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How Florida’s No-Fault Insurance Impacts Car Accident Victims

When you’re injured in an accident, such as a car crash or slip and fall, you may assume that the person who caused the accident would be the one on the hook for paying your medical expenses, lost wages, and other related damages.

However, that’s not necessarily the case in the Sunshine State. Unlike many other states, which follow a fault-based insurance rule that we described above, Florida is considered a no-fault insurance state. This term is a common source of confusion for many car accident victims, so we discuss more about what no-fault insurance means below.

What Is No-Fault Insurance?

No-fault insurance, also referred to as a personal injury protection (PIP) policy, is a type of auto insurance coverage that is designed to compensate the insured individual should they be injured in a car accident, regardless of who was at fault. In Florida, PIP policies generally cover the following:

  • Medical Costs. PIP policies will cover 80% of medical costs associated with emergency medical conditions up to the policy limits, given that the treatment is being done by a licensed physician, dentist, hospital, or facility owned by the hospital.
  • Lost Wages. PIP policies also cover 60% of lost wages for 13 weeks; these include any time the worker was unable to work due to the accident or any time off for doctor’s appointments or medical procedures related to their injury.
  • Death Benefits. If the insured is killed in an accident, PIP policies will pay up to $5,000 in death benefits to qualified survivors for funeral and burial expenses.

The purpose of no-fault insurance is to reduce the number of personal injury lawsuits so that accident victims can be compensated as quickly as possible through their own insurance coverage.

When Does My PIP Coverage Apply?

If you cause an accident and are injured, you are generally able to file a PIP claim through your own insurance company for the damages and amounts listed above. You may be barred from filing a PIP claim if you were found to be driving while impaired at the time of the accident.

Additionally, if you are injured in an accident caused by another negligent driver, you and your vehicle occupants would also file PIP claims through your own insurance company. Florida law requires those filing a PIP claim to seek medical treatment within 14 days of the accident to remain eligible for coverage.

There are certain damages, however, that are not covered under PIP policies, some of which include:

  • Damage to your vehicle and property and the other driver’s vehicle and property
  • Bodily injuries of adult passengers in your car
  • Bodily injuries of other car’s occupants
  • Pain and suffering claims

Are There Exceptions to the No-Fault Insurance Rule?

One common misconception regarding Florida’s auto insurance rules is that fault does not matter. That is simply not true. In fact, there are several exceptions to the no-fault insurance rule where fault must be taken into consideration.

If one’s own PIP coverage is not enough to pay for the entire extent of their medical bills and lost wages, the injured would then be eligible to file a third-party claim against the at-fault driver’s insurance company.

Additionally, Florida allows certain accident victims to seek compensation by filing a personal injury lawsuit against the at-fault driver if their damages exceed their PIP coverage limits and they suffered a “permanent injury,” which may include:

  • Significant and permanent loss of an important bodily function
  • Permanent injury within a reasonable degree of medical probability
  • Significant scarring or disfigurement
  • Death

Other situations where no-fault insurance may not apply would be out-of-state accidents or crashes involving uninsured motorists.

Do I Need an Attorney?

When it comes to insurance companies, even your own, paying out claims is the last thing they want to do. You may pay your premiums and take all the right steps after being injured, but your PIP claim may still wind up denied or undervalued.

Don’t go up against the insurance company when you don’t have to. At the Law Offices of John D. Ameen, our team of car accident attorneys is committed to protecting the rights of policyholders across Florida. Get seasoned legal advocates on your side so you have the best chances of receiving maximum compensation for your losses.

Contact our firm at (800) 953-2858 to get started on your case today!