Weinstein Legal personal injury law firm Fort Lauderdale

How Will I Pay My Medical Bills When FL PIP Benefits Run Out?

 
05/22/2019
Justin Weinstein
Read Time: 6 Minutes

If you've been injured in a Florida automobile or personal injury accident, you may have to rely on your personal injury protection (PIP) benefits to cover your medical bills until insurance details are sorted out. Unfortunately, medical bills can accumulate quickly in the days following a car crash. This is especially true when injuries are more severe, such as a traumatic brain injury or fractured bones.

If you are still in need of treatment after your coverage runs out, don't allow the fear of growing debt stop you from getting the care you need. Learn how to pay your medical bills when your PIP benefits run out.

How Do PIP Benefits Work?

Florida is one of 12 "no-fault" states who instituted personal injury protection (PIP) laws in an effort to streamline car accident insurance claims. This means that in Florida, the default option for covering costs following an auto accident is for your doctors to receive payment directly from your own insurance company, no matter which driver was at fault.

Florida minimum auto insurance law requires all drivers to carry a minimum of $10,000 of personal injury protection (PIP), though you may carry a larger policy if you wish. In the case of an accident, PIP claims are made against your own insurer for payment of medical bills and lost earnings. Your insurer will pay 80 percent of your medical bills and 60 percent of lost wages, up to $10,000. Whatever fees or damages remain after PIP coverage will need to be recovered otherwise.

How Do I Claim PIP Benefits?

Claiming PIP benefits is a very straightforward process. To begin, call the police as soon as possible to complete and receive a long-form accident report. This report will include insurance and personal information for each driver as well as the circumstances surrounding the accident. Then, notify your insurance company. Using the phone number listed on your insurance policy will get you in contact with a claims adjuster who can begin a formal claims process for you.

Step 1. Medical Attention

To begin claiming PIP benefits, first seek medical attention from any PIP medical provider. Under the Florida PIP statute, initial care and services can be provided by any licensed M.D., D.O, D.C., hospital, facility owned hospital, emergency medical personnel, or even dentist.

You must have your initial assessment within the first 14 days of your accident. While of course this does not mean that all treatment must be received within this two-week window, it means that a licensed medical professional must at least assess and document all present injuries within 14 days.

Step 2. Filing a Claim

Once you've received a diagnosis from a PIP medical provider, you can file a claim with your PIP insurance provider. This can be done by calling your insurance adjuster and providing them with your doctor's diagnosis. You can also begin the claims process online, typically found under tabs like "Claims" or "Report a Claim" on your insurance provider's website. Your personal injury attorney typically assists in handling this process for you.

How Much Are PIP Benefits?

Florida law requires every driver to carry at least $10,000 of personal injury protection, however, it is possible to purchase more. Most PIP policies are available in $10,000, $15,000, or $35,000 limits. How much of your benefits you're qualified to receive after an accident is dependent on your medical diagnosis. 

For a PIP claim, your medical professional must determine if the accident resulted in an emergency medical condition (EMC). An EMC is a condition that, without treatment, could result in serious jeopardy to the patient's health, bodily function, or dysfunction of any bodily organ or part. If a doctor diagnoses you with an EMC, you will be eligible for the maximum payout available from your PIP coverage.

If you do not have an evaluation by your doctor that determines you suffered from an EMC, you will only be eligible for benefits up to $2,500. In serious cases, these limits can be exhausted rapidly.

How Often Are PIP Payments Paid?

PIP benefits can be paid by your insurance company each time you are involved in an auto accident. For instance, if you were involved in a serious auto accident twice in one year, your auto insurance would provide your limit of $10,000 or more once for each claim. This is because insurance companies view each accident as a completely new and separate claim. 

Once you've qualified for your PIP benefits, medical bills or lost wages are typically compensated within 60 to 90 days. 

Paying Medical Bills After PIP

One of the most common PIP questions is, "Which comes first - my PIP coverage, health insurance, or Medicare?" The answer is simple: for car accident  or pedestrian injuries, your PIP coverage will always be the primary coverage. In fact, health insurance or Medicare may even reject medical bills that are sent to them until PIP coverage has been fully exhausted.

Once you're fully utilized your entire PIP coverage, your health insurance will then take over and begin paying. Unfortunately, this means that you will likely have to take on out-of-pocket expenses, such as co-pays and deductibles in order to continue treatment.

Florida Law Also Gives You a Right to Sue

Under Florida law, drivers are allowed to sue an at-fault driver so long as their medical costs exceed $10,000. So, if you've been charged $20,000 for a hospital stay, you are allowed to sue the other driver for the remaining $10,000 not covered by your PIP. Additionally, Florida drivers can also sue for emotional pain and suffering caused by the accident injuries, lost wages, past, current, and future medical bills, future rehabilitative therapy, and more.  

Working alongside a Florida PIP attorney can help ensure that you've fully exhausted every option before moving forward with a lawsuit. For example, many Floridian drivers carry Bodily Injury Liability (BI) coverage on their policy. In the case that your PIP benefits failed to cover all of your medical expenses, you could sue against a driver's BI insurance rather than the individual directly.

A knowledgeable attorney can negotiate a settlement with the at-fault insurance company to speed along the process and save you the trouble of needing to file a formal lawsuit. In the case that the insurance company denies your claim, or offers you an amount far below what you deserve, a personal injury attorney can move ahead with a lawsuit in order to secure the compensation you're owed. 

Contacting a Trusted Personal Injury Attorney 

As soon as you've been involved in an accident, contact a trusted Personal Injury attorney. A trusted Florida PIP attorney will be very familiar with PIP claims and what to do when those benefits run out. They will also be more likely to get a claim made against the at-fault driver's insurance company settled more quickly and more efficiently than if you tried to go at it alone.

After you've been injured by an at-fault driver, your medical bills should not be your responsibility. Time is of the essence, especially when serious injuries quickly drain your limited PIP coverage. If you've been injured in an auto accident and are rapidly depleting, or have depleted, your PIP benefits, do not hesitate to contact the trusted attorneys at Weinstein Legal today.