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The Lennox Family
Sandra Dee Sizemore
In this video, we are going to discuss how Florida Personal Injury Protection Coverage Works.
You’ve been in an accident, and it’s not your fault. You get hurt in the accident, and it’s not your fault and now you need to seek medical treatment.
The success of any legal matter depends on the unique circumstances of each case, therefore, we cannot guarantee particular results for future clients.
A legit question is, who’s going to pay these medical bills?
Because of your injuries, you are now going to the hospital or you’re going to urgent care or you’re going to an orthopedic, an MD, or a chiropractor. They need to get paid for what they do. So how will they get paid?
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Understanding Personal Injury Protection Insurance
That’s where Florida Personal Injury Protection Coverage, also known as PIP insurance, comes into play. This is a specific type of insurance. It’s mandatory insurance. You have it. If you have insurance in Florida, you have Florida Personal Injury Protection Coverage. There’s no way around it. Your family members, very likely, have Florida Personal Injury Protection Coverage.
It’s what we call primary coverage, which means that it will jump in line. So if you go the hospital, it’s going to jump up ahead of your health insurance, and it’s going to be the coverage that’s going to be used, and it covers a lot of medical treatment.
What Does A Personal Injury Protection Cover?
It covers 80% of eligible emergency medical costs and/or it could be 60% of your lost wages up to 10 grand.
If you have non-emergency medical cost, in other words, you go see your doctor or whatever the case may be, and they declare it be non-emergency, it’ll cover 80% up to 2,500 bucks.
What Are PIP’s Eligible Medical Costs?
What are PIP’s eligible medical costs? Pretty much anything that you’re going to go see is going to be covered, any medical services and medication.
If you had surgery, that would be covered. Or if you went to an orthopedic or some sort of MD, that would be covered. If you have to go to the hospital after your accident or if you had to go to urgent care after your accident, that’s all going to be covered.
If there are any rehab costs, that’s all going to be covered.
Usually, if you have an injury where there is whiplash or any trauma to your spine, and cervical sprain, your treatment provider’s going to send you out for MRIs or for DXT, which are cervical X-rays, some sort of objective diagnostic procedure to really figure out what’s going on is going to be covered by Personal Injury Protection.
What’s Not Covered?
In the old days, people would get acupuncture and some other, more Eastern sort of treatments. That is not going to be covered.
Some of the massage stuff in the old days used to be covered. But now that’s not going to be covered, however, your treatment providers know what will be covered and what’s not.
Is There A Deadline For Florida Personal Injury Protection Coverage?
There is a big-time deadline in a Personal Injury Protection claim. You’ve probably seen on some of those lawyer commercials, “You’ve got 14 days. You’ve got 14 days.”
The practical effect of that is it scares people and they think that they don’t have a motor vehicle claim after 14 days.
That’s not true.
The 14 days is related to PIP and the PIP law, which says that for you to file your PIP claim, which is this medical treatment stuff we’re talking about, that you need to have sought medical treatment within 14 days of your motor vehicle accident.
Who Is The Personal Injury Protection Carrier?
When we’re filing the claim, we need to determine who the Personal Injury Protection carrier is.
It’s usually your car insurance carrier.
If you have car insurance, and you’re covered under insurance at the time of the accident, it’s going to be through your insurance company.
But sometimes, it’s not. Sometimes, you could’ve been a pedestrian, and you could’ve been clipped by a car or hit by a car, hopefully not, but if so, you may not have had PIP insurance, and we can go look and see if you’re going to be covered by a family member’s policy or if you’re going to be covered by the at-fault person’s policy. We’ll talk about that more in just a bit.
Opening A Personal Injury Protection Claim
When we’re opening up a claim, we open it up over the phone. This is stuff that you don’t do, by the way. This is stuff our firm does. I just want you to be informed to know what’s going on, but we’ll open up a claim over the phone. We always do it within 24 hours of you retaining our firm.
After we open up the claim, ultimately, the insurance company’s going to send us some paperwork to fill out for you. We’ll get most of that filled out for you, but ultimately, we’re going to have you sign it because you have some information that we don’t have and frankly, you need to sign it.
But we’ll get started with that for you. You can anticipate what’s going to happen within the first 30 days.
What If I Don’t Have A Motor Vehicle?
When we’re determining who the Personal Injury Protection carrier is, again, I was mentioning, first, we look at your insurance policy, but if you don’t have a motor vehicle, then we’re going to look at your relatives.
If there were no motor vehicles in your household, so there’s no PIP coverage in your household, then we’re going to look at the vehicle you were riding in if you were a passenger in a vehicle.
Obviously, if you have no insurance, and you’re driving a vehicle, then that’s a problem. We’re probably not going to be able to have a PIP claim for you because everyone’s required to have it.
But if you’re the passenger, and you don’t have coverage, then we’re going to start looking at the person who you were riding with at the time of the accident.
If you’re on foot, then we’re going to look at the bad driver’s PIP.
The long and short of it is, there’s a public policy interest in making sure that there is this Personal Injury Protection no-fault coverage is available to people as long as you’re not driving in a way that you’re not supposed to. For example, if you’re driving without insurance or ridesharing or taxis or if you’re riding on a bus.
but if you’re riding in a regular vehicle and you weren’t doing anything wrong, there’s going to be PIP coverage, we as your auto wreck lawyer are going to find it, and we’re going to apply it to your medical bills.
Application For Benefits With Florida Personal Injury Protection Coverage
I had mentioned an application for benefits with Florida Personal Injury Protection Coverage. This is what it looks like. As I said, we’re going to get it mostly filled out for you, but we’re going to have you sign it, and so we can send that to you. In some cases, we’re able to send it to you via Adobe Sign or DocuSign, and in other cases, we’ll just email it to you, have you sign it, bring it back.
An important thing to remember is if PIP’s available, we want to use Florida Personal Injury Protection Coverage because thinking about what we’re doing here if you have a motor vehicle claim.
Valuing Your Claim
If you have a claim with us, it means that you’re injured. It’s not your fault. Somebody else drove bad. They caused the accident, and then they caused your injuries. If you have injuries, you are going to seek medical treatment.
That’s a portion of what we use to value your claim is what your medical bills are going to be, along with your pain and suffering and basically you’ve been put out, and so we’re going to put all of it together to make your claim, but medical bills are a big portion of it.
Unpaid Medical Bills
At the end of the day, if you have medical bills, and they haven’t been paid, then we gotta make sure they get paid. That’s what happens at the end of your case. We got some other videos that discuss this.
If they gotta get paid anyway by whatever settlement we get for you, then we might as well make sure that we use all the different coverages that are available to get them paid, and so one of them can be PIP. We do this for you, by the way, but it’s important for us to make sure that when we’re opening up your Personal Injury Protection claim that we’re looking for any medical bills that maybe your providers forgot to submit to PIP.
We have to make sure at the end of the day when we’re settling your claim if there’s any in that $10,000 still available, we’re going to go and we’re going to coordinate with your medical providers to get them to take their bills and submit it to PIP to make sure you exhaust 100% of whatever that PIP coverage is.
Questions? Contact Us
That’s it! If you have any questions, give us a ring, or contact your case manager or the attorney that’s assigned your case.
We have your back. Whatever you might be suffering from, accidents, injuries or medical malpractice, we have you covered throughout Florida
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