When you're involved in a car accident in Florida, your first line of financial defense for medical expenses isn’t someone else’s insurance; it’s your own. This is because Florida is one of the few states with a no-fault insurance system, which requires drivers to carry Personal Injury Protection (PIP) as part of their auto insurance policy. You can use PIP protection to pay for your medical bills and other expenses. The goal is to reduce the number of lawsuits that stem from minor car accidents and ensure all involved parties have quicker access to medical care.  However, there are also certain expenses it doesn’t cover, but which ones? And how does it affect you after an accident? Continue reading to learn more about PIP coverage.

What Is Personal Injury Protection (PIP)?

Personal Injury Protection (PIP) is the part of your insurance that covers medical expenses and other related costs following a car accident, regardless of who was at fault. In Florida, all drivers are required by law to carry a minimum of $10,000 in PIP coverage. This coverage applies to you the policy holder, relatives living in their household, passengers without their own PIP coverage and pedestrians who might were injured in the accident. Bear in mind you must seek medical treatment within 14 days of the accident in order to qualify. Not receiving medical care in that time frame will result in you forfeiting your PIP benefits; this is strictly enforced. Approved providers include physicians, hospitals, emergency medical personnel etc. Some cases might also include dentists and chiropractors. In short, your PIP coverage ensures you receive the medical and financial support you need to recover from an accident.

What Does PIP Cover in Florida?

PIP insurance in Florida generally covers the following:

1. Medical Expenses – Up to 80%

PIP pays for up to 80% of necessary and reasonable medical expenses, up to your policy limit. Medical expenses tend to cover the following under PIP protection:

• Doctor visits: PIP covers visits to physicians for initial assessments, follow-up care, and ongoing treatment related to your injuries from the accident.
• Hospital bills: PIP covers emergency room fees, inpatient stays, diagnostic tests and any hospital related charges resulting from the accident
• Surgery: PIP can also cover any necessary surgical procedures, whether in a hospital or outpatient facility as long as the addressed injuries were caused by the car accident.
• Imaging Services: PIP covers your X-Rays, CT scans, and MRIs if they are needed to diagnose and monitor injuries from the accident.
• Dental work: Some accidents can also result in broken or lost teeth. PIP can cover these expenses as long as they were related to the accident.
• Rehabilitation: PIP can be used to cover Physical Therapy, occupational therapy and other rehabilitative treatments needed to regain function after an accident.
• Ambulance services: Emergency transportation to the hospital by ambulance and paramedic care during transit are covered by PIP.
• Medication: You can get reimbursements for prescriptions needed to manage pain, inflammation, infection, etc. through PIP coverage.

As you can see, PIP insurance provides coverage for a variety of medical expenses, helping you gain access to medical care without determining who is at fault. Understanding what it covers ensures that you get the most out of your benefits for a speedy recovery. Always review your policy details and keep thorough documentation to support your claims, since coverage can vary depending on your policy’s limits.

2. Lost Wages – Up to 60%

If your injuries prevent you from working, PIP can help you ease your financial burden by reimbursing part of your lost income.  PIP will typically reimburse up to 60% of your lost wages within the limits of your policy. This means that you may receive partial compensation to cover essential expenses like rent, utilities, groceries, and other daily costs. However, the reimbursed amount can vary depending on your policy payout limits. To maximize these benefits, be sure to provide medical documentation of your inability to work. Some insurers may also require proof of employment such as pay stubs or a letter from your employer to process your claim. If your injuries result in long-term or permanent disability, you may need to explore additional assistance beyond PIP.

3. Replacement Services

If your injuries prevent you from performing daily tasks, such as household chores or childcare, PIP can help cover the cost of hiring someone to help with these responsibilities. This is often referred to as ‘essential services coverage.’ This coverage ensures that your household continues to function while you recover. These tasks include, cleaning, cooking, taking care of children, and running errands. As previously discussed, this coverage is subject to limits within your policy, and you may have to provide documentation and receipts to support your claim. Examples of this documentation include medical documents, receipts, proof of payment for household, etc.

4. Death Benefits

In the unfortunate event that the accident results in death, PIP provides a $5,000 death benefit to the policyholder’s estate or family for funeral and burial expenses. These benefits are typically paid to the policyholder’s estate or designated beneficiaries in order to cover funeral and burial expenses including burial expenses, mortuary services, cremation/burial costs and related arrangements. This amount may not cover all end-of-life expenses, but it can provide some immediate financial relief during a difficult time. Like with other PIP benefits you must provide appropriate documentation like a death certificate and funeral invoice to support your claim.

Who Is Covered by PIP?

