What is Personal Injury Protection (PIP)?

Anyone involved in a Florida car accident must familiarize themselves with PIP insurance coverage. PIP is short for “personal injury protection,” and it’s the cornerstone of the Sunshine State’s no-fault auto insurance system. The Miami car accident attorneys at Gerson & Schwartz, P.A., recognize PIP has limitations. But PIP benefits are typically the first source of financial benefits available in any car crash case.

Florida state law mandates every vehicle registered in Florida carry at least $10,000 in PIP coverage. PIP provides compensation to drivers, passengers and, in some cases, pedestrians, for medical bills and wage los regardless who was at-fault for the crash. Florida PIP law’s do not prohibit lawsuits against an at-fault driver. But in some instances, the benefits obtained could make such car accident litigation claims in Miami unnecessary or not worth the fight. If you were injured in auto, car, or motor vehicle crash or were injured in Miami, it’s important to understand the Florida’s PIP statutes, restrictions and protections. By contacting a personal injury lawyer at Gerson & Schwartz, PA we can show how these laws can benefit you.

Why Do We Have PIP Benefits?

Florida was the second state in the U.S. to adopt a no-fault auto insurance system, which formally went into effect Jan. 1, 1972. As the Florida Senate has noted, it was devised to replace the tort reparations system to quickly compensate people injured in car accidents regardless of who was at-fault.

Its legislative objectives were outlined in the 1974 Florida Supreme Court case of Lasky v. State Farm Insurance Company:

• Insure victims of Florida car accidents would be directly compensated by their own insurer, even if they were at-fault;
• Reduce burden on the court system by limiting the number of lawsuits;
• Lower auto insurance premiums;
• Reduce the alleged inequality of recovery under the traditional tort system.

Whether these goals have been achieved is debatable. What we can say is that while a total of 16 states went on to pass no-fault laws, several states later repealed them. Debate continues in Florida as to the future of the no-fault system, but for now, PIP benefits are generally the first avenue for recovery following a car accident in Miami.

What Does PIP Cover?

PIP benefits are paid by your own auto insurance company in the event you are injured in a crash. To recover PIP benefits, it is not necessary to prove the other person was to blame, or that you were innocent to receive PIP benefits.

Florida Statute 627.736 stipulates that PIP benefits will cover:

• 80 percent of medical expenses up to ($10,000.00)
• 60 percent of lost wages. (up to $10,000)
• $5,000 worth of death benefits (in addition to medical/ disability benefits);
• Mileage reimbursements to-and-from the doctors and treating physicians.

These are all subject to any applicable deductibles, up to the limits of the policy – which are only required to be $10,000.

Car accident victims that may be covered by Florida PIP benefits include:

• The named insured (the person whose name is on the policy).
• Relatives residing in the same household as the named insured so long as they do not own their own motor vehicle.
• Persons operating the motor vehicle with the owner’s permission
• May apply to an injured passengers in a motor vehicle
• Other persons struck by the motor vehicle who suffered bodily injury such as pedestrians and bicyclists

The 14-Day Rule and Emergency Medical Condition Rule

Florida’s personal injury protection law was heavily amended during the 2012 legislative session with two major changes to the law going into effect in 2013 and 2014. These changes have a substantial impact on the ability of a car accident victim to recover damages.

• The 14-Day Rule - Prior to the amendment, there was no time limit on how long after a crash a person had to seek treatment and still collect PIP benefits. That is no longer true. Now, PIP benefits are reduced from $10,000 to $ 2,500 unless you receive treatment within 14 days of the Miami auto accident.
• The Emergency Medical Condition Rule - To access the full $10,000 in PIP benefits, one must be diagnosed by a medical doctor, advanced registered nurse practitioner or dentist with an “emergent medical condition.” This is defined by statute as a medical condition manifested by acute symptoms of sufficient severity that if untreated would put patient at risk of serious jeopardy to overall health, impairment of bodily functions or serious dysfunction of any bodily organ or part. This has led to a great deal of confusion because there is ample room for interpretation. If a patient is not diagnosed with an emergent medical condition, by law he or she will only be entitled to receive $2,500 in PIP benefits.

These rules put certain car accident victims in a precarious spot because not all injuries are revealed right away. Soft tissue injuries and concussions might not be apparent for weeks.

For this reason, our auto accident attorneys in Miami recommend always seeking medical attention after a crash, even if you generally feel “fine.” Failure to do so may result in your forfeiting the opportunity to collect damages should injuries arise later.

Can I Collect PIP Benefits and Still Sue the Other Driver?

Exploring other legal options outside of PIP is always recommended because PIP is limited. Accident victims cannot collect damages for non-economic damages, such as pain and suffering.

Still, you will only be allowed to step outside this no-fault system and file a lawsuit against the other driver for permanent injuries as outlined in Florida Statute 627.737.

The statute allows plaintiffs to recover damages for pain and suffering, mental anguish and inconvenience due to bodily injury stemming from the crash only if the injury resulted in whole or in part to:

• Significant and permanent loss of an important bodily function;
• Permanent injury, within a reasonable degree of medical probability;
• Permanent and significant disfigurement and/ or scarring;
• Death

Some examples of car accident injuries that would likely qualify you to pursue further legal action outside of PIP:

• Traumatic brain injuries
• Paralysis
• Spinal cord injuries
• Amputations
• Broken bones

It’s not unusual for the at-fault driver’s insurer to classify a crash victim’s injuries as minor or temporary. An experienced Miami car accident attorney can help you gather the necessary medical evidence to prove your injuries are sufficient to file a personal injury lawsuit. If you or someone you love has been injured in a car accident, please contact the Miami Car Accident Attorneys at Gerson & Schwartz, P.A., for a free consultation by calling (305) 371-6000 or using our online contact form.

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