What doesn’t Personal Injury Protection (PIP) insurance cover?

The state of Florida is one of ten states in the U.S. in which drivers must carry Personal Injury Protection (or PIP) insurance as part of their auto insurance. Personal Injury Protection is also referred to as “no-fault” insurance, which means the insurance provider is required to cover the costs of the policyholder’s injuries in an auto accident, regardless of who is at fault.

Woman with a neck injury

However, Personal Injury Protection does not cover all costs associated with an accident. In fact, because of limitations in the coverage, you will be left on the hook for part of your medical costs. Furthermore, you will not receive compensation for your pain and suffering, unlike third-party liability insurance. In cases where the injury victim has major costs they cannot cover, it may be necessary to hire a Tampa car accident lawyer to file a third-party claim in order to cover these gaps in coverage.

High Medical Costs Are Associated with Auto Accidents

After you or a loved one has been injured in a car accident, you may be left wondering who is going to pay the medical bills that resulted from the injury.  In Florida, drivers carry Personal Injury Protection of $10,000 to help them cover most medical costs, but PIP will inevitably leave gaps in coverage and outstanding medical bills.

PIP in Florida only pays up to 80% of your medical costs in the event of an emergency. Some procedures and practices, such as massage and acupuncture, are not covered. If you have a typical $10,000 policy, this means that you may have to pay up to $2,000 of your own medical costs, even if the accident was not your fault.

Personal Injury Protection insurance does cover the following services and expenses:

  • Costs associated with ambulance services
  • Diagnostic procedures/services
  • Surgical costs and related expenses
  • Medication and costs associated with rehab

If your injury is classified as a “non-emergency”, you are only entitled to $2,500 worth of benefits.  Furthermore, costs associated with any pre-existing medical condition may not be covered.

In 2013, Florida passed new legislation that states you only have two weeks to seek treatment for injuries associated with an accident for PIP claims to be eligible. Some injuries, such as whiplash, may not show up right away. Be sure to seek medical treatment as soon as possible in order to file a viable claim.

Recovering Lost Wages After an Accident

If you are injured in an auto accident in Florida, PIP will pay up to 60% of wages lost due to disability following an accident. But, this is subject to a $10,000 limit.

However, services you normally provide but now cannot, such as cleaning or taking care of pets, are potentially included in your compensation and eligible for coverage.

In order to file for lost wages coverage under PIP, you must submit a “Work and Salary” verification form filled out by your employer, which verifies your wages for the 13 weeks prior to the accident. It is also possible that the insurance provider will require a note from your physician confirming your disability.

Death Benefits

In the tragic event that a loved one is lost in an auto accident, how to pay for expenses associated with their death may be the last thing on your mind. The average funeral in Florida costs at least $6,500 and the costs are rising. Under Florida Law, you are entitled to reimbursement for costs associated with funeral and burial expenses under PIP, but only up to $5,000.

You Can Still Recover Costs Not Covered by PIP

PIP will only cover up to $8,000 of your medical costs associated with an auto accident injury and the average hospital stay now exceeds $10,000. If your medical bills go over the $10,000 maximum you can file against PIP, you may consider filing a separate claim against the driver’s bodily injury liability (IL) insurance if they have it.

BIL insurance is not mandatory in Florida for non-commercial drivers, so if the driver who caused your accident does not carry BIL, you can sue them directly for the outstanding costs associated with your medical bills, loss of wages, pain, and suffering, disability, disfigurement, and mental anguish. In some cases, your uninsured motorist/under-insured motorist (UM/UIM) coverage may also apply. There may also be other third parties responsible for your injuries, including defective vehicle manufacturers, all of whom you could pursue a claim against in order to reclaim your remaining losses after PIP coverage ends.

Tampa Car Accident Lawyers are Available for Consultation

The goal of PIP is to provide quick funds to aid in the costs associated with an auto accident in Florida. But, in many instances, PIP only covers a fraction of the costs associated with an accident and doesn’t reimburse you for pain and suffering in any way, regardless of fault. If this circumstance describes you, it is advisable to contact a personal injury attorney in Tampa to help you understand your rights and fight for every dollar you deserve following an accident.

Attorneys at Darrigo & Diaz are experienced in navigating Florida laws and promise to fight to recover maximum compensation for your medical bills, lost wages, pain, and suffering, and — in the worst possible cases — the costs associated with the death of a loved one. Our firm has broad and comprehensive experience representing victims of personal injury accidents. Contact us online, or call (813) 774-3341 to schedule a free consultation.


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