Auto accidents. They happen. It is an unfortunate situation that can overwhelm just about anyone. You have to deal with insurance companies, finding a replacement vehicle, and possible injuries. If you’ve been injured in a car accident, and have auto insurance (like you are required to have), then it will pay what is called personal injury protection benefits (“PIP”). It is important to note a distinction – PIP is covered by your auto insurance and not your health insurance. PIP covers “eighty percent (80%) of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices and medically necessary ambulance, hospital, and nursing services if the individual receives initial services and care.” F.S. 627.736(1)(a). PIP is covered under Florida Statutes Section 627.736.
So, does PIP only cover the insured? No. PIP covers “the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in the motor vehicle, and other persons struck by the motor vehicle and suffering bodily injury while not an occupant of a self-propelled vehicle.” F.S. 627.736(1). However, for the purposes of this article, I will only focus on PIP being covered by the named insured who was driving their own vehicle so you are aware of what you should do after an auto accident.
First, you must receive medical treatment within fourteen (14) days of the accident. Therefore, it is imperative that you seek medical treatment as soon as possible not just for your own health but also to document your injuries should you later seek to pursue a personal injury law suit.
Next, you must receive the “allowable” medical treatment. By “allowable”, I mean “allowable” under the statute. You can only have PIP cover services rendered by a physican, dentist, or chiropractor.
Most physicians, dentists, or chiropractors are well-versed in PIP. Or, at least versed enough to know the basics. You shouldn’t have any issues with confusion from the medical professional that you are obtaining treatment from through PIP. If you do, then I would recommend finding another treating medical professional that fits the “allowable” definition previously mentioned.
So, you have an accident, get injured, and go obtain medical treatment – then your auto insurance company refuses to pay. What happens? Do you have to pay that money out of pocket? The answer is a resounding NO! You should seek an attorney that is competent in handling PIP suits. They need to know whether there was an assignment of benefits or revocation, whether your injury was emergency medical care or not, and how to properly file a lawsuit against your auto insurance provider. It is important that your attorney be capable of handling the auto insurance provider and not back down. You may need aggressive representation. Often times, this will result in a speedy and fair settlement.
Additionally, your attorney should do all of this without you having to pay anything. If your attorney is successful in your PIP suit then attorney fees are paid for by the other side, most likely, as part of the speedy and fair settlement. Don’t let an attorney nickel and dime you.