As an insurance policyholder, you pay your premiums with the expectation that if you ever need to file a claim, the insurance company will cover the cost.

Blog

Overview of Personal Injury Protection “PIP” Benefits in Florida

Many Floridians are unaware that they may have as much as $10,000 of medical benefits (commonly referred to as Personal Injury Protection benefits or PIP benefits) if they are injured in a car accident within the State of Florida. PIP benefits are often available even if you do not own the motor vehicle involved in the accident and regardless of who was at fault.

florida pip benefits overview - KMW

What is Personal Injury Protection?

Personal injury protection, or PIP, is a component of a vehicle’s insurance policy that reimburses policyholders for reasonable and necessary medical expenses resulting from a car crash. The limit of PIP insurance coverage is $10,000.

Only a handful of states have PIP benefits and Florida is one of them. This type of insurance is also commonly referred to as “no-fault insurance” because payments are made regardless of fault or who was responsible for causing the crash.

PIP covers injured policyholders as well as any passengers even if they don’t own a car or have auto insurance of their own.

Even if you have health insurance, you are entitled to PIP benefits. If the cost of your medical care goes over the PIP limit, then the additional costs may be paid by your health insurance policy.

What expenses does Personal Injury Protection cover?

PIP covers a wide range of expenses following a crash, so it is important to know your rights. Some of the covered expenses include:

Medical Expenses

After an auto accident, if you have personal injury protection (PIP) coverage, it may even help pay your health insurance deductible on top of covering the medical expenses for you and your passengers. This is in addition to covering the costs of treating the injuries sustained in the accident.

PIP coverage pays 80% of medical bills up to $10,000. This means if your medical bills are $8,000 then PIP will cover $6,400.

Learn more: What is Medpay?

Lost Wages

If you are hurt in an accident and have to miss time from work as a result of those injuries, you may be eligible to get assistance from PIP benefits to cover lost wages. This benefit may also be available to you if you are self-employed and require the aid of temporary workers to fulfill particular tasks. If this describes your situation, you may be qualified for it.

Take for example a person who works in a supermarket stocking shelves and lifting boxes that are over 20 pounds. If your doctor directs that you not lift anything over 10 pounds for the next 60 days, you may have a claim for lost wages until you are cleared by the physician to work again.

PIP pays 60% of lost wages if the injured individual cannot work. If you miss $1,000 in wages because of your injury, then PIP will pay you $600.

Funeral Expenses

If you lost a loved one in a vehicle accident, personal injury protection (PIP) might pay for the costs associated with the funeral, burial, or cremation.

If death occurs, PIP offers compensation of up to $5,000.

Survivors’ Loss

In the event that you pass away as a result of injuries sustained in an automobile accident, your personal injury protection (PIP) insurance may make a financial contribution toward the replacement of lost income for your family.

Essential Services

Your personal injury protection (PIP) insurance can also help pay for tasks that you would have normally performed if you hadn’t been injured, such as taking care of your children and cleaning your house, if you were unable to do so because of your injury.

If a person needs replacement services, PIP coverage pays 100 percent for these losses.

Who does Personal Injury Protection cover?

PIP will cover the driver of a vehicle involved in a car accident. It will also cover the passengers in the vehicle involved in the accident.

PIP auto insurance will also protect you even if you are not using a motor vehicle at the time of the accident. For instance, if you are injured by a car while you are walking, PIP coverage may help pay for your injuries.

As we have mentioned, if you were involved in a car accident and you have your own Florida auto insurance policy, the PIP benefits will go through your own car insurance.

For example, you own a vehicle that is insured with GEICO. You are in your friend’s car who is insured with Allstate and he backs into someone who has Progressive and you are injured. You will receive PIP benefits through your own insurance with GEICO. In addition, the not-at-fault party who has Progressive will get their PIP from Progressive. Your friend who has Allstate, even though he is at fault, will receive PIP benefits through his policy with Allstate.

