NO-FAULT AUTOMOBILE INSURANCE
March 10, 2010 @ 03:14 PM — by SEO Admin
My car was rear-ended and my insurance company has to pay my medical bills? In Florida, the answer is yes. As a no-fault state, an automobile insurance company is primarily responsible for their own insured's medical expenses and lost wages, regardless of fault. No-fault is otherwise known as Personal Injury Protection (PIP). PIP is mandated coverage and provides benefits to the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in such motor vehicle, and other persons struck by such motor vehicle and suffering bodily injury while not an occupant of a self-propelled vehicle for loss sustained by any such person as a result of bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle, subject to a limit of $10,000.00. Extended PIP coverage can be purchased for an additional premium. Though not recommended, automobile owners may purchase PIP at a discount, by absorbing a deductible and/or waiving any right to benefits for lost wages.
PIP pays eighty percent (80%) of all reasonable expenses for medically necessary medical, surgical, x-ray, dental and rehabilitative services, including prosthetic devices, and medically necessary ambulance, hospital, and nursing services. Additionally PIP will cover sixty percent (60%) of any loss of gross income and loss of earning capacity from inability to work proximately caused by the injury sustained by the injured person, plus all expenses, reasonably incurred in obtaining from others ordinary and necessary services in lieu of those that, but for the injury, the injured person would have performed without income for the benefit of his or her household. Additionally, in accidents involving a death, qualified persons are entitled to the lesser of $5,000.00 or the remainder of unused personal injury protection benefits.
Unlike many health insurance policies which require an insured to pick a doctor "in network," those injured in automobile accidents are free to choose their own doctor without concern as to whether PIP will pay. However, PIP benefits come at a price. Because all Florida automobile owners are mandated to purchase PIP coverage, their ability to sue negligent drivers that cause accidents is limited. Florida law requires that injured victims meet a minimum threshold before any entitlement to damages for pain and suffering, mental anguish or other non-economic damages accrue. Specifically, they must suffer at least one of the following:
(a) Significant and permanent loss of an important bodily function;
(b) Permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement;
(c) Significant and permanent scarring or disfigurement; or
(d) Death.
Once an injury from a motor vehicle crash crosses the no-fault threshold, then non-economic pain and suffering type damages are recoverable for the injured person.
PIP pays eighty percent (80%) of all reasonable expenses for medically necessary medical, surgical, x-ray, dental and rehabilitative services, including prosthetic devices, and medically necessary ambulance, hospital, and nursing services. Additionally PIP will cover sixty percent (60%) of any loss of gross income and loss of earning capacity from inability to work proximately caused by the injury sustained by the injured person, plus all expenses, reasonably incurred in obtaining from others ordinary and necessary services in lieu of those that, but for the injury, the injured person would have performed without income for the benefit of his or her household. Additionally, in accidents involving a death, qualified persons are entitled to the lesser of $5,000.00 or the remainder of unused personal injury protection benefits.
Unlike many health insurance policies which require an insured to pick a doctor "in network," those injured in automobile accidents are free to choose their own doctor without concern as to whether PIP will pay. However, PIP benefits come at a price. Because all Florida automobile owners are mandated to purchase PIP coverage, their ability to sue negligent drivers that cause accidents is limited. Florida law requires that injured victims meet a minimum threshold before any entitlement to damages for pain and suffering, mental anguish or other non-economic damages accrue. Specifically, they must suffer at least one of the following:
(a) Significant and permanent loss of an important bodily function;
(b) Permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement;
(c) Significant and permanent scarring or disfigurement; or
(d) Death.
Once an injury from a motor vehicle crash crosses the no-fault threshold, then non-economic pain and suffering type damages are recoverable for the injured person.