Understanding PIP (Personal Injury Protection) Coverage in Florida
If you’ve been in a car accident in Florida, one of the first things your insurance company will mention is PIP — or Personal Injury Protection. Florida is one of only a few states that operates under a no-fault auto insurance system, which means your own insurance covers your medical expenses and certain losses, regardless of who was at fault.
But what exactly does PIP cover? What are the limitations? And how can you make sure you’re getting everything you’re entitled to after an accident?
This guide explains how PIP coverage works in Florida, what it includes, what it excludes, and how to make sure you’re protected.
What Is Personal Injury Protection (PIP) in Florida?
Florida PIP is a mandatory part of every auto insurance policy in the state. It’s designed to make sure injured parties can receive medical treatment immediately after an accident — without waiting for legal battles over who caused the crash.
Why Florida Uses a No-Fault System
In Florida’s no-fault system, your own insurer pays for your initial medical expenses and lost wages, regardless of whether you or another driver was to blame. This is intended to speed up claims processing and reduce unnecessary lawsuits.
Who Is Covered Under PIP?
PIP applies not just to you, but also to your passengers, relatives living in your household, and even pedestrians or bicyclists injured in a crash involving your vehicle. The coverage follows you — not just the car.
What Does Florida PIP Insurance Actually Cover?
PIP is designed to cover basic and immediate expenses after a car crash.
1. Medical Expenses
Florida PIP pays for up to 80% of necessary medical treatments, including emergency care, surgery, imaging, chiropractic visits, rehabilitation, and more. The care must be provided by a licensed medical provider recognized under Florida law.
2. Lost Wages
If you’re unable to work because of your injuries, PIP will cover 60% of your lost income up to the policy limit. This includes both full-time and part-time wages, as long as you can provide appropriate documentation.
3. Death Benefits
If the accident results in a fatality, PIP also offers up to $5,000 in death benefits. These funds can be used toward funeral and burial expenses, and they are payable to surviving family members or the estate.
The $10,000 Limit – And Why You Might Not Get All of It
Although Florida law requires $10,000 in PIP coverage, that doesn’t mean you’re guaranteed to receive all of it.
Emergency Medical Condition Requirement
To access the full $10,000, a medical provider must diagnose you with an “Emergency Medical Condition” (EMC). Without this diagnosis, your PIP benefits may be capped at just $2,500, regardless of your actual expenses.
What Counts as an Emergency Medical Condition?
An EMC is a condition that could result in serious jeopardy to your health, impairment of bodily functions, or dysfunction of any body organ. Common examples include head injuries, broken bones, and internal bleeding — but a qualified provider must document the condition for the full benefit to apply.
What Is NOT Covered by Florida PIP?
While PIP provides critical early coverage, it doesn’t pay for everything.
1. Vehicle Damage
Florida PIP does not cover repairs to your vehicle or any damage to other property. For that, you’ll need collision insurance or property damage liability coverage.
2. Pain and Suffering
You cannot claim compensation for pain, suffering, or emotional distress through PIP. These non-economic damages are only available through a personal injury lawsuit when certain legal thresholds are met.
3. Injuries in Certain Situations
PIP excludes coverage for injuries sustained while committing a felony, fleeing law enforcement, or participating in organized racing. It also does not apply to motorcycle riders unless they have separate motorcycle PIP coverage.
Florida’s Minimum PIP Coverage Requirements
Florida law requires every vehicle owner to carry:
- A minimum of $10,000 in PIP coverage
- And $10,000 in Property Damage Liability (PDL)
These are the base legal requirements. You can choose to increase your limits or add optional coverages, but many Florida drivers stick to the state minimum — which may not be enough in serious accidents.
The 14-Day Rule: Don’t Miss This Deadline
One of the most critical pieces of Florida’s PIP law is the 14-day treatment rule.
What Is the 14-Day Rule?
To qualify for PIP benefits, you must seek medical treatment within 14 days of the accident. This is a strict deadline. If you miss it, your claim may be denied — even if your injuries are real and documented later.
What Types of Treatment Count?
Treatment must come from a licensed medical doctor, dentist, chiropractor, or a facility authorized under Florida’s insurance regulations. Over-the-counter medication or self-treatment won’t qualify.
How to File a PIP Claim in Florida
Filing a PIP claim should be straightforward, but insurers often require detailed documentation and follow-ups.
Step 1: Get a Police Report and Seek Medical Treatment
Always report the accident to law enforcement and seek medical treatment immediately — ideally on the same day or within a few days. This satisfies the 14-day requirement and ensures your injuries are properly documented.
