Florida 14 day PIP Law
What is the Florida PIP Law and how does it affect me?
As a Tampa Injury Attorney, I can tell you that it can be difficult to navigate Florida’s “no-fault” auto insurance laws and what is this 14-day rule that we hear about on the radio.
One issue that often arises after a collision is Florida’s 14-day rule in personal injury protection (PIP) insurance. It’s very important to understand the 14-day rule as a crash victim. Otherwise, you could face major hurdles in trying to secure benefits – or lose your right to compensation entirely. Here’s a breakdown of how the personal injury protection rule works.
Under the 2013 PIP law change, an accident victim must get “initial services and care” within two weeks of a crash if they want to receive benefits through their PIP coverage. Almost any type of medical attention will meet this requirement, as long as it comes from a qualified health care provider, or a qualified health care provider supervised or prescribed the care.
A qualified health care provider might include:
- A medical doctor
- A dentist
- A chiropractor
- An emergency medical technician
It is important to note that seeing a physical therapist, massage therapist, or other care provider not specifically listed in the statute will likely not meet the criteria. Your insurance company will likely deny your claim, and you will not receive benefits. It is always a good idea to go to the emergency department or see your doctor as soon as possible after a crash, both to ensure you are healthy and to meet this qualification as outlined in the Florida PIP 14-day Rule.
In addition to those injured, massage therapists and acupuncturists will no longer be allowed to treat patients under PIP. Even more worrisome to Florida citizens is that the law does not require insurance companies to notify policyholders that changes are forthcoming, effectively pulling coverage away from them without their knowledge or understanding. The new PIP law forces insurance companies to reduce their PIP rates by at least 25% by 2014, but they may petition the government to be excluded from these requirements. As many are receiving exceptions to the law, the changes have a chilling effect of ripping benefits from policyholders and proving a windfall for insurance companies.
The new law also created two different amounts that can be reimbursed to an individual seeking PIP benefits depending on whether that person has been diagnosed with an emergency medical condition. If a physician, osteopathic physician, dentist, physician’s assistant, or advanced registered nurse practitioner has determined that the injured person has an emergency medical condition, then that person will be allowed to obtain the full $10,000.00 in PIP benefits. An emergency medical condition, or “EMC” for shorthand, is defined as a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to patient health, serious impairment to bodily functions, or serious dysfunction of a body organ or part. An injured person who is not diagnosed with an emergency medical condition (EMC) will be limited to $2,500.00 in PIP benefits even though the injured persons pays for $10,000.00 in benefits through their insurance policy.
For a multitude of reasons, avoiding medical attention after an accident is never smart. Being afraid of high medical expenses, for example, is a reason to seek treatment – not to avoid it – because that treatment could cost you much more in the future. If you’re anxious about missing work, you’ll miss much more if your condition later becomes serious. After a traffic collision, seek medical attention at once. If you get a “clean bill of health” you’ll also get peace of mind. And if you’ve suffered an injury, discuss your legal rights and options as quickly as possible with a good personal injury attorney.
Emergency Medical Condition
“Emergency medical condition” as it applies to PIP insurance claims in the state. The statute outlines this as a situation where victims suffered from acute symptoms that require immediate attention to prevent:
- Endangering their health and wellbeing
- Impairment of a major body function
- Serious dysfunction of any organ or body part
It is a good idea to discuss this with your doctor, who can note in your charts that you suffered an emergency medical condition. This may help your case. It is important to note there does not have to be a determination of whether your injury is an “emergency medical condition” within the first 14 days after an accident. As long as you seek medical care within the first two weeks, you should be eligible for some type of payout from your PIP insurance provider.
Some misconceptions surround how much PIP covers. It does not necessarily pay all of the bills. PIP coverage pays the reasonable customary charges for medical treatment for injuries causally related to the accident.
If an individual injured their neck in an accident and if it still hurts three days later and it is not related to the accident, their PIP coverage is not going to pay for it. It only pays for those symptoms of those injuries that were caused by the accident. Even for the injuries causally related to the accident, Personal Injury Protection will only pay 80 percent of the bills.
No Fault insurance is mandatory in Florida – you are required by law to purchase it, therefore it’s important to know what’s required of you to take advantage of it in the event you need it.
Contact a personal injury attorney to discuss the specifics of your case and decide whether you need legal representation. A personal injury attorney could mean the difference between getting a settlement that barely covers your expenses or a settlement or verdict that pays all of your bills and allows you to get back to living your life.
Tampa Attorney Martin J. Hernandez
Attorney Martin J. Hernandez of Fernandez & Hernandez, LLC in Tampa provides legal representation for families in auto accident injury and wrongful death cases. Our Tampa personal injury attorneys welcome the opportunity to interview with you and your loved ones. We invite you to review our recent results from settlements to trial verdicts. Our qualifications and background are available to you as well. Our Tampa Attorneys Martin Hernandez and Daniel Fernandez are bilingual as well. Just call us at 813-229-5353 for your free consultation.
The Tampa personal injury lawyers of Fernandez & Hernandez, serve Florida communities including Tampa, Brandon, Carrollwood, Westchase, Riverview, Temple Terrace, Pasco, Pinellas, St. Petersburg, Clearwater, Lakeland, Plant City, Ruskin, Apollo Beach, Dover, Valrico, Lutz, Lakeland and many other neighborhoods in Tampa Bay area. Contact an Experienced Tampa Auto Accident Attorney from Fernandez & Hernandez Law.
If you have been involved in an Auto Accident in the Tampa Bay area, call Tampa personal injury lawyer Martin J. Hernandez of Fernandez & Hernandez for a free consultation now. We recommend also reading his reviews on Google Reviews, Avvo and Yelp.
Call Tampa Personal Injury Attorney, Martin J. Hernandez of Fernandez & Hernandez at 813-229-5353 or read more at: www.InjuryLawyersOfTampa.com
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