ABC's of Personal Injury Protection (PIP) in Florida
A common topic that we are asked to explain to clients in our Florida law office is the Florida Law on PIP. There are several misconceptions out there on what PIP covers. This blog post will go over the ABC's of Florida Personal Injury Protection Insurance.
PIP is a guaranteed health insurance policy for a person who is injured in an automobile accident. When a person is injured in an automobile accident if they do not have regular health insurance, but they have PIP insurance, they are guaranteed $10,000 of health insurance less what ever deductible they have chosen. In other words, the person injured is guaranteed $10,000 worth of health benefits. If they have a $1,000 deductible for example, the first $1,000 of medical bills is their responsibility.
PIP pays 80% of your reasonable and necessary medical bills. The PIP law just changed, so there are Medicare fee schedules that PIP pays 80% of those schedules. For example, if there is a charge for $100, Medicare's fee schedule would be $80. Eighty percent of the first bill would get applied to the deductible. When the deductible is met, PIP then pays 80% of those next bills, up to $10,000. One of the benefits of PIP is that it gives the injured person in an accident, $10,000 of insurance for their medical bills. It is also the law in Florida as the minimum requirement to operate a vehicle. In the State of Florida, you must have PIP and Property damage insurance.
Is it always the $10,000 limit?
Yes. I have seen on occasion, extended PIP, but those would be associated with out of state policies. I have not seen extended PIP on a Florida policy.
What is the deductible for PIP?
You can manipulate your deductible, meaning you have options too choose from, which includes: no deductible, $500 deductible or $1,000 deductible.
Does PIP cover you in an accident that happens out of Florida?
The PIP statute is very clear about this for Florida residents. If you are a Florida resident, and involved in an accident out of the state while driving your vehicle, you are covered. If you are operating another vehicle, then you are not covered by your PIP policy.
According to the Florida statute, it states that the Insurance company shall pay Personal Injury Protection (PIP) benefits for and there are four scenarios.
The first scenario is: Accidental Bodily Injury sustained in Florida by the owner, while occupying a motor vehicle. Or while not the occupant of a self propelled vehicle, if the injury is caused by physical contact with a motor vehicle. An example of this is if the injured person was a pedestrian or on a bicycle.
The second scenario that an insurance Company will pay Personal Injury Protection (PIP) benefits is for accidental bodily injuries sustained outside of the State of Florida but within the United States by the owner, while occupying the owner's motor vehicle. Meaning the owner has to be in his/her own motor vehicle that is insured. He can't be in a friend's motor vehicle.
The third scenario where an insurance company will pay Personal Injury Protection (PIP) benefits is for accidental bodily injuries sustained by a relative of the owner who resides in the same household of the insured. This is called the relative resident rule under the Florida statute for PIP. Under any of the circumstances just described. Meaning injury in the state, while occupying the motor vehicle or caused by the motor vehicle, or if it is outside of the state of Florida, if that person was occupying the owner's motor vehicle. This extends to resident relatives, for example, if I am married and I own a vehicle, but my wife does not and my wife is a passenger in my car and gets injured, she is entitled to PIP under my policy, because she is a resident relative. The definition of a resident relative, means the person is a relative by blood or marriage and lives in the same household. If it is a non-married, significant other, such as a boyfriend or girlfriend, the person does not qualify as a resident relative.
The fourth scenario where an insurance company will pay Personal Injury Protection (PIP) benefits is for accidental bodily injuries sustained in this state by any other person while occupying the owner's motor vehicle. An example of this would be if I have a friend who is in my vehicle, and that friend does not own a vehicle of his/her own, nor does he/she live with a resident relative, then he can get PIP benefits through my policy. This applies to any friend driving the car of a person with PIP.
Does PIP pay for lost wages if I am in an accident?
Yes, Personal Injury Protection (PIP) Insurance pays 60% of lost wages. Typically the insurance companies will see what your current job at the time of the automobile accident was and they will pay 60% of those current wages.
Does PIP cover death benefits?
Yes, this was just enacted through the Florida Legislature as a part of the PIP benefits. If someone dies as a result of an automobile accident, PIP will pay $5,000 of death benefits. This was legislated when the PIP statute was put into effect.
When is PIP required in Florida?
The law in Florida says that if you have a vehicle in Florida for more than 90 days, you must have the vehicle registered and you have to comply with the law of the State of Florida.
How is PIP different from Property Damage Insurance?
PIP is Personal Injury Protection, it pays for personal injuries. Property Damage Insurance pays for property damage. When you have PIP (Personal Injury Protection) Insurance, this pays for your medical bills, regardless of who is at fault in the accident. Property Damage Insurance, pays for the other person's vehicle, if you damage the other person's vehicle. An example of this is if I get into an auto accident with you, regardless of who is at fault, PIP pays for my medical expenses and your PIP pays for your medical expenses. If the accident, was my my fault, my Property Damage Insurance, is what you would use to pay for the repairs on your vehicle.
I hope that I have given our readers the fundamentals of the ABC's of PIP. If you have any questions, please drop me line and let me know.
Carl J. Wald, Esq.
