Personal Injury Protection (PIP) Benefits and the 14-Day Rule
Personal Injury Protection (PIP) Benefits provide coverage for medical expenses and lost wages for those injured in an accident, regardless of who is determined to be at-fault for the accident. This type of coverage is also referred to as “no-fault” insurance. Florida law requires that all drivers carry a minimum of $10,000 in PIP coverage. In some cases, PIP coverage may be the only insurance available to help cover any medical expenses or lost wages that were caused by injuries you sustained in a car accident. However, specific requirements must be met to be entitled to the full $10,000 in PIP coverage.
14-Day Rule
Pursuant to Florida Statute §627.736, a person injured in an accident must seek medical treatment within 14 days of a crash. If you don’t seek medical treatment within 14 days of an accident, you will forfeit your PIP benefits. After seeking medical treatment within 14 days of a crash, you should know that you are not automatically entitled to the full $10,000 PIP benefit. Based upon the type of treatment or the injuries sustained, you may only be entitled to up to $2,500 in PIP benefits. To be entitled to the full $10,000 PIP benefit, your injuries must qualify as an Emergency Medical Condition (EMC).
Emergency Medical Condition (EMC)
An Emergency Medical Condition (EMC) is defined under Florida Statute §627.732. To determine whether you have an Emergency Medical Condition (EMC), you must seek treatment of a qualified physician, osteopathic physician, dentist, physician’s assistant, or advanced registered nurse practitioner who can determine whether your injuries qualify as an EMC. “Emergency medical Condition” means a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:
- Serious jeopardy to patient health
- Serious impairment to bodily functions
- Serious dysfunction of any bodily organ or part
Personal Injury Protection Limits
As previously stated, PIP benefits are limited to a maximum of $10,000. It is important to understand that our of the $10,000 PIP limit, medical expenses are only reimbursed by 80%. The remaining balance or any medical expenses exceeding the $10,000 limit then become part of your bodily injury claim against the at-fault party.
PIP Benefits in Practice
After being in an accident, you must make a PIP claim with your insurance. When opening a PIP claim, you should remember to write down the claim number for future reference. Your medical providers will need the claim number in order to submit your medical expenses to your insurance company.
If you were negligently injured in a crash and need help navigating your insurance claims, contact the experienced attorneys at Moody Law for a free consultation.
