Things to Know About Personal Injury Protection (PIP)

Things to Know About Personal Injury Protection (PIP)Personal Injury Protection (PIP) is mandatory for all drivers in Florida. Despite it insuring most all of us, and despite it being used in almost every accident, there are a lot of things that most drivers do not know about what PIP will and will not cover after a car accident.

How PIP can Help

One of the benefits of PIP insurance is that it will reimburse you for certain damages regardless of how the accident happened, even if it was your fault (hence the name, “no-fault insurance”). This supposedly gives victims quick access to funds without having to prove that anybody was liable for an accident.

PIP will pay you 80% of your medical bills which includes prescriptions, therapy, and dental bills, and 60% of lost wages. It will also pay some mileage reimbursement and funeral expenses in the event of a car accident-related death.

PIP will pay these benefits after your deductible is reached. PIP will pay up to $10,000 total, although it is possible to pay for extra coverage. That $10,000 is aggregate, meaning that however you want to use that $10,000 between medical and wages is up to you but the combined total cannot exceed $10,000.

You can use your own health insurance to pay for any medical bills that exceed PIP’s maximum, or even for the amount that constitutes your deductible. However, unlike PIP, health insurance (including Medicare and Medicaid) will want reimbursement of some or all of what they paid towards your treatment should you eventually settle your case or win a verdict.

A better option is to opt for what is known as MedPay. This insurance option will not only add to the $10,000 coverage, but can be used to pay for deductibles immediately when they are incurred. Usually MedPay does not add much to an auto insurance bill. 

If you cannot pay the deductible, you physician may wait until your case settles or resolves before collecting it. Any settlement or verdict received later on will be paid to satisfy that amount.

Time and Injury Limitations Apply

Remember how we just said PIP entitles you to $10,000 in benefits after an accident? Well, PIP may not be available to you if your accident does not result in what is considered an “emergency medical condition.” The law defines this as a condition or injury that puts your health, bodily functions, or any organ or body part in serious jeopardy or serious risk of disfunction.

There is no rule that you must go to an emergency room or be taken by ambulance to qualify as having an emergency medical condition. Almost any type of care qualifies, so long as it is done within the required legal time frame, and as long as the condition being treated meets the definition of an emergency medical condition.

Even if you do have an emergency medical condition, you will not be able to get the full amount of PIP benefits unless you meet the statutory time requirements. Generally, you must receive medical coverage within two weeks of the accident.

For most, that is plenty of time. Although many injuries do manifest themselves days after an accident, it is somewhat rare for injury to show up more than two weeks after an accident. Of course, that means that you need to be diligent about seeking treatment. If your injuries start to bother you a day after the accident and you wait three weeks for a doctor’s appointment, there could be trouble.

You cannot Opt Out of PIP

You must use PIP if the accident and your injuries qualify. In other words, you cannot opt to use someone else’s insurance, even the other driver caused the accident. You could opt not to use your PIP at all, which would of course make you responsible for outstanding bills. In many cases, health insurance will not pay for medical bills if you have PIP coverage but elect not to use it.

PIP Covers a Wide Range of Victims

PIP travels with you. If you are in someone else’s car and get injured, your PIP will still cover your injuries or lost wages. Likewise, if someone is injured in your car when you are in an accident, so long as that person owns a car, that person’s PIP will pay their bills, which could lessen any liability you may have.

Even if you do not own a car, but you live with a relative who does, that relative’s PIP will pay your benefits according to the policy.

PIP even covers you if you are a pedestrian or bicyclist hit by a car, and in some cases, may even cover your children if they are injured in an accident, including an accident in a school bus, or someone else’s car.

PIP will not cover or apply to motorcyclists so long as they are over the age of 21. Motorcyclists should take special attention when purchasing insurance, and should not assume they get the same protections as car owners.

Damages that Exceed PIP Limits

For some, PIP benefits may be enough to cover injuries sustained in a car accident. For many, the PIP limits will only scratch the surface of medical expenses, especially in today’s environment of increasing medical costs.

As you may have also noticed, PIP does not cover non-economic damages, such as pain and suffering, mental anguish, frustration, loss of social relationships, and all the emotional trauma that an accident can cause.

While PIP pays a part of your lost wages, it does not pay you for future lost wages beyond the limits. Someone who will not ever be able to return to his or her former line of work, or who, because of injuries, will never advance in his or her career, will get nothing from PIP to compensate for those losses.

These are losses that must be addressed in an injury lawsuit, which is why so many people will end up using PIP benefits and still filing an injury lawsuit. Assuming there is a liable or negligent other party, an injury lawsuit will fill in the gaps that PIP leaves, as well as help victims with larger or long term expenses, and damages that do not have a readily ascertainable price tag on them.

After a car accident you may have medical bills to take care of and insurances to manage.  Contact Brill & Rinaldi today about a free consultation to discuss handling your finances and obtaining damages after an accident.