You’ve been in an accident, sustained injuries that are determined to be an “Emergency Medical Condition” and you have sought treatment with a doctor within those super important 14 days, now what? Under your PIP coverage, when related to the injury sustained as a result of your motor vehicle accident, most medical costs will be covered with the exception of acupuncture and massage.
More specifically, these costs include ambulatory services, diagnostic services, rehabilitation costs, medical services and medications and surgical services and hospital expenses. They are, however, not covered at 100% by PIP. Rather, PIP will pay 80% of your medical costs. Therefore, if you have injuries with treatment that costs $10,000, PIP will only cover $8,000 of those fees. Most times, your personal health insurance will cover the rest. Do know that if your treating provider determines that you do not have an actual Emergency Medical Condition, then you will only be entitled to $2,500 in benefits.
Personal Injury Protection covers lost wages. Yes, if you are injured in an accident and a doctor states you are unable to work, your PIP will pay for 60% of your lost wages subject to the $10,000 limit. This even includes services that you are unable to perform now because of the accident like cleaning around your home and other daily tasks. I will say that I have spoken with people before that get excited when they hear this only to realize that having PIP pay for your medical treatment is sometimes a better route than utilizing this part of the coverage.
There is even a death benefit. If the unfortunate happens and the policyholder was killed, PIP would cover the funeral and burial expenses in addition to the other benefits. You or the policy holders next of kin are entitled to $5,000 for these costs. This is definitely one of those benefits you hope to never have to use, however, in my experience, it can be a true gift in a time of suffering. I have unfortunately had to hand over this check before and while it was absolutely heartbreaking, I know that it was a true help in a dire time of unexpected need.
While all of these things are good news if you have been involved in an accident, the stark reality is that for many, the full $10,000 can be used up before you even get out of the hospital. Health care is expensive and many times, the injuries sustained in an accident can require extensive treatment both at the ER and after.
Relying on this PIP coverage is not your best bet. Because of Florida’s lack of required Bodily Injury coverage, you can be left with mounting bills following an accident that was not your fault. That is why I always recommend looking into Uninsured/Underinsured Motorist coverage. I know, it stings when you have to purchase extra insurance coverage to protect yourself from an accident that is NOT your fault, but trust me when I say, there are thousands of drivers on our Florida roads that are not insured. I have had to tell some very injured clients that there is nothing I can do for them as the at fault party had no insurance and they personally have no UM coverage. As you can see PIP can be just a drop in the bucket if you do sustain significant injuries so, be proactive and schedule a consultation to learn more about UM coverage.