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Understanding Florida’s PIP Insurance and No-Fault Laws

August 7, 2023 Legal Team
Insurance policy terms and conditions contract

Navigating the landscape of auto insurance can be a complex task. Terms like ‘Personal Injury Protection (PIP)’ and ‘no-fault’ often cause confusion. In this blog post, we will demystify these concepts, focusing specifically on what they mean for Florida residents.

What is Personal Injury Protection (PIP) Insurance?

Personal Injury Protection (PIP) insurance is a type of auto insurance that covers medical expenses and, in many cases, lost wages resulting from an auto accident, regardless of who was at fault. It is also known as “no-fault” insurance because the coverage applies no matter who caused the accident.

PIP coverage in Florida pays:

– 80% of necessary medical expenses

– 60% of lost income due to the accident

– $5,000 in death benefits

– 100% of replacement services like child care or housekeeping [1]

These benefits apply up to the limit of the policy, which is typically $10,000 in Florida [1].

Florida: A No-Fault State

Florida is one of a handful of states that follow a “no-fault” system when it comes to car accidents. This means that after most traffic accidents, an injured person’s own insurance policy (specifically, their PIP coverage) will provide compensation for certain out-of-pocket losses, regardless of who caused the accident. This system aims to limit the number of lawsuits stemming from traffic accidents.

So, if you’re injured in a car accident in Florida, you would turn first (and often exclusively) to your own PIP insurance to get compensation for medical expenses and other financial losses, without needing to establish that the other driver was at fault for the crash.

Limitations of No-Fault/PIP in Florida

Florida law does put some limitations on PIP coverage. Most importantly, PIP only covers up to $2,500 of medical costs unless the injured person has an “emergency medical condition,” as defined by the statute. If the injury qualifies as an “emergency medical condition,” the full $10,000 PIP limit is available.

Further, to be eligible for PIP coverage, you must seek medical treatment within 14 days of the accident.

When Can You Step Outside the No-Fault System?

While the no-fault system aims to streamline the claims process, it also limits your right to sue the at-fault driver. However, Florida law does allow you to step outside of the no-fault system and file a lawsuit against the at-fault driver if your injuries are considered “serious” under Florida’s statutory threshold [5]. This includes significant and permanent loss of an important bodily function, permanent injury within a reasonable degree of medical probability, significant and permanent scarring or disfigurement, or death.

The no-fault/PIP system in Florida aims to ensure quick payment of claims for medical bills and lost income without the need to prove fault. However, navigating this system can still be complex, especially when serious injuries are involved. Consult with one of Shapiro | Delgado | Hofmann personal injury lawyers in Sarasota and Bradenton. They can help you understand your rights and obligations under Florida’s unique system. Furthermore, they will determine whether you have a viable case.