What if there are multiple passengers in the car? Are they all covered under Personal Injury Protection?

PIP coverage of the insured pays for all of the passengers’ medical expenditures, regardless of who was to blame for the accident.

What if you do not own a car, will you receive Personal Injury Protection?

If you do not own a vehicle but are a driver or passenger in another person’s vehicle, it is likely that you do not have your own PIP insurance. This is because PIP insurance is only required for vehicle owners/listed operators.

If you were a passenger in a vehicle that was being driven by another individual at the time of the accident, the coverage for the car you were in can apply to you.

People who may be entitled to PIP benefits, other than the driver or owner of the car, include:

  • pedestrians who are walking or riding a bicycle outside
  • relatives who live in the same house as the owner of the vehicle and are related to the owner by blood, adoption, or marriage
  • passengers who do not have their own personal injury protection coverage
  • parties that drive your car with your permission.

What if you are injured in someone else’s car, whose PIP benefits will you receive?

If you own your own vehicle and have your own PIP insurance coverage, your PIP will be responsible for the accident regardless of who was at fault.

PIP insurance always sticks to the person. Even if you were riding as a passenger in another person’s vehicle at the time of the collision, your PIP benefits are responsible.

But, if you are injured in someone’s car and do not have your own insurance, then you will get the driver’s benefits.

Will you receive Personal Injury Protection even if you have health insurance? How does this work?

PIP and health insurance differ in 4 key ways, each of which is discussed below.

  1. Standard health insurance does not pay for non-medical expenses such as lost income or funeral fees.
  2. Personal Injury Protection can cover you in most situations even if you do not have health insurance (unless you opted for a work exclusion policy).
  3. The degree to which your medical costs are covered by your health insurance will be established by the specific policy that you have purchased.
  4. Even if you already have regular health insurance, you are still required to purchase PIP coverage. This is an absolute necessity.

When will I not get PIP benefits? Are there any exclusions?

  • You were involved in an accident while riding a motorcycle. Motorcycles never get PIP.
  • You were involved in an accident while you were a passenger in a bus, limousine, or taxi. Buses, limousines, and taxis never have PIP. But that doesn’t mean you can’t recover damages. You might have a potential claim (just not through PIP) and you should call an experienced attorney as soon as you can.
  • You own a vehicle that is operable but is not insured. The key word here is operable, meaning you can drive it. So, if you have a car at home, that is uninsured but needs a new transmission or new battery, etc. you can still receive PIP benefits. However, if you have a car at home that is drivable, and you failed to insure it, you can never, under any circumstances, receive PIP benefits. This is an important point that most people do not know about.

Some Final Things to Know about PIP Coverage in Florida.

If you were involved in a car accident you have fourteen (14) days to receive medical treatment.

If you fail to seek medical treatment within fourteen (14) days of the loss you waive your right to receive PIP benefits. It is crucial that if you are injured in an automobile accident that you do not “wait and see” if you start to feel better.

We all have crazy schedules filled with work and family obligations, but if you do not make time to tend to your health you might be waiving your right to benefits. Those medical benefits are potentially worth $10,000.

If your general practitioner or orthopedic physician cannot see you within fourteen days, it is imperative that you seek medical treatment elsewhere so you can get your full PIP benefits.

PIP is primary and then health insurance kicks in.

In the State of Florida, PIP benefits are primary. That means if you seek medical treatment as a result of an automobile accident, your PIP insurance should be paying your medical bills until your PIP insurance benefits are exhausted.

It is always beneficial to provide both your automobile insurance and health insurance to your medical providers who are treating you as a result of an automobile accident. Your health insurance will kick in after your PIP benefits are exhausted.

 

If you have any questions or concerns regarding your PIP benefits, please contact us and we’d be happy to help. We can be reached by calling (561) 295-5825 or filling out our online contact form.

CONTACT OUR FIRM

Menu