The Florida PIP 14-day rule requires any injured victims to seek medical care within 14 days of an accident.
If you believe you suffered injuries, it is paramount you see a doctor right away to get the care you need. If you fail to seek care within the first two weeks after an accident, your insurer will likely deny your claim.
We recommend you seek medical care even if you are unsure whether you suffered injuries. Many injuries take hours or even days to appear.
Get Approved Medical Care on Time
Under the 2013 PIP law change, an accident victim must get “initial services and care” within two weeks of a crash if they want to receive benefits through their PIP coverage. Almost any type of medical attention will meet this requirement, as long as it comes from a qualified health care provider, or a qualified health care provider supervised or prescribed the care.
A qualified health care provider might include:
- A medical doctor
- A dentist
- A chiropractor
- An emergency medical technician
It is important to note that seeing a physical therapist, massage therapist, or other care provider not specifically listed in the statute will likely not meet the criteria. Your insurance company will likely deny your claim, and you will not receive benefits. It is always a good idea to go to the emergency department or see your doctor as soon as possible after a crash, both to ensure you are healthy and to meet this qualification as outlined in the Florida PIP 14-day Rule.
The Florida PIP 14-Day Rule and Payout Limits
When Florida passed the amendment to its PIP law, the new statute also established limits on the benefits available through a personal injury protection claim. Under the new rules, if you received treatment within 14 days, and:
- Suffered only non-emergency injuries, you can only receive $2,500 in benefits
- Suffered an “emergency medical condition,” you can receive the maximum payout available from your PIP coverage
You should have at least $10,000 in coverage available to you. This is the state’s minimum amount of PIP coverage required; however, you might carry a larger policy.
Defining an “Emergency Medical Condition”
Florida Statute § 395.002(8) defines an “emergency medical condition” as it applies to PIP insurance claims in the state. The statute outlines this as a situation where victims suffered from acute symptoms that require immediate attention to prevent:
- Endangering their health and wellbeing
- Impairment of a major body function
- Serious dysfunction of any organ or body part
It is a good idea to discuss this with your doctor, who can note in your charts that you suffered an emergency medical condition. This may help your case. It is important to note there does not have to be a determination of whether your injury is an “emergency medical condition” within the first 14 days after an accident. As long as you seek medical care within the first two weeks, you should be eligible for some type of payout from your PIP insurance provider.
What If My Insurer Refuses to Pay?
While your insurer should be dedicated to helping you recover the benefits you need — after all, you do pay a premium every month — this is not always the case. Insurers are businesses and, as such, will do what they can to pay you as little as possible. To do so, they might claim:
- You did not receive medical care within 14 days
- You did not suffer an emergency medical condition
- You did not suffer injuries in the accident as you claimed
You do not need to handle this fight alone. The car accident team at the Law Offices of Anidjar & Levine can protect you from your insurer and get you the compensation you need.
Talk to a Florida Car Accident Attorney About Your Case
If you have questions about recovering benefits from your PIP policy after a car accident, the legal team from the Law Offices of Anidjar & Levine offers free case reviews and consultations. Call us at 800-747-3733 to get started.