
Dolman Law Group
1663 1St Ave S.
St. Petersburg, FL 33712