If you have recently suffered an injury in a Florida motor vehicle accident, you may have questions about how Florida’s no-fault insurance system affects your personal injury claim. Medical bills, missed work, insurance paperwork, and questions about fault can make the process difficult to understand. Florida’s Personal Injury Protection system provides certain benefits without first requiring proof that another driver caused the crash, but those benefits have limits and do not replace every type of personal injury claim.
What Is Florida’s No-Fault Insurance System?
Florida’s Motor Vehicle No-Fault Law requires Personal Injury Protection, commonly called PIP, on many motor vehicle insurance policies. After a covered motor vehicle accident, PIP can provide certain benefits without first determining who was responsible for causing the crash.
Florida PIP generally provides up to $10,000 in medical and disability benefits, subject to statutory requirements, exclusions, deductibles, and policy terms. Covered medical benefits generally reimburse 80 percent of reasonable and medically necessary expenses, while disability benefits generally pay 60 percent of covered lost income. Initial services and care generally must be received within 14 days after the motor vehicle accident for medical benefits to be available.
PIP is not a general personal injury insurance system. It applies to injuries arising from the ownership, maintenance, or use of a covered motor vehicle and does not govern ordinary premises liability, slip and fall, product liability, or other unrelated negligence claims.
Do I Need to Prove Fault to Receive PIP Benefits?
You generally do not need to prove that another driver caused the crash before obtaining qualifying PIP benefits. That is why Florida’s system is described as “no-fault.” The amount available, however, depends on the statute, the policy, the medical treatment received, and other circumstances surrounding the claim.
PIP benefits also do not necessarily compensate an injured person for every loss caused by a crash. Medical expenses and lost income can exceed available PIP benefits, and PIP does not generally pay damages for pain, suffering, mental anguish, or inconvenience.
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Can I Pursue a Claim Against the At-Fault Driver?
A person injured in a Florida motor vehicle accident may have a negligence claim against an at-fault driver or another responsible party. Economic damages that are not paid by PIP may be recoverable if liability and damages can be established.
Florida law places an additional limitation on recovery of certain noneconomic damages, including pain, suffering, mental anguish, and inconvenience, in claims covered by Florida Statutes section 627.737. When that statute applies, the injury must meet one of the statutory threshold categories before those damages may be recovered.
What Is Florida’s Serious Injury Threshold?
Florida law does not simply define the threshold as any injury that is “severe.” Section 627.737 identifies specific categories of injury. When the statute applies, noneconomic damages may generally be recovered if the injury consists in whole or in part of:
- A significant and permanent loss of an important bodily function.
- A permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement.
- Significant and permanent scarring or disfigurement.
- Death.
A diagnosis alone does not necessarily establish that the threshold has been met. Medical records, diagnostic testing, physician opinions, treatment history, and evidence of any permanent impairment can all be important when evaluating whether an injury satisfies the statutory requirements.
Mike Serrano’s law office was everything I needed after a very traumatic accident. He was always super up front and honest with me. I never got the feeling he was trying to sell me on something or to do something that I wasn’t comfortable with. He listened to my concerns and when it tough moments came that I needed to stand my ground. He backed me and made me feel 100% secure. He got me exactly what I needed in a settlement and I would never consider using anyone else. His office staff is also phenomenal.” - Mary Mike Serrano was a great attorney for my case!! He was very flexible with phone calls/ Zoom meetings. His staff are always friendly, whether it be on the phone or emails. They keep you updated during your entire case! They don’t leave you silent for months. if you call, they always call back with updates! Highly recommend!" - Kylie Collier Border I’ve never had to deal with a lawyer before but Mike has set the bar HIGH. He was always available to communicate my concerns and explain each step of the way. I know no other lawyer would have been able to achieve the same results because he jumped on an opportunity that was a little out of the ordinary and it paid off. He really fought for my case and over delivered. I really hope I never have another accident but if I do I’m running to Mike for help." - Sandy Carter
How Does the No-Fault System Affect My Personal Injury Case?
In a covered motor vehicle accident, PIP is often one of the first sources of benefits for qualifying medical expenses and lost income. However, PIP benefits are limited, and an injured person may have additional claims depending on who caused the crash, the available insurance coverage, and the extent of the damages.
For example, an at-fault driver’s bodily injury liability coverage may be available if that driver carried such coverage. Uninsured or underinsured motorist coverage may also be relevant when the responsible driver has no liability insurance or insufficient limits. The specific policies and circumstances of the crash determine what coverage may be available.
The no-fault system also should not be confused with the question of fault in a negligence lawsuit. PIP benefits may be available without proving fault, but a claim against another driver generally requires evidence that the other party was negligent and that the negligence caused the injuries and losses being claimed.
How Do I Start a Florida Motor Vehicle Injury Claim?
After a motor vehicle accident, address your immediate medical needs first. For PIP medical benefits, initial services and care generally must be received within 14 days of the crash. Keep records of medical treatment, prescriptions, work restrictions, expenses, and communications with insurers.
Notify the appropriate insurance carrier and keep copies of claim numbers, letters, emails, and other correspondence. If another driver may have caused the accident, preserving evidence such as photographs, witness information, crash reports, and available video can also be important.
If your losses exceed available PIP benefits or another party may be legally responsible, a separate liability claim may be available. That claim may involve medical expenses, lost income, reduced earning capacity, property damage, and other damages supported by the evidence. Noneconomic damages may also be available when permitted under Florida law.
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What Should I Do If My Insurance Company Denies My PIP Claim?
A PIP claim can be denied or reduced for a number of reasons, including disputes about coverage, the timing or type of medical treatment, the relationship between the treatment and the accident, or whether the claimed expense is covered under the policy and Florida law.
If a claim is denied, review the insurer’s written explanation and the applicable insurance policy before assuming that the denial is final. Depending on the circumstances, additional documentation, an appeal or dispute process, or legal action may be available.
A dispute with your own PIP insurer is also different from a negligence claim against the person who caused the accident. Those claims can involve different legal issues, defendants, damages, and deadlines.
How Long Do I Have to File a Personal Injury Lawsuit in Florida?
For Florida negligence claims accruing on or after March 24, 2023, the statute of limitations is generally two years. Claims that accrued before that date may be governed by the prior limitations period, and different causes of action can have different deadlines.
Claims involving government entities, wrongful death, medical malpractice, insurance disputes, or other specialized circumstances may also involve different notice requirements or filing periods. The correct deadline depends on the type of claim, the date it accrued, and the parties involved.
Waiting can create problems even before the statute of limitations expires. Surveillance footage may be deleted, witnesses can become harder to locate, and other evidence can disappear. Determining the applicable deadline and preserving evidence early can help protect a potential claim.
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How Can an Attorney Help Me With My Personal Injury Case?
Navigating Florida’s no-fault insurance system can involve questions about PIP benefits, liability, medical evidence, available insurance coverage, comparative fault, and damages. An attorney can review the accident, identify potential sources of insurance coverage, gather evidence, communicate with insurers, and determine whether a liability claim may be available.
At Serrano Law, we can review the circumstances of a Florida motor vehicle accident and explain how PIP and other insurance coverage may apply. If another party may be responsible for the crash, we can also evaluate the evidence supporting a negligence claim and the damages that may be recoverable under Florida law.
If you have questions about a motor vehicle injury claim or Florida’s no-fault insurance system, contact Serrano Law to discuss your situation. A consultation can help you understand the available insurance benefits, potential claims, and important deadlines without promising a particular outcome.
To learn more about this subject click here: Comparing Slip and Fall Cases to Other Personal Injury Claims in Florida