Florida’s Personal Injury Protection (PIP) coverage extends beyond just the policyholder. One of the unique features of PIP is its “no-fault” nature, meaning it provides benefits regardless of who caused the accident. In addition to covering your own medical expenses and lost wages, PIP can also apply to others involved in the accident. Here’s a closer look at who may be covered under your PIP policy:

• The Policyholder (You): If you're injured in a car accident, whether as a driver or passenger in your insured vehicle, PIP will cover your medical expenses, a portion of lost wages, and other eligible benefits—regardless of fault.
• Passengers in Your Vehicle (If They Don’t Have Their Own PIP): If a passenger in your car is injured during the accident they do not have their own Florida PIP insurance, your policy may cover them.
• Pedestrians or Bicyclists Struck by Your Vehicle: If your vehicle hits a pedestrian or cyclist, your PIP may help cover their injuries if they do not have their own PIP coverage.
• You as a Pedestrian or Cyclist: If you are struck by a motor vehicle while walking or biking your PIP policy can cover your injuries.

It’s important to note that coverage details can vary based on the specific terms of your policy and the individual circumstances of the accident. In some situations, such as when multiple policies could apply (e.g., both the driver’s and the passenger’s PIP), insurers may determine primary and secondary coverage responsibilities.

What Is Not Covered under PIP Coverage

While Personal Injury Protection (PIP) provides essential support for medical expenses and certain financial losses after a car accident, it still has its limitations. There are several key areas PIP does not cover and require additional insurance for protecting yourself financially. Here are some important exclusions, along with examples:

• Property Damage: PIP does not cover damage to your vehicle or another person's property. These expenses typically fall under Property Damage Liability (PDL) or your own collision coverage.
• Pain and Suffering: PIP focuses on tangible economic coverage. Non-economic damages, however, are not covered. These include emotional trauma, physical pain, or loss of enjoyment of life. For this, you will have to file a personal injury lawsuit against the at-fault party.
• Injuries to Others When You're at Fault: PIP only covers your injuries and those covered under your policy; it does not apply to other drivers, passengers, or pedestrians that you injured. Bodily Injury Liability (BIL) can cover this gap in your policy.
• Vehicle Theft or Vandalism: PIP offers no coverage for stolen or vandalized vehicles. These cases are covered under your gap insurance policy.
• Accidents While Committing a Crime or Driving Under the Influence (DUI): If the accident occurred while you were breaking the law, Your PIP coverage and your insurance claim may be denied. For example, Driving under the influence at the time of the crash.

While PIP may have its limits, complimenting your insurance with other coverages can fill the gap. These limitations can be covered by Bodily Injury Liability, Personal and, in some cases, a Personal injury lawsuit. Doing so can help close these gaps and offer a more complete financial protection.

Can You Sue After an Accident in Florida?

Since Florida is a no-fault state, your ability to sue is limited. Each driver’s medical expenses are covered by their PIP insurance. However, there are some cases where a lawsuit can take place. You can file a lawsuit against the at-fault driver if:

1. Serious Injury Threshold is Met

Florida law allows you to step outside the no-fault system and sue the at-fault driver if you suffer a serious injury, which is defined as the following:

• Significant and permanent loss of an important bodily function
• Permanent injury like permanent nerve damage, herniated discs, or permanent spinal injuries
• Significant and permanent scarring or disfigurement
• Death: In this case, your surviving family members can pursue a wrongful death claim against the at fault driver.

These categories are defined under Florida Statutes § 627.737 and are meant to ensure that only the most severe cases result in litigation.

2. Damages Exceed PIP Coverage

Florida’s PIP insurance typically covers up to $10,000 in medical expenses and lost wages. If your total damages, including medical bills, lost income, and other related expenses, exceed your PIP limits, you may pursue a liability claim or lawsuit against the other driver.

Conclusion

Understanding Florida’s Personal Injury Protection (PIP) coverage is crucial for ensuring you're financially and medically protected after a car accident. While PIP covers medical expenses, a portion of lost wages, and certain replacement services, it does not cover everything relating to the accident. There may still be gaps when it comes to property damage, pain and suffering, and injuries to others. Knowing who is covered, what documentation is needed, and when you can pursue a lawsuit can help you better navigate the aftermath of an accident. Review your policy regularly to stay fully protected. Also, keep records of all accident-related expenses, and supplement your PIP with additional coverage for your needs. The more informed you are, the better equipped you will be to avoid any unexpected financial hardship.

Visit North Florida Medical Center Today

If you've recently been in a car accident, getting timely medical care is important for both your recovery and protecting your PIP benefits. At North Florida Medical Center, we specialize in treating accident-related injuries and are an approved provider under Florida’s Personal Injury Protection (PIP) guidelines. Whether you’re dealing with whiplash, back pain, or fractures, we are here to help you every step of the way. Don’t risk losing your PIP coverage by waiting too long; Florida law requires you to seek medical treatment within 14 days of the accident to be eligible. At North Florida Medical Center, we’ll make sure you get the care you need, document your injuries thoroughly, and guide you through the insurance process so you can focus on healing. Don’t wait. Contact us today and start your journey towards recovery with us.