Florida No-Fault Law Explained

After your car accident, your automobile insurance company is required to pay out money in the form of no-fault benefits. No fault benefits are also called PIP (Personal Injury Protection) benefits. In most cases, your automobile insurance company will be required to pay up to ten thousand dollars ($10,000) towards your medical expenses, wage loss, and out of pocket expenses. You are eligible for these benefits regardless of who was at fault for causing the collision. In other words, you could cause the accident, and your automobile insurance company will be required to pay out these benefits. Alternatively, you could be the victim of a negligent driver, and your automobile insurance company would still be required to pay out PIP benefits of up to ten thousand dollars. Regardless of who caused the car accident, your own automobile insurance company is required to set aside up to $10,000 to pay for the medical expenses, wage loss, and out of pocket expenses incurred.

It is important to note that your PIP benefits will only pay a percentage of your medical expenses and wage loss. For example, PIP will only pay 80% of your medical expenses up to $10,000.00. Additionally, regarding your wage loss, PIP will pay only 60% of your wages lost after your car accident. After your car accident, your PIP benefits must exhaust before your health insurance will step up to pay your medical bills. In fact, your PIP benefits must exhaust before the at-fault driver’s automobile insurance company pays your medical bills, wage loss, or out of pocket expenses. After your Florida car accident, remember that your PIP benefits must pay first before anyone else is required to pay. However, when a driver gets hurt on the job, there is an exception to this rule because the injured worker may have workers compensation benefits available.

Recent changes in Florida law make it more difficult for drivers to access their PIP benefits. For example, if a driver fails to seek treatment within fourteen (14) days of his car accident, he forfeits his right to PIP benefits. In other words, failing to seek medical treatment within two weeks of the car accident will harm your case and cost you money. It is extremely important that you seek medical treatment immediately after your car accident. Additionally, under Florida law, you must seek medical treatment from a particular doctor to receive the full amount of your PIP benefits. Reimbursement for medical treatment is limited to $2,500 unless a medical doctor states in his or her medical records that you have an “emergency medical condition” (E.M.C.). Florida statute defines an emergency medical condition as a medical condition that manifests itself by acute symptoms of sufficient severity, which may include severe pain. The statute that an E.M.C. exists only when the absence of immediate medical attention could reasonably be expected to result in serious jeopardy of a patient’s health, serious impairment, or serious dysfunction. A medical doctor, osteopathic physician, dentist or advanced registered nurse practitioner must make a determination of whether an E.M.C. exists. A chiropractor or physical therapist cannot make this determination under Florida law.

In sum, after your car accident, your own automobile insurance company must pay out first regardless of who caused the car accident. PIP benefits are referred to as No-Fault Benefits because the benefits are available to all Florida insured parties after a car accident. It is extremely important that you report your car accident to your car insurance company so that a PIP claim is opened for you. It is also important that you seek out medical treatment immediately after your car accident. Your PIP benefits are forfeited if you fail to seek medical treatment within 14 days of your car accident. Finally, check your medical records to see if a medical doctor has diagnosed you with an E.M.C. (emergency medical condition). Without an E.M.C., your PIP benefits will be reduced from $10,000, to $2,500.