Auto Accident Laws

Jacksonville Auto Accident Insurance (PIP) Law

Information on PIP insurance in Florida

Motorists in Florida are required to carry personal injury protection (PIP) coverage, a limited form of no-fault insurance that covers the first $10,000 in damages from an accident regardless of whether you were at fault in an accident where you were injured. PIP covers, among other things, medical expenses for injuries suffered in an accident; however, that amount is subject to a deductible that you must pay before your PIP insurance kicks in. Under Florida law, PIP only covers 80% of medical bills up to the $10,000 coverage amount.

Most medical costs will be covered by your PIP insurance. In Florida, you can choose whether you want your PIP to cover just yourself or other residents in your household. The following are eligible for a PIP claim:

  • Medical services
  • Medication
  • Surgical services
  • Hospital expenses
  • Rehab costs
  • Diagnostic services
  • Ambulatory services

Important Things to Remember When Dealing with PIP Insurance:

The Florida PIP 14-day rule requires any injured victims to seek medical care within 14 days of an accident. If you fail to seek care within the first two weeks after an accident, your insurer will likely deny your claim.

To qualify for the full benefits, your injury must be deemed an “Emergency Medical Condition” (EMC) and be diagnosed as an acute (recent) injury. In addition, it must be deemed ‘highly painful’ with serious potential outcomes if not treated quickly.

For the full auto insurance benefits to be available to you, the practice where you find care for your injuries must employee the proper medical staff (who qualify to make the determination of an EMC). Furthermore, these qualified medical staff must make the correct determination after a thorough exam of your injuries.

In addition to only qualifying for the full auto insurance benefits by using a practice with the proper medical staff and the proper diagnosis, your follow-up treatment can only be given to the areas that are related to the medical diagnosis during the first visit.

Be sure not to miss both the visits with the treating provider or visits with insurance company doctor. If you miss two insurance company appointments, no insurance coverage nor benefits will be available to you.

Insurance companies are required to take a recorded statement—called an Examination Under Oath (EUO). If you have an attorney representing you, he or she can ensure that the insurance company’s questions are relevant and within the proper boundaries.

Be patient and remember that while you only have 14 days to see your healthcare provider, insurance companies may have up to 90 days to pay claims.

First Coast Medical Center has a board-certified Orthopedic Physician as its medical director, as well as two Advanced Registered Nurse Practitioners (ARNP), all of whom qualify to make the determination of an EMC, as well as a chiropractic staff who stand ready to help your auto related injuries.

Call (904) 358-BACK for an appointment or for more information.