If someone asks us whether they should go to the ER immediately after an accident, we'll probably advise them to do so no matter where they are. Trained medical professionals are simply much better at determining whether you're injured than you are. Even things you think seem minor, like mild soreness, could be an indicator of a (sometimes much) more serious injury. But if you live in Florida, our current insurance laws make that even more vital.
Florida is what is called a no-fault insurance state. This means that in many cases, it's not necessary to prove who's at fault for the accident in order to get your insurance company to pay for your injuries under your personal injury protection (PIP) insurance. However, in order to combat insurance fraud, Florida does have very specific laws and limits regarding PIP, and knowing how to work within them could mean the difference between getting compensated and shelling out the cash yourself.
Emergency Medical Condition
To understand Florida's PIP laws, it's important to understand what an emergency medical condition is as defined by law. Whether or not you're diagnosed with one will determine how much you qualify to be compensated under your PIP coverage.
Under Florida law, an emergency medical condition (EMC) is "a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to patient health, and/or serious impairment to bodily functions, and/or serious dysfunction of any bodily organ or part."
In order to qualify for full $10,000 PIP benefits, you must be diagnosed with an EMC by a qualified medical professional; otherwise, you may be limited to only $2,500 in benefits.
Florida Limits to Treatment Timeframe
In Florida, you must seek treatment for injuries within 14 days in order to file a PIP claim for the benefits. That means you'll have to pay out of pocket or use your regular health insurance if you seek treatment on day 15 or later. It's not uncommon for people to feel sore after an accident and believe it's a minor injury, thinking they can just take a few aspirin and they'll be better later, only to have the condition to persist or get worse as it remains untreated.
Remember, even if the injury isn't serious, you still may qualify for up to $2,500 in compensation to get you back on your feet.
In general, it's always best to see a doctor immediately after an accident. Not only is it important to get treatment within the 14-day period for PIP benefits, but if a lawsuit does become necessary, waiting opens you up to potential arguments by the defense that you received the injuries in an unrelated accident.
Common Issues With Florida PIP Laws
Your PIP benefits only cover up to $10,000, but many people have injuries so severe that their medical bills rack up (or will rack up due to ongoing needs related to the injury) so much that $10,000 just won't compensate them fairly. In this case, you may have to sue.
Additionally, many people find themselves in an argument with the insurance company over whether the diagnosis they received truly was an EMC (that's right… they may question your doctor's diagnosis!).
Still others are just confused by the entire process or too busy to deal in a prompt manner with the multitude of hoops people can be asked to jump through just to get compensated for a legitimate claim they made on insurance they've faithfully paid.
Whatever the circumstances, don't take on the insurance company or a defendant's lawyers on your own. Get a qualified Kissimmee car accident lawyer on your side as soon as possible to protect your best interests. If you're in the Orlando, Florida, area, you can call the experienced PIP insurance lawyers at Draper Law Offices at 866.767.4711 for a free, no-obligation consultation.