In Florida, the law requires all drivers to have certain minimum insurance coverages, including Personal Injury Protection (PIP). Regardless of whose fault the accident was, your own PIP insurance pays you benefits. These benefits include eighty percent of reasonable and necessary medical expenses and sixty percent of lost wages. Florida’s PIP laws are designed to ensure that every driver can obtain necessary medical care after an accident without financial hardship.
Each driver can also purchase optional medical payments coverage (Medpay) from their insurance company. Medpay benefits pay twenty percent of medical bills that are not payable by PIP, and typically one hundred percent of bills after PIP coverage has been fully used.
The statutes and regulations that govern PIP are numerous and confusing. PIP laws govern who is entitled to PIP, including certain passengers and pedestrians, which doctors are eligible to receive PIP payments, how much doctors can and do charge, and what you can do if you have a dispute with your insurance company. These regulations can have a big impact on your treatment and your wallet. Some doctors may stop treating you if your insurance company doesn’t pay properly. In some situations, if your doctor doesn’t bill correctly, not only won’t your insurance pay, but you won’t have to pay the bill either.
Many people believe that when they “buy” PIP and Medpay coverage in certain amounts, they should be able to use all of it after a car accident. Realistically, you are covered “up to” the limits of the policy amounts, subject to many terms and conditions of the statute and the policy itself. Most significantly, the medical treatment must be necessary and related to the car accident.
Often an insurance company will have you examined by a doctor who will say that the treatment is not necessary or related to the accident. In that case, the insurance company will stop paying and you will be responsible for any future bills unless you take appropriate steps to challenge the insurance company.
If you have been in an accident, you should speak to an experienced attorney who is knowledgeable about PIP laws. Having an attorney will put you on an equal footing with your insurance company and ensure that you get the benefits you paid for.
