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Have You Exhausted Your PIP Coverage?

Can I Still Seek Treatment?

Many clients come into our firm confused about how to treat injuries resulting from an automobile accident. They have recently received a letter in the mail from their insurance company stating “your personal injury protection benefits have been exhausted.” Clients have many questions such as, “does this mean I can no longer get treatment for my injuries?” The simple answer is yes—you can still seek treatment, and if you are injured, you should continue to get treatment for your injuries.

What Exactly Is PIP?

Florida is defined as a “no fault” state. Every driver in Florida is required to carry insurance that has Personal Injury Protection, commonly referred to as PIP. Personal Injury Protection is paid out by your insurance company even if you were not at fault for the accident. Florida statute 627.733, or the Florida PIP statute, states:

An insurance policy complying with the security requirements of 627.733 must provide personal injury protection to the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in the motor vehicle, and other persons struck by the motor vehicle and suffering bodily injury while not an occupant of a self-propelled vehicle, subject to subsection (2) and paragraph (4)(e), 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 as follows:

What Can PIP Cover?

The above statute says that PIP insurance covers 80% of your first $10,000 in reasonable medical expenses. It can also cover reimbursement for gas and some lost wages. Your PIP insurer will pay the medical providers directly. Many people do not understand why their insurance is paying. The simple answer is because they are obligated to by law.

However, PIP only covers 80 percent of your first $10,000 in reasonable medical bills. After that your PIP benefits are exhausted. When a client receives that exhaustion letter, it only means that your insurance company has paid everything that they are required to pay under the PIP statute. This does not mean that you can no longer treat, though. Any bills that are not covered by PIP can be covered through the at-fault’s bodily injury policy when the case is settled.

Therefore, just because your PIP benefits have been exhausted does not mean that is the end of your case. In fact, many times it is just the beginning of the case.

Contact Brooks Law Group

The Brooks Law Group has 25 years of experience handling personal injury claims. Our team of lawyers works with medical professionals, valuation experts, technical experts and other lawyers to get you what you deserve. If you or a loved one suffered an injury or a death, please call us at (863) 299-1962.

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