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What are Florida’s PIP benefits and what do they cover?

Florida Personal Injury Protection (PIP) Insurance:  New Changes to the Law

Effective January 31, 2013, the Florida legislature revised the Motor Vehicle No-Fault Law, otherwise known as PIP insurance. The new statutory changes indicate which injured victims qualify to receive PIP benefits and the maximum amount of medical bills that can be paid.

Florida is among only 10 states which offer PIP no-fault auto insurance.  Here’s a basic summary of how some of the benefits have changed:

PIP Medical and Death Benefits

  • A fourteen-day deadline for initial treatment. Anyone trying to obtain PIP medical benefits must receive his or her initial services and care within 14 days following the auto accident;
  • Parties allowed to provide initial services and care. This type of care can only be “lawfully provided, supervised, ordered or prescribed by a licensed physician, osteopathic physician, licensed chiropractic physician, licensed dentist, or must be rendered in a hospital . . . or a licensed emergency transportation and treatment provider;
  • Conditions that must be met for follow-up services and care. This type of care must be initiated by a referral from one of the providers named in the paragraph above. Such care must be “consistent with the underlying medical diagnosis rendered when the individual received initial services and care;”
  • Two different coverage limits for PIP medical benefits. These types of limits are to be based upon the “severity of the medical condition of the individual.” The injured party can receive “up to $10,000 in medical benefits for services and care if a physician, osteopathic physician, dentist, physician’s assistant or advanced registered nurse practitioner has determined that the injured person had an emergency medical condition;”
  • Definition of an “emergency medical condition.” As set forth in Senate Bill 1860, this term is defined as one that “manifest[s] itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to patient health, serious impairment to bodily functions, or serious dysfunction of a body organ or part;”
  • PIP financial limitations when no emergency medical condition is present. When an individual “is not diagnosed with an emergency medical condition, the PIP medical benefit limit is $2,500.00.  Massage and acupuncture are not reimbursable, regardless of who the type of provider [is] rendering such services;”
  • PIP death benefits. Survivors of motor vehicle accident victims will be comforted to know that PIP (Personal Injury Protection) “now offers $5,000.00 in death benefits in addition to $10,000.00 in medical and disability benefits.” In the past, the death benefit was calculated by looking to “the lesser of the unused PIP benefits up to a total of $5,000.00.”

Additional Changes in PIP Provisions  

Your car accident attorney can address any questions you have about the other PIP law changes, including those that address:

  • PIP medical fee schedules;
  • Attorney fees;
  • The investigation and payment of claims;
  • Statements requested by your insurance company;
  • How your PIP benefits work with a workers compensation accident; and
  • How to maximize your PIP benefits.

If you’ve recently suffered a serious car accident injury, you need the help of a knowledgeable attorney. Contact the Law Offices of South Florida car accident lawyer Joseph M. Maus. He can answer all of your questions and evaluate your accident or injury claim. Please call today and schedule your free initial appointment: (855) 999-LAWS TOLL FREE or locally (954) 784-6310.




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"Even when I was not able to get a physician to follow up with me for a broken bone following a car accident, the Maus firm, in particular Rocio, worked hard on my behalf and reached a good settlement for me. This was accomplished long distance, as the accident happened in Florida and I live in Indiana. They worked on my case for 3 years and did not give up."

Posted By: Debra Murray

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