What Is PIP Coverage In Florida? An Easy-To-Understand Guide

Florida is one of 12 states that operates under a “no fault” auto insurance policy, so every driver is legally required to purchase PIP – personal injury protection – coverage. However, just because you have PIP doesn’t mean that the cost of any accident will be paid for. 

Understanding PIP can be confusing, especially if you moved here from a state that did not operate under this system, but having a solid grasp of it is important so you can know what your legal rights and obligations are (particularly if you ever get injured in a crash!). 

In this blog, we’ll break it down into super easy-to-understand terms!

What is PIP coverage in Florida?

PIP, or personal injury protection coverage, is a type of insurance policy that pays benefits for some costs resulting from a vehicle accident. It’s also commonly referred to as “no fault insurance”. If and when you are involved in a collision, your PIP benefits will cover some (but not all) of the costs associated with property damage, medical bills, and more. 

So what does “no fault” mean?

“No fault” doesn’t mean that there is not someone to blame for an accident. Someone did cause it, whether it was 100% one person’s fault or both drivers shared a little of the responsibility. It just means that no matter who caused it, both drivers go to their PIP coverage first to get costs covered rather than to the other party’s insurer. 

Why does Florida do it this way?

The idea behind PIP coverage in Florida is that because every driver is legally required to have it, drivers who get into accidents won’t need to sue each other for damages as much. However, this isn’t exactly realistic. 

For one thing, Florida has one of the highest rates of uninsured drivers in the country (possibly because Florida also has the most expensive car insurance rates in the nation – policies cost 52% more than the national average). 

For another, Florida drivers do have the right to sue when medical costs exceed $10,000. Because of the high costs of healthcare – again, Florida ranks as one of the most expensive states – this is likely to be the case for most injured accident victims. The average hospital stay after an accident costs around $60,000, according to ValuePenguin, so making a claim with the other party’s insurer is going to likely be something you need to do if you are hurt in a collision 

What does PIP cover?

Medical expenses –  PIP coverage in Florida pays for 80% of medical bills resulting from the crash, but only up to the $10,000 PIP limit per person. This can be costs including things for imaging tests like X-rays, hospital stays, surgeries, ambulatory transport, prescription medications, physical therapy, and more. 

Note that PIP only covers medical expenses that are deemed “medically necessary” by your insurer. That’s a incredibly gray area, and means that not all treatments may be covered. 

Lost wages – Personal injury protection pays for 60% of your lost regular income, up to the $10,000 PIP limit per person (this isn’t including what other bills are contributing to reaching that limit). 

Wrongful death – If someone is killed in a car accident, their PIP coverage will pay for $5,000 apart from the $10,000 limit. 

Like with any insurance, there is a deductible that policyholders have to pay before they can access benefits.

PIP does not cover pain and suffering costs. For example, if you’re having trouble sleeping because of the accident due to pain in your back, there is a very real cost of your quality of life and sleep, but there’s no receipt for it, so there’s nothing PIP will do to compensate you for that.  

Seeking treatment within the PIP coverage time window

In order to be eligible for benefits, you not only have to pay a deductible, but you also have to seek treatment within 14 days after the accident. If you don’t, you risk losing coverage for the incident altogether. 

Because there is a high incidence of insurance fraud in Florida, legally, your insurer has 60 days to investigate your claim for fraud, but they have to pay damages to you within 30 days of you filing a claim. That’s why it’s good to keep a record of any medical treatment and get an accident report from the police. 

Coordination with other benefits

If you have private health insurance, your PIP coverage will work together with that insurance (in most cases) to make sure you don’t pay for the same expenses twice; PIP can cover what your private health insurance policy won’t, up to the coverage limits. 

Why you shouldn’t settle for PIP coverage if you’ve been injured

Think of PIP kind of like a first-aid kit for some kids who bumped into each other while playing soccer. Regardless of who hit who, and even if it was a total accident, both kids can access what’s in the first aid kit, and it does well for treating minor cuts and bruises. It’s fast, and accessible. But if one of the kids broke their leg in the incident, they’re going to need a lot more medical attention – what’s in the kit isn’t going to cut it. 

That’s what PIP is for most car accident injuries. If you broke any bones in the crash, or slipped any discs, or had internal bleeding, or got a concussion, you’re going to need more expensive medical treatment, and you shouldn’t have to pay for it out of your own pocket! PIP covers 80% of costs, but the other 20% may be significant enough for you to take legal action. 

A Florida personal injury attorney may be able to help you understand whether or not you have a claim for additional compensation. At The Florida Law Group, we have successfully gone to bat with major insurance companies for accident victims who were injured due to negligence, and we’ve recovered over $1 billion on behalf of our clients. Call today to schedule a free consultation and discuss your options!