Florida PIP: 14-Day Rule and the Emergency Medical Condition Determination

Under Florida’s No-Fault Insurance Law, every vehicle owner is required to have at least $10,000.00 in Personal Injury Protection (PIP) coverage. PIP coverage applies regardless of who caused the car accident.

If you are the insured in your policy, PIP will cover your accident whether you were the driver or passenger in your own or someone else’s car. Relatives who are living with you and other people who have permission to drive or ride in your car may also be covered under your PIP insurance. If your relatives or friends have their own PIP insurance, then their own PIP insurance will cover them even if they were driving or riding in your car.

After all applicable deductibles are met and subject to the coverage amount limit, PIP will pay:

– 80% of Medical Bills (PIP will not pay for massage and acupuncture therapy)

– 60% of Lost Wages

– $5,000.00 Death Benefits

– Mileage Reimbursement to and from your Doctor

If you do not get medical treatment within 14 days of the car accident, PIP will not pay for your medical bills.

If you do not have an “Emergency Medical Condition,” (EMC) you will only receive up to $2,500.00 for your medical bills. EMC is defined by Florida law as a medical condition that if not given immediate medical attention, could reasonably be expected to result in serious jeopardy to the patient’s health, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part. The finding of an EMC can only be done by a medical doctor, osteopathic physician, dentist, physician assistant, or advanced registered nurse practitioner. The EMC certification does not have to be issued within 14 days of the car accident for you to obtain the full PIP coverage.

If your initial treatment was for an EMC, PIP will only pay for your follow-up treatment bills that are related to the diagnosed EMC.