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Important Information About Your PIP Coverage

If you drive on Florida roads, by law, you are required to have Personal Injury Protection (“PIP”) insurance coverage. The intention of PIP or, what many refer to as “No-Fault” insurance is to provide injured drivers up to $10,000 in immediate medical coverage in lieu of establishing fault through the court system.  A drivers PIP policy will provide him or her 80% medical coverage for all medical bills related to a motor vehicle crash up to $10,000.00.  Further, it does not matter if the driver is at-fault or not-at-fault, PIP usually will cover accident-related medical care.

Back in 2012, Florida lawmakers passed House Bill HB 119 – Personal Injury Protection (PIP) for Auto Insurance Fraud.  In 2012, the Florida Office of Insurance Regulation claimed:

“In recent years, the number of drivers and auto accidents has remained relatively constant, but the amount of PIP claims, and PIP payments have skyrocketed. The National Insurance Crime Bureau lists Florida as having several cities reporting the highest amount of “questionable claims” nationally.”

Therefore, it passed HB 119, which created a fourteen (14) day grace period for claiming PIP benefits from one’s own PIP insurance policy.  Under this law, if an injured driver does not seek medical care and that medical provider does not open a PIP claim with the injured driver’s insurance, the injured driver is no longer entitled to the $10,000.00 in PIP insurance that he or she paid for.  While some argue that an injured person will always see a doctor within 14 days if they truly are injured, practically speaking, everyone knows that person who will put off medical care for illnesses or injuries far in excess of 14 days.

The stated reason for restricting PIP to a 14-day window for claiming PIP benefits is that fraudulent PIP claims were costing insurance companies a lot of money.  The Florida Senate sought a guaranteed 10 to 25 percent reduction in premiums after the passage of the bill.  However, the statistics from the National Association of Insurance Commissioners (“NAIC”) do not back up the claim that “PIP payments skyrocketed”.  Moreover, if the companies were paying “skyrocketing” PIP claims before 2012, the 14-day rule certainly has not brought premiums down by the 10 to 25 percent discussed by the Senate.  According to the NAIC, since 2012 premiums have gone up.

The bottom line is we purchase PIP insurance to provide for medical care when we are injured from a motor vehicle crash.  Accordingly, if you are in a crash, and you have injuries, you should seek medical care immediately or within 14 days.  Otherwise, you lose your right to utilize the $10,000.00 of medical benefits that you paid for.  Some consumers may feel that they don’t want to use their PIP insurance because they do not want their premiums to go up.  However, regardless of a claim, premiums are statistically going up anyway.  As such, a consumer should get the benefits he or she paid for and will continue paying for every year they drive on Florida roads.

If you, a family member, friend or loved one had a car crash and need more information about the 14-day rule and PIP the attorneys at Lesser, Lesser, Landy & Smith PLLC are experienced and can help you navigate the complexities of the PIP rules.

Blog is written by Partner Chad Hastings.

Palm Beach County: 561-655-2028
Martin County: 772-283-6839
Toll-Free: 1-877-LAW-LLLS

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