Insurance Information

Many of you that have been involved in an accident will have a lot of questions about insurance coverage. This is especially true in South Florida where a lot of accidents are caused by drivers without insurance coverage. Here are a some of the more common questions…..

Questions About Insurance:

What is PIP and "No Fault"?

Years ago, anyone involved in even the most minor car accident had to sue the other driver to get just compensation for even the most minor injury. "No Fault" laws were enacted around the country to make it easier to resolve smaller cases without clogging court dockets. Florida is a "No Fault" State. This simply means that you go to your own auto insurance to pay your medical bills up to a preset amount. This insurance is referred to as PIP or Personal Injury Protection coverage. This coverage is mandatory in Florida and covers 80% of medical expenses up to $10,000.00. It pays your medical bills before your own medical insurance coverage has to pay and is therefore considered "primary" coverage. PIP also pays 60% of your lost wages. You might want to consider putting your claim for lost wages in before your PIP gets exhausted by medical expenses. PIP follows the person, other car insurance coverage follows the car. As long as you come into contact with another motor vehicle, whether on a bicycle, as a pedestrian, in your auto or someone else's vehicle, you are covered under your PIP and must present a claim to your PIP carrier. If you do not own a motor vehicle but reside with a relative who does, you are covered under their policy.

Why does the insurance company only have to pay 80%?

Good question. Insurance companies want you to have a financial stake in your treatment. They do not want you to run up a medical bill for massages and chiropractic manipulation and believe that if you have to pay 20% of your bill you are less likely to do so. It also gives them a way to sell extended coverage. You increase the can increase the $10,000.00 PIP coverage limit by buying extended PIP coverage or you can purchase Medical Payments Coverage which would pay the other 20% that PIP does not pay.

What happens when PIP is exhausted?

You will get a letter from your insurance company telling you that they have paid the limits of their insurance coverage and that you will be responsible for all your medical expenses from that point on. If you are fortunate enough to have other medical insurance they will have to start paying your medical bills according to the terms of you policy.

What if I have no other insurance - can I still get medical treatment?

This is becoming more common. Some medical providers will allow you to continue to treat as long as they receive a "Letter of Protection" or "LOP" from an attorney that is handling your case. This letter obligates that attorney to notify the doctor of any settlement and pay him for his services out of settlement or judgment proceeds. Typically, the attorney can reduce the amount of medical bill by having the doctor agree to a compromise settlement figure which reduces the amount that you have to pay.

Does "No Fault" mean that I can not recover more than $10,000.00 for my injuries?

"No Fault" does not mean that no one was at fault. Usually accidents occur because someone was not paying close attention to what they were doing. You are always assumed to be in control of your vehicle. If you were hit from behind or were hit by someone going through a red light then obviously someone else is at fault. However, you now have to make a claim against the person that caused the accident. This is typically handled by their insurance company. You have to understand that it is the job of the insurance adjuster handling the claim to save his company as much money as possible. You would be well advised to hire an attorney at this point. You should NEVER give the other driver's insurance company a written or recorded statement. They will typically start by offering you a very small amount of money to settle your claim against their insured. If you do not want to settle for this amount then you have to file a lawsuit against the person that caused the accident. NEVER sign anything the opposing insurance company sends you without talking to a lawyer.

What can I recover?

Florida requires that you have to meet a the statutorily defined tort threshold in order to recover in excess of PIP for reasonable and necessary medical expenses and lost wages (past and future) and pain and suffering. The statute requires that you must have: (a) Significant and permanent loss of an important bodily function; (b) Permanent injury within a reasonable degree of medical probability; and/or a (c) Significant and permanent scarring or disfigurement. If you meet the tort threshold then you can recover for your personal injuries which may include: Loss of income (past wages, future wages, lost earning capacity); Pain and Suffering (physical pain, enjoyment of life, psychological problems relating to the accident, emotional distress, disfigurement); Expenses (medical treatments, medical examinations, travel expenses, prescriptions, property damage); and Disability (temporary disability, partial disability, permanent and total disability). In the event of a fatality you can recover for the wrongful death damages for the loss of a loved one, funeral expenses, and reasonably anticipated loss of income.

What is my case worth?

The value of your case depends on a variety of factors. A fair evaluation would include information regarding the injury, medical bills, loss of income, permanency of the injury and the amount of comparative negligence, if any. Each case has to be looked at individually.

Do I have to pay an attorney up front?

Most law firms will agree to pursue a car accident claim for a contingency fee, which means that the law firm's fee is subtracted from any amount that the firm collects for you. If no amount is recovered, then the firm receives no fee, but the client is typically responsible for actual expenses, such as court filing fees or witness fees, whether he or she wins or loses.

What is Property Damage Liability Coverage?

This coverage pays the other party's property damage in the event you are at fault in an accident. If you were not at fault in the accident, it does not apply.

What is MEDPAY?

Medical Payment coverage pays the other 20% of your medical bills that is not covered by PIP.

What is Bodily Injury or BI coverage?

If the person that hit you is at fault for the accident then his Bodily Injury Liability Coverage will pay money or compensatory damages to you as long as you meet certain requirements under Florida's No Fault Law, up to the limit of his coverage. If he does not have enough insurance coverage available to pay for your injuries then you would look next to your own Underinsured/Uninsured Motorist Coverage/ Most states have statutes requiring that motorists have at least some Bodily Injury Liability Coverage. However, in Florida, only PIP and Property Damage Liability Coverage is mandatory. That is why it is so important that you protect yourself and your family with adequate underinsured/uninsured motorist coverage. This is especially true in Florida.

What is Collision Coverage?

Collision Coverage is what pays for damage to the cars. If you are hit by someone who is uninsured (or if you were at fault) then this coverage would pay for the damage to your car.

What is Uninsured/Underinsured Motorist "UM" Coverage

This is the thing that scares me the most about living in Florida. If the person that hit you does not carry Bodily Injury Liability insurance then you will not receive fair compensation for your injuries unless you have Underinsure/Uninsured Motorist coverage on your policy. This insurance is optional in Florida and pays you money damages if you are hit by someone at fault who does not carry insurance coverage or does not carry ENOUGH insurance coverage. I can attest to the benefit of this coverage. In 2004 my family car was hit by someone who tumbled across the median on the Florida Turnpike. They only carried $20,000 of insurance that had to be shared by the 7 people that hurt as a result of the accident. Underinsured Coverage eventually paid for the excess medical bills and compensated my family for our injuries. I can not stress how important this is in the State of Florida. A lot of folks here don't insure their car for BI or only have minimal coverage. You have to protect yourself and your family.

How does UM coverage work?

First you have to make a claim against the driver that hit you. Once you confirm that he does not have coverage or adequate coverage you can make a claim against your own insurance company for compensation for your injuries up to the limits of your policy. If you settle the claim against the driver that has inadequate coverage it is VERY IMPORTANT that you get your own insurance company's permission to settle prior to going after their Underinsured Coverage. This is another time that you want to seek the advice of an attorney. If you have multiple vehicles on your policy, you may be able to "stack" or add these coverage's together for additional limits.

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