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Why Is My Insurance Paying For My Medical Expenses?

On Behalf of | Nov 23, 2015 | Insurance

In order to register your Florida automobile, you must meet minimal insurance requirements. The requirements are as follows: (1) $10,000.00 of Personal Injury Protection (“PIP”) and (2) $10,000 of property damage liability.

If you have been injured in a car accident, you are likely receiving large medical bills. While you may understand property damage coverage, most people do not understand “PIP” benefits. Simply stated, PIP benefits help you pay for your medical bills arising from a car accident. Personal Injury Protection (“PIP”) is also referred to as “No-Fault” Insurance. PIP or No-Fault pays for injuries to you, your family and people in your car, regardless of who is at fault for the accident. PIP can pay 80% of medical expenses and/or 60% of any loss of wages up to $10,000.00. PIP coverage also provides for a $5,000.00 death benefit. Depending on your policy terms, a deductible may be due when you use your PIP coverage.

Since 2013, the Florida legislature has passed laws making it more difficult to qualify for PIP benefits. To take advantage of the full $10,000.00 in PIP benefits, you must be treated within fourteen (14) days of the car accident. The initial treatment must be provided in a hospital or licensed clinic or by a select group of professionals, including medical doctor, dentist, chiropractor and paramedic. If you are not treated within fourteen (14) days, you are completely barred from claiming any benefits. Also, you must make sure that your treating medical providers determine whether you have an “emergency medical condition”. Without this diagnosis, your automobile insurance carrier will likely limit your PIP benefits to $2,500.00.

In addition to the required No-Fault or PIP benefits, you may select to purchase an optional coverage of Medical Payment benefits. Medical Payment coverage is similar to PIP in that both will help with your medical costs no matter who is found at fault for the accident. This coverage supplements PIP. Unlike PIP benefits, Medical Payment coverage can only be used for medical costs and funeral expenses. In most cases, Medical Payment coverage can be purchased in increments of $5,000.00.

Some consumers choose not to purchase Medical Payment coverage when they have a good health insurance policy. If you do not have Medical Payment coverage, make sure that your medical providers are given your health insurance information. Your health insurance company (private, Medicaid, Medicare, Tricare, etc.) will likely cover what PIP does not. Health insurance is considered your secondary coverage following a motor vehicle accident. Once your PIP benefits are exhausted, your health insurance becomes primary. This is very important to remember, if you take money from the person that caused your car accident or from their insurance company, you MUST make sure that your health insurance company is repaid. It is very likely that your health insurance company has legal rights to be repaid from the settlement proceeds. This is called a subrogation lien. An attorney that has limited his practice to personal injury matters should be able to explain your rights and obligations.

Most people become frustrated after being involved in an accident once they see who will be paying for their medical bills in the beginning. However, do not fret. The responsible parties will be held accountable. If the responsible person or company has bodily injury liability insurance, their insurance coverage will make a one-time payment at the end of your case. Hopefully, this coverage is large enough to satisfy your needs. If you do not know how much liability insurance the responsible party carried at the time of the accident, contact our office. A request for information to their insurance company can usually be completed in less than a few weeks, if not immediately over the phone.



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Our legal team consists of attorney Wm. Dennis Brannon and his son C. Paul Brannon. We work together as a father and son team to provide our clients with exceptional service and solutions in car accident claims and other personal injury matters.

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