Navigating the intricacies of Personal Injury Protection (PIP) suits in Florida can be a complex journey, especially when faced with the aftermath of an automobile accident. Understanding the ins and outs of PIP, the process of filing a PIP suit, and the role of a PIP lawyer are crucial steps toward securing the full compensation you deserve.

In this blog post, we explore the realm of PIP in Florida – breaking down what PIP is, the process of filing a PIP suit, and shedding light on the pivotal role of a PIP lawyer in such proceedings. Whether you are grappling with the aftermath of a car accident or seeking insights into PIP lawsuits, join us on this exploration of the essential steps and considerations for navigating the PIP landscape in the Sunshine State.

Let's unravel the legal complexities and empower you with the knowledge needed to navigate the PIP process effectively.

What Is PIP?

PIP is a type of insurance coverage that provides medical expense and wage loss benefits to individuals involved in an auto accident, regardless of who is at fault for the accident. In Florida, PIP coverage is mandatory for all vehicle owners and is part of the state's no-fault insurance system.

What Should I Know about PIP and Insurance in Florida?

PIP provides additional insurance coverage to Florida drivers. Even though you may already carry health insurance through your employer, you still need the PIP protection, which is mandated in the state of Florida. The Florida Motor Vehicle Act requires that car owners maintain pip coverage through a PIP insurance policy. Regardless of who is at fault in an auto accident, each person must utilize their pip coverage, prior to pursuing a third party claim against the at fault party. 

Understanding the coverage limits of your Personal Injury Protection (PIP) policy is crucial when navigating a claim. Below is a breakdown of the typical PIP coverage limits in Florida:

Medical Expenses

PIP coverage in Florida typically covers up to 80% of reasonable and necessary medical expenses related to bodily injuries sustained in a car accident. This includes expenses for hospital visits, surgeries, doctor's appointments, diagnostic tests, rehabilitation, and other medically necessary treatments for injuries sustained in the accident.

Lost Wages

 PIP coverage also includes reimbursement for lost wages due to injuries sustained in the accident. Typically, PIP covers up to 60% of your gross wages, subject to the overall policy limit.

This includes wages lost while receiving medical treatment and recovery, as well as potential future lost earnings, if the injuries result in a reduced ability to work.

Policy Limits

PIP coverage has specific policy limits, which can vary based on the terms of your insurance policy. In Florida, the minimum PIP coverage limit is $10,000. This means that, in the event of an accident, your PIP coverage can pay up to $10,000 for medical expenses and lost wages. Some policies may offer higher optional limits, and therefore it is essential to be aware of your specific policy terms and coverages of your policy.

Coordination with Health Insurance

PIP coverage is primary in Florida, which means it pays benefits first, before any other health insurance coverage, in an auto accident. However, if your medical expenses exceed the PIP coverage limit, your health insurance may become the secondary payer for additional medical costs exceeding the 10,000 medical expense limit paid by your PIP Insurance carrier.

Deductibles

Some PIP policies may have deductibles, usually $500 or $1,000, depending on the deductible election you made on the subject policy. If your policy includes a deductible, you will be responsible for paying that elected amount before your PIP coverage kicks in.

Understanding these coverage limits is crucial for individuals involved in car accidents, as it helps manage expectations regarding the compensation they can receive through their PIP insurance. It is also important to be aware of any specific terms and conditions outlined in your insurance policy, and if you have questions, be sure to contact your insurance provider for additional clarification.

Filing a PIP suit in Florida is a complex process that requires a deep understanding of the state's insurance laws and legal procedures. It is crucial to seek experienced legal representation to navigate the nuances of the PIP process effectively. This comprehensive guide aims to empower individuals with the knowledge needed to navigate the PIP landscape in Florida, ultimately ensuring they receive fair compensation for medical expenses and lost wages sustained after an auto accident.

The PIP Process

Seek Immediate Medical Attention

After an auto accident in Florida, seek medical attention immediately, even if injuries seem minor. PIP coverage typically extends to medical expenses incurred within 14 days of the auto accident. Receive medical treatment from qualified medical providers. PIP may not cover treatments deemed unreasonable or unnecessary.

