When you’ve been injured in a car accident in Florida, personal injury protection (PIP) insurance benefits help cover the expenses and losses resulting from the accident. In recent years, however, the state made sweeping changes to personal injury protection — and these changes didn’t favor people who carry insurance.
Work with Crestview personal injury attorneys like the ones at Powell, Powell & Powell to ensure you receive the maximum benefits you are entitled to from your personal injury protection insurance.
Your Insurance Claim Depends on Your Injuries
Many car accidents are covered by the Florida’s no-fault insurance system. This means that as long as there are no serious permanent injuries, each driver files claims with his or her own insurance company to provide for expenses and losses.
While a serious injury entitles you to pursue damages from the other driver's insurance company, anything that fails to meet Florida’s serious injury threshold — a permanent injury, significant and permanent scarring, or disfigurement — is usually taken care of through your own personal injury protection benefits.
Florida requires you carry a minimum of $10,000 in PIP coverage. Changes made in 2013 impact what you can claim against that $10,000, though. For example:
- If you have an emergency medical condition, you can claim up to $10,000 in PIP.
- If you do not have an emergency medical condition, you can only claim up to $2,500.
An emergency medical condition is when there is serious jeopardy to your health, serious impairment to your bodily functions, or serious dysfunction of your body’s organs or parts.
What You Can Claim
Within the limits of your PIP benefits' availability, you can claim medical expenses, disability benefits and death benefits.
According to the statute, medical expenses include “80% of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices and medically necessary ambulance, hospital, and nursing services,” as long as initial treatment is sought within 14 days.
Also per the statute, PIP covers 60 percent of “any loss of gross income and loss of earning capacity per individual from inability to work proximately caused by the injury,” plus all expenses related to obtaining in-home care for services you would normally do yourself if you weren’t injured. Examples of these might include laundry or cleaning your floors.
If someone covered under the policy dies in an accident, the executor or administrator of the deceased’s estate is entitled to $5,000, as well.
What You Can’t Claim
Exclusions to personal injury protection are considerable. If someone operates your vehicle without your express or implicit consent, PIP does not cover that person. Additionally, if the driver intentionally injures someone, including his or herself, or if the driver is in the process of committing a felony, PIP does not cover those situations.
If you own a vehicle, but it is not the vehicle covered under a particular policy, an insurer will not cover that vehicle just because you were driving it and have insurance with the insurer on a different vehicle.
You also cannot claim amounts covered by workers’ compensation. Amounts covered by workers’ compensation accrue against your available PIP.
Not all medical care is covered anymore, either. Starting with the changes made in 2013, neither massage therapy nor acupuncture is covered. These two modalities helped many injured people in the past, but the prevalence of fraud made the state change the law.
Some of these expenses or losses may be covered by medical payments coverage on your insurance policy, by your personal medical insurance, or by the driver at fault in the accident. Contact the personal injury attorneys at Powell, Powell & Powell to learn more about how we can help you claim PIP coverage.