Your PIP Insurance Policy and the 14-Day Rule

Because Florida is a no-fault state, your auto insurance company must provide coverage for your medical bills, lost wages, and other related expenses whenever you are injured in a car accident. That coverage is limited by the terms of your insurance policy, but the minimum coverage that you must purchase is $10,000. (Note that your injury might not qualify for the full $10,000 payout. It depends on the severity of your injuries.)

One important caveat to receiving compensation under your insurance policy is that you must receive medical treatment within 14 days of the accident.

Personal Injury Protection

The Personal Injury Protection (PIP), or no-fault, system is designed to reduce personal injury litigation. Negligent drivers who might otherwise be legally responsible for accident-related damages are exempt from tort liability to the extent that those damages are covered by the injured party’s insurance. If the insurance doesn’t pay for all of those damages then the injured party may bring a personal injury lawsuit.

But injured parties are not eligible for benefits at all if they don’t seek medical benefits within the 14-day timeframe.

Who Is an Eligible Healthcare Provider?

The injured party must receive initial healthcare services and care from an eligible healthcare provider. But qualifies as an eligible provider?

The most obvious answer is an emergency room or other licensed person or entity that provides emergency transportation and treatment. That’s the likely scenario for someone who suffered an obvious injury like a broken leg. Some injuries, though, don’t manifest immediately, and when you start experiencing symptoms you might not need to go to an emergency room. Florida law provides for that scenario as well, which is why you may also receive initial treatment from a licensed physician, dentist or chiropractor.

The healthcare provider who initially treats you may refer you to another provider for follow-up care. Any treatment that you receive for that underlying medical diagnosis from a licensed physician, dentist or chiropractor may also be covered under your PIP policy. Other persons or entities that may provide follow-up services include:

• Licensed hospitals or ambulatory surgical centers,
• Licensed physical therapists, but only upon referral, and
• Accredited health care clinics.

Call your insurance provider if you have questions about eligible healthcare providers under your PIP policy. But if you experience a medical emergency seek medical attention immediately.

Non-Economic Damages

Your PIP policy doesn’t cover damages for pain and suffering and other non-economic damages. However, injured plaintiffs who meet the “serious injury” threshold may file a personal injury lawsuit seeking such damages from the responsible party. Florida car accident plaintiffs may recover damages for pain and suffering, mental anguish, and inconvenience caused by bodily injury if the injury consists of:

• Significant and permanent loss of an important bodily function;
• Permanent injury within a reasonable degree of medical certainty (this does not include minor scarring or disfigurement);
• Significant and permanent scarring or disfigurement; and/or
• Death.

An experienced attorney can help determine if your injury meets this threshold.

Contact Us Today

Contact a Miami personal injury attorney at The Pendas Law Firm today for a free consultation if you have been injured in a car accident. We will assist you with any insurance disputes that arise and help you seek additional compensation if your injuries are not covered by your insurance policy.

The Pendas Law Firm also represents clients in the Fort Lauderdale, West Palm Beach, Orlando, Jacksonville, Fort Myers, Tampa, Daytona Beach and Bradenton areas.

Resources:

leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0600-0699/0627/Sections/0627.737.html

floir.com/Sections/PandC/ProductReview/PIPInfo.aspx

leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0600-0699/0627/Sections/0627.736.html