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Medical Bills

Key Points

Personal Injury Protection (PIP) is insurance coverage that mandatory when a person owns a motor vehicle in the State of Florida. PIP is a part of the Florida No-Fault system of insurance, laws, rules, and regulations. PIP can be quite confusing. Many clients and prospective clients do not feel that PIP under the client's insurance policy should apply since the other driver was at fault for the crash. It should be noted that PIP and the related Florida Statutes and laws are not guided by common sense or fairness. Here are some key points to keep in mind as to PIP otherwise known as Personal Injury Protection:

PIP is required insurance under Florida law.

PIP generally has a maximum total payout of $10,000 for medical bills, wage loss (under some policies), and mileage to and from the doctor.

If the injury victim suffers a personal injury that is deemed by the medical providers AND the insurance company to be an Emergency Medical Condition, PIP may pay out up to $10,000.

If the injury victim did not suffer a personal injury deemed to be an Emergency Medical Condition, PIP may limit the maximum total pay out of up to $2,500.

PIP may be subject to a deductible that generally ranges from $500 to $1,000. Once the deductible is reached, PIP will pay 80 % of reasonable and necessary medical expenses.

An injury victim must receive medical evaluation / treatment within 14 days from the accident / crash date in order to qualify for PIP benefits. If the injury victim fails to get a medical evaluation / medical care within 14 days, the injury victim will essentially waive the rights to benefits / payments under the PIP (Personal Injury Protection) portion of the automobile insurance policy.

The following persons / claimants may qualify for PIP benefits for medical bills related to the automobile accident / crash:

  1. The named insured on the PIP policy;
  2. A Resident relative of the named insured assuming that the resident relatives were disclosed to the insurance company at the time of the application for the insurance AND assuming that the resident relative does not own his or her own motor vehicle which would require the purchase of separate automobile insurance for that policy;
  3. Occupant of the insured vehicle assuming that the occupant does not own a vehicle and assuming that the occupant does not qualify for PIP benefits under the automobile insurance policy for a resident relative.

It should be noted that no all medical providers accept PIP as a payment source. There is no law in place that requires a medical provider to accept PIP as a payment source. As such, it is important for the injury victim to make sure that the medical provider accepts PIP as a payment source before setting up an appointment with a particular medical provider. Most emergency rooms and hospitals accept PIP as a payment source. It should also be noted that PIP is typically primary to other forms of health insurance, Medicare, and Medicaid. In other words, PIP will be the first insurance carrier billed. Other insurance sources (health insurance, Medicare, and Medicaid) may deny payment of a medical bill if PIP is available. As such, it is important for medical providers to have the PIP information in place before submitting or processing the medical bills.

PIP can be quite confusing and challenging especially for clients with limited experience in dealing with insurance and legal issues. David A. Wolf is quite familiar with PIP and other insurance issues that arise in the aftermath of an automobile accident / crash. David A. Wolf provides his potential personal injury clients with a Free Consultation. If you have questions about medical bills, PIP (Personal Injury Protection) or other issues, contact David A. Wolf today. He is available days, nights, weekends and holidays as a resource and as the attorney and advocate for his clients. Get D Wolf On Your Side - At Your Side.

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I was in need of legal advice and David was there to assist. I was given advice most attorneys would charge outrageous fees for. When I called David promptly replied, got a grasp of my issue and gave wonderful advice and then referred me to someone who could better handle my issue. I would highly recommend him and if anything else comes up, my first call will be to him. Tracey
David did a great job representing my family in a recent legal matter. He provided great communication in a clear, concise and timely manner. He thoroughly outlined what our options were and answered all our questions. We were extremely pleased with the outcome and highly recommend anyone seeking legal counsel to contact him. David
David Wolf has provided legal advice and representation to me on a variety of issues. I have referred family members and friends to him as well. Whenever a legal issue arises, he is the first person I contact because I am always provided prompt and practical legal advice. I know that I am not David’s only client but he sure does his best to make me and others feel that way. Jill Kestner
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