Contact Your Insurance Company

Report the accident to your insurance company promptly. Provide details about the incident and inform them that you will be seeking medical treatment. Understand the limitations of PIP coverage. In Florida, PIP typically covers 80% of reasonable medical expenses and 60% of lost wages, up to a total limit of $10,000. Additionally, be sure to cooperate with your insurance company's investigation into the accident. The insurance company may request statements, supporting documentation, or examinations under oath. If your PIP benefits are denied or insufficient to cover your medical expenses, you may need to file a PIP lawsuit against your insurance company to compel payment of the overdue/underpaid medical expenses.

Document Medical Expenses

Keep detailed records of all medical expenses related to the automobile accident. This includes bills, prescriptions, out of pocket expenses, and any other relevant supporting documentation.

Lost Wages Documentation

If you have lost wages due to the accident, be sure to document this. Provide pay stubs or a statement from your employer to substantiate your lost wage claim. 

Consult with a PIP Lawyer

Seeking legal advice is crucial when considering a PIP suit. A PIP lawyer can assess the circumstances, review denials, and guide you through the complex legal process. The process may involve filing a lawsuit against your own insurance company for failing to fulfill its contractual obligations under the PIP insurance policy. The lawsuit typically seeks the payment of overdue benefits to pay your medical expenses incurred after an auto accident. 

Filing your PIP claim

Filing your PIP claim within the specified time limits is crucial to ensure that you are eligible for benefits and to avoid the risk of claim denial.

Here's an explanation of the importance of meeting these crucial deadlines:

Compliance with Policy Terms

Insurance policies, including PIP coverage, come with terms and conditions outlined in the insurance policy documents. One of these conditions is the requirement to report and file a claim within a certain time frame following the accident. Failing to adhere to these specified time limits, means that you might not be in compliance with the terms of your insurance contract, and could ultimately result in a denial of your claim .

Preservation of Rights

Insurance policies often include provisions that require policyholders to take certain actions promptly after an incident, such as a car accident. These actions may include notifying the insurance company and filing a claim within a specified time period. Meeting these strict deadlines is essential to preserve your contractual rights under the policy. Failure to do so could result in the insurance company denying coverage or benefits.

Prompt Investigation and Evaluation

 Timely reporting of a claim allows the insurance company to promptly initiate an investigation into the incident. It helps in assessing the facts, collecting relevant information, and evaluating the damages. Delays in filing a claim may hinder the insurance company's ability to conduct a thorough and timely investigation of the claim.

Avoidance of Claim Denial

 Insurance companies have strict procedures, and they may deny a claim if the policyholder does not adhere to the reporting and filing requirements. If you fail to report the incident or fail to file a PIP claim within the stipulated time frame, the insurance company may argue that you did not fulfill your contractual obligations as outlined in the policy, potentially leading to a denial of the claim.

Statute of Limitations

 In addition to policy-specific deadlines, there are also legal statutes of limitations that set the maximum time frame within which a lawsuit or claim must be filed. Missing these statutory deadlines could result in losing the right to seek compensation altogether.

To ensure that you are within the specified time limits, review your insurance policy promptly after an accident. Take note of reporting requirements and the timeframe within which a claim must be filed. If there are uncertainties or questions, reach out to your insurance company for clarification.

Filing your PIP claim within the stipulated time is not only a contractual obligation, but also a critical step to secure the benefits you are entitled to under your insurance policy.

With the guidance of your PIP lawyer, you file a lawsuit against your insurance company, seeking the payment of overdue benefits. The lawsuit outlines the reasons for disputing the denial or disputing an underpayment of medical expenses incurred following an accident. 

A resolution of the claim may ultimately involve a full and final settlement, or a jury verdict. If the case proceeds to court, both parties present their evidence and arguments. The Court thereafter makes a decision based on the merits of the case. If either party is dissatisfied with the court's decision, they may have the option to appeal within a specified timeframe. The appeals process can extend the resolution timeline.

Filing a PIP claim in Florida involves a series of steps to ensure you receive full compensation for medical expenses and lost wages incurred after an auto accident.  By following these steps and seeking experienced legal guidance when necessary, individuals can navigate the PIP claim process effectively and ultimately work towards securing fair compensation for their bodily injuries and damages, after an auto accident in Florida.

If you have sustained injuries in a car accident, you might have grounds for a claim against the responsible driver of the other vehicles and any other negligent parties implicated in the collision. Reach out to theDaniel Sagiv Law Group by calling or texting at 561-569-1387 for further assistance with your potential PIP suit.