What Happens When Your Injuries’ Costs Exceed PIP in Florida

In most other states, when you get into a car accident, one of the drivers is determined to be “at-fault.” Our state, however, is a “no-fault” state where the other driver cannot be held responsible for injuries that you incur from the accident unless those injuries are serious enough to meet Florida’s “injury threshold.” Before we get into that, though, it is important to talk about injuries that do not meet this threshold, because far too many simply do not, even though costs for victims frequently end up exceeding what insurance will cover.

Here is how our system works when someone doesn’t meet Florida’s injury threshold:

• Two people get into an accident.
• Despite one of them clearly causing the crash, Florida’s “no-fault” system kicks in and each driver has to pay for medical costs out of his or her own insurance coverage.
• These costs come out of our state’s required PIP coverage, which covers $10,000 worth of medical bills – though recent laws have limited the medical providers that you can see.
• If your injury is relatively minor, the $10,000 will cover it and you can go on about your life none the wiser.
• If your injury is serious or does not seem to go away, your PIP coverage will stop paying for it as soon as the cost reaches $10,000 and you will have to cover the rest.

How Can You Avoid Paying for Injuries That Cost Over $10,000 to Fix?

It doesn’t seem very fair to make someone pay for injuries incurred in a car accident that someone else caused, but unfortunately that is the system that Floridians currently have to live with, and it is one that does not look like it will be abandoned any time soon.

So how can you make sure that you are protected for more than $10,000 if your problem isn’t serious enough to pass the injury threshold? The answer is pretty simple, really, but it is one that most people will not like hearing: buy more insurance.

There are essentially two ways that you can supplement your basic level of insurance to protect yourself from having to pay for injuries to yourself that are not your fault: opt for more PIP insurance than is required by law, and purchase uninsured/underinsured motorist coverage.

Increase your PIP insurance. The state of Florida requires all drivers to have at least $10,000 in personal injury coverage in order to legally drive here. However, anyone can choose to purchase additional PIP coverage to make sure that they are covered no matter what happens to them. Your insurer may even attempt to talk you into buying it when you sign up for your policy, because any extra coverage just means more money for them – unless, of course, you do end up in an accident.

Purchase UIM. UIM, or uninsured/underinsured motorist coverage is exactly what it sounds like. Under Florida law, your insurer is required to offer you uninsured motorist coverage so that you will be protected if the other driver does not have any insurance or the insurance that he or she does have is not enough to pay for your medical bills and any other damages that you incur. Essentially, UIM is a backdoor way to get extra PIP benefits, but only in specific situations.

Of course, both of these methods are things that a driver would need to do prior to getting into an accident in order for the benefits to apply and help them to cover any medical costs incurred. Which brings us back to the original way mentioned for people to seek additional compensation: meeting the injury threshold.

How to Prove That Your Injury Meets Florida’s Threshold Standards

What exactly does Florida’s injury threshold statute say? That you:

“May recover damages and tort for pain, suffering, mental anguish, and inconvenience because of bodily injury, sickness, or disease arising out of the ownership, maintenance, operation, or use of such motor vehicle only in the event that the injury or disease consists in whole or in part of:

(a) Significant and permanent loss of an important bodily function.

(b) Permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement.

(c) Significant and permanent scarring or disfigurement.

(d) Death.”

In short, you have to show that the injuries or issues that you suffered will in some way be with you for the rest of your life. Wording it in this way is important, because one way that your injury can be “permanent” is if you will continue to experience pain from it for the foreseeable future.

Proving ongoing pain is not easy and requires the testimony of a medical expert, but it is possible, and contact us today.

About the Author:Lawlor Winston White & Murphy. He has been recognized for excellence in the representation of injured clients by admission to the Million Dollar Advocates Forum, is AV Rated by the Martindale-Hubbell Law Directory, and was recently voted by his peers as a Florida “SuperLawyer”—an honor reserved for the top 5% of lawyers in the state—and to Florida Trend’s “Legal Elite.”