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Everything you need to know about Florida’s No-Fault Law in one page.
What is Florida No-Fault (PIP)?
Personal Injury Protection (PIP) in Florida is automobile insurance coverage that pays 80% of your accident-related medical expenses, 60% of your lost wages, and reimburses you for mileage to and from your doctor’s appointments if you are involved in an accident. This is true whether or not you were at-fault for the accident, hence the “no-fault.” PIP coverage is mandatory in Florida and requires that all drivers to carry $10,000.00 in coverage. PIP coverage is also primary (meaning it pays out first) over any other type of insurance, including private health insurance.
In 2012, the Florida legislature passed a new version of the PIP law (HB 119) by a narrow margin. The new law took effect on January 1, 2013, and in typical fashion, it did less to benefit consumers and more help the insurance industry. Prior to this change, there was no set time limit as long as your doctor could prove that the treatment was medically necessary and related to the accident.
EMC is defined in the statute as:“a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following: serious jeopardy to patient health, serious impairment of bodily functions, serious dysfunction of any bodily organ or part.” This diagnosis has to be done by a medical doctor (MD), an osteopath (OD), a dentist (DMD), a physician’s assistant (PA), or a registered nurse practitioner (ARNP).
The new Florida no-fault (PIP) statute states that if you are diagnosed with EMC, they will pay up to full $10,000.00. However, the statute allows your insurance company to cap your PIP benefits at $2,500.00 if a medical professional authorized to make the EMC diagnosis “determines that the injured person did not have an emergency medical condition.”
Not all providers have you execute an AOB. These include your emergency room (ER) related expenses. In those situations, always provide these institutions with your private health insurance information (if any) and your auto insurance information.