We’ve all seen and heard the countless jokes and memes about Florida—and, as a Floridian myself, I can say that some are funnier than others.
But perhaps we’re getting the last laugh because Florida is one of only 10 states that ensures immediate medical coverage if you’re injured in a car crash.
Personal Injury Protection (PIP) is required for owners of every registered motor vehicle in Florida.
It’s not just another premium for you to pay, though. If you’re injured in a car crash, you can receive $10,000 or more for qualifying injuries from your own insurance company regardless of whether you’re at fault for the collision.
That’s pretty smart, and a big help for many accident victims in Florida.
When is someone covered under PIP?
PIP insurance automatically covers the owner of the car that’s involved in a collision. It also provides coverage in these situations:
- Your children are covered if they’re riding in your car or on their school bus.
- Giving a lift to someone who doesn’t own a car? No problem. If an injured passenger doesn’t own a car, they’re covered under the PIP policy of a relative whom they live with. If they don’t live with a relative who has a PIP policy, they’d be covered by the other driver’s policy.
- Pedestrian and bicycle injuries could benefit from PIP, as well. If a bicyclist or pedestrian is injured and doesn’t have their own PIP policy and doesn’t live with a relative who has a PIP policy, they’d be covered under the policy of the at-fault driver.
What does PIP cover, exactly?
PIP no-fault insurance coverage pays medical bills and lost wages.
To claim a PIP benefit, you must have received treatment within 14 days of the crash. The treatment could be from a hospital, primary care provider, urgent care clinic, chiropractor, or even emergency medical technicians at the scene.
Even if your injuries didn’t require follow-up at a hospital or with a doctor, treatment has been established if you were treated at the scene by an EMT.
Massage therapy and acupuncture is not covered under PIP.
PIP covers the following expenses:
- Medical services
- Medication
- Surgery and hospital costs
- Rehabilitation
- Diagnostics
- Ambulatory services
- 60% of lost wages (up to $10,000) which includes costs for services like housecleaning, child care, and other tasks that you can’t complete yourself because of your injury.
- Death benefits (in the amount of $5,000) for funeral and burial expenses provided to the policyholder’s survivors
For example, if your total medical bills equal $10,000, PIP covers $8,000. PIP also caps payment at $2,500 for non-emergency treatment.
PIP limits on non-emergency treatment
Yes, you read that right. If your injury is considered a “non-emergency,” there’s a $2,500 cap on what you can recover through PIP.
You can receive the maximum PIP payout if you experience an emergency medical condition (EMC).
What qualifies as an emergency medical condition?
Florida law says that an EMC involves acute symptoms that would result in the following if you don’t receive immediate medical attention:
- Serious jeopardy to health
- Serious impairment of bodily functions
- Serious dysfunction of any body organ or part
When receiving treatment, the doctor should note in the chart if it’s an EMC.
Do you have enough coverage?
Accidents happen.
Although you’re required to carry a minimum of $10,000 in PIP coverage, we encourage you to purchase a policy with a higher amount. That’s because $10,000 could be just the tip of the iceberg for the costs associated with treatment if you’re in a serious crash.
If your accident is very serious and you experience a permanent or chronic injury such as traumatic brain injury, amputation, scarring or disfigurement, paralysis or loss of major bodily function, you could bring a claim outside of PIP.
If that happens, you’ll need a qualified and experienced personal injury lawyer to make sure that you receive what you need to cover your expenses.
Jay Closky says
While my brother-in-law was living in Florida (they’ve since moved to Las Vegas) he had an accident. My sister-in-law was a passenger in the car and sustained injuries. Their insurance company is refusing to pay her medical bills because my brother-in-law was at fault, AND as his spouse the policy didn’t cover her.
From what I’ve been able to research, Florida is no-fault and that would have no bearing on the claim.
I cannot find anything about a relative/spouse being denied a PIP claim as a passenger…….Is this true??
Thank you!
Lance says
What does pip cover for the driver not at fault?
Ian Pisarcik says
Lance,
Thanks for the comment.
Personal injury protection (PIP) generally covers medical expenses (and sometimes lost wages) for the person who is covered (regardless of who’s at fault). However, exactly what’s covered depends on your state and the language in your specific policy. If you need help understanding your policy, I would recommend contacting your insurance company. If you believe your insurer is denying coverage you should be afforded, you’ll need to contact an attorney in your area to pursue a potential “bad faith claim.”
Annie says
If you feel your insurance denied your claim in bad faith, how long before you can’t claim anymore?
Ian Pisarcik says
Annie,
Bad faith claims are contract claims and therefore you have 5 years to file a bad faith claim in Florida.
Eugenia says
I am being treated at the chiropractor clinic for my back and shoulder injury after a car accident. All the medical bills and charges are sent to my lawyer’s office. How do I find out when I reach the limit of my PIP? My lawyer’s response to my request was vague and I did not get the bills.
It seems also that I am being overcharged in the amounts that are times more than regular prices at the clinic providing me with the treatment. I will appreciate any advice or direction. Thank you
Melissa Gold says
Hello, Eugenia. I’m so sorry that you were injured. You can call your insurance company any time and ask for an accounting of coverage. Remember, you are the policy holder, not your lawyer. However, your lawyer is responsible for communicating with you about your claim. You can ask your medical providers to send a copy of the bills to both you and your lawyer. If you believe that the clinic is overcharging you, that’s an issue to raise with your lawyer.
You have the right to know what’s happening with your case, what you’re being billed for, and for how much. If you feel that your lawyer isn’t being forthcoming with this information, ask for copies of your records. The medical provider should also be able to justify the cost for each service. Never be afraid to ask questions!
Addiewag724 says
I live in florida and this past September was in a serious auto accident. A distracted driver hit me causing me to roll my vehicle 3x. The firefighters had to cut my vehicle 4 different ways just to get me out and i was airlifted to a trauma hospital. Once there it was discovered that i had 3 fractured vertabres with 1 being completely crushed and 3 broken ribs. I had surgery to fuse my spine and im still in therapy. I have awesome medical insurance but terrible auto insurance..we only had PIP as did the driver who caused the accident 🙁 i KNOW ive used up my PIP benefits but not sure yet about what my medical insurance has paid. My question is even though we both only have PIP can i go after her PIP and if my medical insurance paid some bills can they take her 10,000 instead? I just found out my hospital bill alone is 30,000 so i think ill be paying medical bills the rest of my life. My neurosurgeon said that im lucky to be alive because i survived that accident and was almost paralyzed so im VERY thankful. The woman who hit me should not be driving with her driving record! Florida insurance laws seriously need changing and i know its Late but we’ve changed our insurance policy to much higher coverage. Sorry for the long post but i hope if anyone reads my story and has the least amount of coverage possible to seriously consider changing it… Especially in no fault states. Its not worth the few bucks you’re saving when it comes to your life or someone else’s. Thanks for the article and thanks for reading.