Personal Injury Protection
What is PIP?
PIP stands for personal injury protection. PIP is auto insurance that is placed on your car. In the state of Florida, PIP insurance is required for all vehicles with a coverage limit of $10,000.00. Florida is one of thirteen states that require PIP insurance.
Other states where PIP insurance is also required to be place on your vehicle include: Kansas, Kentucky, Massachusetts, Hawaii, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania, Utah and The District of Columbia. The rest of the states have made PIP insurance optional.
What is Covered Under PIP?
PIP suits are governed under Florida statute 627.736. This statute allows for a statute of limitations of five years. However, this is not five years from when the accident occurred but five years from when the claim was not paid and became overdue. A claim becomes overdue if it is not paid within 30 days after the insurer has received written notice of a covered loss.
Under the statute, the insurance company is required to provide coverage to the named insured. The insurance provider is also required to provide coverage for the insured’s relatives residing in the same household, persons operating the vehicle, and passengers in the vehicle.
Some of the benefits of PIP insurance are that it will cover medical expenses, lost wages, and other related expenses regardless of who was at fault during the accident. For this reason, PIP insurance is also commonly referred to as No-Fault insurance.
To explain a bit further, the insurance carrier will still cover a claim regardless of who was at fault during the accident. PIP insurance will pay 80% of your expense up to the required $10,000.00 limit. In order to qualify, the insured will need to find a qualified medical provider within 14 days of the accident occurring. This time frame of 14 days is important because if you do not go see a medical provider within 14 days, then no PIP coverage applies.
PIP insurance will cover up to $10,000.00 for medical and disability benefits and $5,000.00 in death benefits. However, if after visiting a medical provider you are not diagnosed with an “Emergency Medical Condition” PIP will only cover up to $2,500.00.
The state of Florida has classified an Emergency Medical Conduction as a condition that requires immediate treatment and could result in serious injury to the patient.
Death benefits are paid if the death is the result of bodily injury, sickness, disease, or death as a result of ownership or use of the vehicle. Furthermore, the death benefits are in addition to the benefits paid for medical expenses.
PIP insurance will cover 60% of your lost wages as a result of injuries sustained during the accident. In order to receive payment from your insurance company your employer will be required to send the insurance company a wage and salary verification letter. Once approved, benefits will be paid every two weeks.
What is a Demand Letter?
A Demand letter is a letter stating that you are entitled to PIP benefits you have not received. A demand letter must be sent to the insurance company before filing a suit. However, a demand letter must be sent timely.
The letter must be sent before filing suit but after the claim is overdue. The demand letter must include language stating that it is a “demand letter under §627.736”.
Additionally, the letter must include the name of the insured that is seeking benefits under the policy, the policy number and the name of any medical provider who provided services. An additional requirement states the letter must be mailed to the insurance company using The United States postal service. The letter can be sent either by certified or registered mail and a return receipt is required for either option.
After the insurance company receives the demand letter, the insurance company has 30 days to respond.
If the insurance company decides to pay the claim, than the insurance company must also include in their payment: (1) a penalty of 10% of the overdue amount and (2) repay the postage. The insurance company is not required to pay any attorney fees if they pay the claim. If the claim is not paid, then a suit against the insurance company will be filed.
Filing a PIP Suit:
If the claims in the demand letter are not paid then a suit will be filed. To begin the suit process a lawyer will file a claim in county court. Typically the next thing to happen is that there will be a Pre-Trial conference scheduled. At this conference, an attorney for the insurance company and an attorney for the insured seeking benefits will appear.
Most cases will settle before or at the Pretrial Conference. What this means is that the case will conclude quickly and the insured will receive the benefits that they are seeking. It is difficult to give an exact time frame, as all cases are different.