Step 2: Notify Your Insurance Company
File a claim with your auto insurer as soon as possible. You may be asked to complete forms, provide medical records, wage statements, and accident reports.
Step 3: Submit Supporting Documentation
Provide all relevant information: medical bills, proof of income loss, travel receipts for medical visits, and prescriptions. Your insurance company may also request an Independent Medical Examination (IME).
Common Problems With Florida PIP Claims
PIP is supposed to be simple — but it can turn into a frustrating process.
1. Denials Due to Lack of EMC
Many claims are denied or reduced because a doctor didn’t document an Emergency Medical Condition. Without this, you’re limited to $2,500 in coverage.
2. Missed Deadlines
If you fail to seek treatment within 14 days, your insurer may reject the claim outright. Delays also raise questions about whether the injuries were truly related to the crash.
3. Reimbursement Disputes
Insurers may underpay or delay payment, dispute whether treatment was medically necessary, or accuse you of receiving excessive care. These disputes often lead to a need for legal assistance.
Can You Sue Beyond PIP Coverage?
Yes, but only under certain conditions.
When Lawsuits Are Permitted
You can file a personal injury lawsuit if your injuries are considered serious, such as:
- Permanent loss of bodily function
- Permanent injury within a reasonable degree of medical probability
- Significant and permanent scarring or disfigurement
- Death
Once you meet the threshold, you can seek compensation for pain and suffering, full lost wages, and long-term care.
Tips to Get the Most From Your PIP Policy
To make sure you’re receiving all available benefits, you need to be organized and proactive.
1. Seek Treatment Immediately
Always get checked out by a doctor — even if you feel fine. Symptoms of whiplash, concussion, or internal injuries can take days to appear.
2. Keep Every Record
Save your medical bills, wage verification, prescription receipts, appointment confirmations, and anything else related to the accident.
3. Don’t Go It Alone
If your claim is delayed or denied, or if you don’t understand why you aren’t being paid the full benefit, speak with a personal injury attorney who understands PIP law in Florida.
When PIP Isn’t Enough
PIP is a starting point, not a comprehensive solution. For serious injuries, $10,000 doesn’t stretch far — especially when you’re dealing with hospital stays, surgery, rehabilitation, and weeks or months off work.
Other Sources of Compensation
Once your PIP limit is exhausted, you may need to rely on your health insurance, file a claim against the at-fault driver, or explore a personal injury lawsuit. These routes can help cover pain and suffering, loss of future income, and long-term care.
Final Thoughts: Know the Limits of Your PIP Coverage
Florida’s PIP insurance is there to provide immediate relief, but it has limits — financially and legally. With strict requirements like the 14-day rule and the EMC diagnosis, it’s easy to miss out on benefits if you’re not careful.
Don’t assume $10,000 is enough to cover your losses. And don’t wait until it’s too late to seek care or speak with a professional.
Frequently Asked Questions About Florida PIP Insurance
Is PIP insurance required for all Florida drivers?
Yes, Personal Injury Protection (PIP) is mandatory for anyone who owns a vehicle registered in Florida. The law requires a minimum of $10,000 in PIP coverage, and you must maintain this insurance to legally operate a vehicle in the state.
Does PIP cover all my medical expenses after an accident?
PIP will cover up to 80 percent of your reasonable and necessary medical expenses, up to the policy limit. However, unless your injuries are diagnosed as an emergency medical condition by a licensed provider, your benefits may be capped at just $2,500. Any remaining expenses would need to be paid out of pocket or through other insurance.
Will PIP cover my lost wages if I can’t work?
Yes, PIP can reimburse you for up to 60 percent of lost income due to accident-related injuries, but again, this is subject to the overall policy limit. If your income loss exceeds that amount or continues long-term, you may need to explore legal options beyond PIP.
Can I use my health insurance instead of PIP?
No, in Florida, your PIP coverage is considered primary. That means it must be used first before turning to your health insurance provider. Only after your PIP benefits are exhausted can you use your health insurance to cover further costs.
What happens if I don’t get treatment within 14 days of the accident?
If you don’t seek medical treatment within 14 days of the accident, you may forfeit your right to any PIP benefits. The law is strict on this point, so even if you feel okay immediately after the crash, it’s strongly advised to get a medical evaluation right away.
Contact Lawlor, White & Murphey Today
If your injuries are serious, if your PIP claim is denied, or if you’re unsure what your next step should be, speak with a qualified personal injury attorney. A lawyer can help you maximize your claim, challenge denials, and pursue additional compensation beyond what PIP provides.
Don’t settle for less than you deserve. Contact Lawlor, White & Murphey today and protect your rights.