Florida motorists have a unique road to follow in a number of ways. When it comes to navigating a motor vehicle on the roads of the sunshine state, Floridians have some unique driving conditions.
- Florida has more toll roads and bridges than any other states.
- State law requires if you drive a car in Florida for more than 90 days per year, it must be registered in Florida.
- Florida is a “No-Fault” state.
What is a “No-Fault” State?
Florida has a relatively unique body of rules that every car owner must follow in order to comply with auto insurance law. One of these rules is the “No-Fault” insurance statute for personal injury protection (PIP).
Most Florida motorists are confused as to what this actually means. It does not mean that you will have nothing to worry about if the accident was your fault. Anyone can still have a claim filed against them even if they are at fault.
Florida's personal injury protection statute mandates that all drivers carry a minimum amount of coverage to pay for medical expenses, property damage or lost wages resulting from an accident.
What is Personal Injury Protection (PIP)?
Essentially, PIP is simply the automobile insurance coverage that Floridians must purchase if they own a motor vehicle. It is referred to as “no-fault” insurance because it means no matter who is at fault for an accident, all parties can cover their expenses. Before you register a vehicle with 4 wheels or more, you have to show proof of PIP.
In the case of an accident, after an automobile accident occurs, all involved drivers must file a claim with their insurance provider in order to ensure that medical and any other costs are covered. Florida is different from other states where a driver may file a claim with another driver’s insurer, or sue the other driver for causing the accident in order to resolve the question of who is responsible for paying the damages.
What does PIP Cover?
PIP on your automobile insurance will cover up to $10,000 of medical expenses following an accident. PIP policies are intended to ensure that anyone injured in a car accident has resources available to pay for medical attention immediately. The idea is that injured parties don't have to wait for a court or insurance company to determine who was at fault.
Typically, PIP covers 80% of medical costs of up to $10,000 and 60% of lost wages.
You are responsible for 20% of all total cost of your medical bills plus any costs that exceed $10,000. However If you also have private coverage, Medicare or Medicaid, you can submit your medical bills this way. By doing this, you stand a better chance of having all of your expenses covered.
PIP does not cover some medical or therapeutic treatments like acupuncture or massage therapy.
The 14-Day Rule
Under Florida’s no-fault system, you have 14 days to seek medical attention after a car accident. The time deadline is a requirement to make a claim for compensation through your no-fault, personal injury protection insurance.
If you do not get treatment within 14 days of an accident in Florida, your PIP insurer will not be legally required to pay you any compensation.
H2: When Should I Seek Medical Attention?
You should seek medical attention immediately following a motor vehicle accident. This is key to your treatment and recovery and the basis for filing a personal injury report.
Some driver's in an accident don't think that they are that injured or believe that their injuries are minor and do not require treatment. This can be a big mistake if a health issue appears at a later time. Especially with the 14-Day rule in place.
Moreover, once a person begins treatment, they may discover that those injuries are more significant than initially diagnosed. Sometimes the person may end up needing more robust treatments, procedures, or even surgery.
It is crucial that you undergo a medical examination if you are experiencing any discomfort or suspected injuries following an accident.
Typical Process of Filing PIP
After an accident, your insurance provider will send you a notification of your PIP benefits in the mail. This letter is an explanation of how they will pay your medical expenses and lost wages. However, it is essentially a very basic explanation. Moreover, it may take some time to get this letter while most injured parties will want to know right away how their expenses will get paid.
The first thing the letter from your insurer will explain is how PIP will apply in your case, regardless of fault.
In Florida, filing a claim will require providing an Independent Medical Examination (IME) along with your PIP to support your case. This is often a troublesome reality that goes hand-in-hand with legalities currently in place. Insurance companies have the right to assign the doctor that will conduct your IME. Unfortunately, often they are biased to find a reason to place your claim in one of the following three rejection categories.
- The car accident was not the cause of your injuries.
- You have not been injured.
- The accident may have caused you personal injuries but your injuries are not as serious as you claim.
Therefore, the IME is commonly used by insurance companies to deny benefits. This means that although you are in good standing and have made car insurance payments regularly, they can legally refuse to pay your PIP benefits.
How Does Your Insurance Provider Select a Doctor for the IME in Florida?
Insurance companies in Florida are required to randomly choose the doctor who will conduct an IME. They do this generally through a rotation system performed by certified vendors within a 10 mile radius of the insured person's residence. This vendor is required by law to randomly choose from the pool of doctors to perform the IME. This provides the insurance company with the argument that they ultimately have no control over the doctor that is chosen.
Claims of Fraud
While the purpose of PIP is to expedite the process of obtaining insurance benefits for medical costs, it has led to widespread claims of fraud in Florida.
The current Florida statute is flawed and many motorists find this process rather sketchy. Many policyholders believe that some doctors participate in this IME vendor process because they provide the type of answers that the insurance company is looking for. The underlying motive for the insurance company is to find a legitimate reason to cut-off the driver's benefits, so they do not have to pay the claim.
There are good reasons to support this skepticism as there are many recorded cases where a doctor gets taken out of IME rotation if they return too many recommendations to continue coverage. Doctors that are being used for IMEs are being paid by the insurance company to give them the answers that allow them to discontinue benefits.
Should I Seek Legal Advice For Filing My PIP Claim?
An experienced Florida personal injury attorney will help you navigate the traps that are designed to block you from receiving your rightful compensation.
The entire process of PIP involves a very technical area of Florida law. You can benefit greatly from an experienced professional. Thankfully, there are attorneys in Florida who are highly qualified and able to handle all kinds of PIP claims.
If you are having some difficulty dealing with an insurance provider and feel insecure moving forward with your claim, DOCS4PI can help. Through DOCS4PI, people in need can now benefit from the combined knowledge of an entire community of medical and legal professionals in Florida.
