Personal Injury Protection: The 14-Day PIP Restriction
Being involved in a motor vehicle crash is a stressful event. If you are injured, it is important to be aware of the personal injury protection benefits you may be entitled to.
What is PIP?
All divers in Florida must carry personal injury protection benefits on their automobile insurance policy. Other terms you may hear used to describe personal injury protection are “PIP” or “no-fault” coverage. This coverage is mandatory and causes a driver to be “self-insured” for medical expenses relating to motor vehicle accidents, regardless of fault. Eighty percent, up to $10,000, of all reasonable expenses for medically necessary treatment may be paid out of your PIP benefits.
PIP Requirements and Exceptions
These benefits come with some requirements and exceptions, though. One requirement is that an injured party must seek treatment within 14 days of the motor vehicle crash in order to obtain PIP benefits. This time restraint is a recently enacted reform; previously, there was no time limit to treat in order to attain these benefits. If you miss this 14-day cut-off, the insurance company no longer has the obligation to provide you with PIP coverage. Additionally, you may be liable for any medical expenses incurred and have to pay out-of-pocket for them. This is why it’s important to follow recent changes to ensure you get the personal injury protection benefits coverage you may deserve.
Also, you can only obtain the PIP reimbursement of up to $10,000 if a physician has determined the injured person has an “emergency medical condition.” If a physician determines you do not have an emergency medical condition, you are entitled up to $2,500 of reimbursement. It is important to note the emergency medical condition does not have to be established at or during the 14-day time-frame. Rather, the time-frame only applies to initial treatment, and the additional requirement of meeting the emergency medical condition can come at a later time if your doctor finds that it has been established. This means you can continue to treat beyond the 14 days to exhaust all $10,000 of your personal injury protection coverage.
Florida Statute §627.736
The statute that mandates the these requirements and exceptions is Florida Statute §627.736. It states, “80 percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices and medically necessary ambulance, hospital, and nursing services” may be awarded “if the individual receives initial services and care…within 14 days after the motor vehicle accident.” You can review these required PIP benefits here.
The legislature has enacted these laws to prevent fraud. However, it is possible for pain and symptoms from a traumatic or permanent injury to become evident at a later time. Even if your pain and symptoms have manifested after this 14-day period, you may still be able to make a claim for bodily injury insurance or uninsured/underinsured motorist benefits.
If you have been injured in an automobile collision, whether it is before or after this 14-day PIP requirement, contact Dennis Hernandez & Associates, P.A. for a free consultation. Call us at (855)-LAW-DENNIS or visit our site.