Short answer: Florida personal injury protection (PIP) generally pays covered medical expenses and part of lost income after a motor-vehicle crash without first deciding who caused it. To qualify for medical benefits, the injured person generally must receive initial services and care from a qualifying provider within 14 days of the crash.
Video: How Florida No-Fault Insurance and PIP Work
Jeremiah Jaspon explains how Florida no-fault insurance and PIP apply after a crash, including why the first 14 days matter.
What Florida PIP can pay
Under Florida Statute § 627.736, a compliant policy provides up to $10,000 in combined medical and disability benefits, subject to the policy, statutory limits, exclusions, deductibles, and the type of medical determination made. Medical benefits generally pay 80% of reasonable expenses for medically necessary covered care. Disability benefits generally pay 60% of qualifying lost gross income and loss of earning capacity.
- Initial care deadline: Initial services and care generally must be received within 14 days after the crash.
- Medical benefit level: Benefits may be available up to $10,000 when a qualifying provider determines that the person had an emergency medical condition. If a provider determines there was no emergency medical condition, medical and disability reimbursement is generally limited to $2,500.
- Lost income: PIP can cover 60% of qualifying lost gross income, unless that benefit was excluded from the policy.
- Death benefit: The statute provides a separate $5,000 death benefit.
Whose PIP policy applies?
The answer depends on the injured person’s role, household, vehicle ownership, and available coverage. A named insured commonly turns first to that person’s own PIP coverage even when riding in someone else’s vehicle. A resident relative may be covered through a household policy. A passenger who does not own a vehicle and is not covered through a resident relative may look to the PIP coverage on the occupied vehicle. Pedestrians and bicyclists struck by a motor vehicle can also have PIP questions. Do not assume the at-fault driver’s carrier is the first or only insurer to contact.
What to do after a crash
- Get appropriate medical attention. Describe symptoms accurately and tell the provider when and how the crash occurred.
- Report the crash promptly to your auto insurer and ask for the PIP claim number, adjuster contact information, deductible, available benefits, and required forms.
- Keep copies of medical bills, explanations of benefits, mileage, work notes, wage records, and insurer correspondence.
- Review each medical bill and insurer payment explanation. PIP does not necessarily pay every charge in full.
- Ask questions before signing an assignment, release, recorded statement, or settlement document you do not understand.
PIP is not the same as a bodily-injury claim
PIP is a first-party benefit under an applicable auto policy. A bodily-injury claim against a responsible driver is different and may address losses that PIP does not fully pay, subject to Florida law and the available evidence and insurance. Using PIP does not itself decide fault, and having $10,000 listed on a declarations page does not mean every injured person will receive $10,000.