A Personal Injury Protection (PIP) lawsuit involves suing an insurance company to get paid for bills a patient incurs following a vehicle accident when the insurance company breaches their contractual duties under a PIP insurance policy.
PIP is an extension of car insurance which is a required personal injury protection benefit that residents of Florida to purchase if they own a car. Even if you already have Medicare or medical health coverage through your employer, you will still need to pay for PIP coverage.
Despite most states adopting fault-based insurance laws, Florida follows a motor vehicle no-fault law (FL § 627.736 ) that makes PIP coverage mandatory for car owners. So, in the event of a vehicle accident, both parties make claims to their own insurance providers, regardless of who is at fault.
While insurance companies should be helping you to recover the benefits you are entitled to following an accident, this is not always the case. In some instances, injured parties can face numerous challenges when attempting to secure damages for covered losses under their PIP policy due to the insurance companies using confusing and litigious tactics to avoid or delay payment.
For a free legal consultation, call (800) 747-3733
More About What PIP Covers
PIP covers necessary medical procedures, as well as reasonable expenses related to treatment and rehabilitation following a vehicle accident. FL § 627.736 states that PIP covers up “to a limit of $10,000 in medical and disability benefits and $5,000 in death benefits resulting from bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle”
It is important to note that FL § 627.736 limits PIP coverage as follows:
- If you do not seek medical treatment within 14 days of the vehicle accident, your PIP provider may deny your claim for benefits
- You must be treated by a medical professional (doctors, osteopaths, chiropractors, hospitals and EMS services)
- Unless you are diagnosed with an emergency medical condition, you can only claim up to $2,500
- PIP will only pay for follow up treatment for the original condition diagnosed as an EMC
- PIP does not cover acupuncture or massage therapy
Emergency medical services are defined under Florida Statute 395.002(8) as a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate attention would be reasonably expected to result in any of the following:
- Serious jeopardy to the patient’s health
- Serious impairment to bodily function
- Serious dysfunction of any bodily organ or part
For costs beyond the cap mentioned above or if you sustain serious injury, emotional trauma, or loss of future earning capacity, you may need to file a PIP lawsuit against the at-fault party in order to seek additional compensation. If you have any questions or concerns, it is a sensible idea to contact a personal injury lawyer who will offer a free case evaluation and discuss your options.
Common Reasons Insurance Companies Delay or Deny Claims
Common tactics PIP providers use to deny, underpay or delay claims include asserting that:
- You did not receive medical care within 14 days
- You did not sustain an emergency medical condition
- You did not suffer injuries that were related to the accident
- You received treatment that was not reasonable or necessary
- Using delay tactics such as not answering calls or email, or continually requesting unnecessary documentation
It may seem a daunting process, but it is important not to let the insurance company avoid its responsibilities. You do not have to face this alone and you do have options. Seeking legal assistance can protect you from your insurance provider and help you recover fair compensation for your injuries and loss.
When to Contact a Lawyer About a PIP Lawsuit
If you are involved in a vehicle accident that causes serious personal injuries, or the death of a loved one, it may be in your interest to file an injury lawsuit against the at-fault party that caused your crash rather than settling with your car insurance company.
Seek legal counsel if you have any concerns before contacting your insurance provider if you have any doubts.
Working alongside a reputable Florida PIP lawyer can help you seek justice and compensation for medical expenses, lost wages, property damage repairs, ongoing medical care costs, loss of earning capacity, and pain and suffering.
The Law Offices of Anidjar & Levine work hard to protect your rights in the event of a serious car accident and can advise you if your injuries are serious enough to qualify for a PIP lawsuit, along with what you are entitled to pursue compensation. Contact us here for a free case evaluation or call 1-800-747-3733 to get started.