The moments and days after a car accident often bring a whirlwind of activity: Contacting law enforcement, communicating with insurance adjusters, and trying to get your car fixed are just some of the tasks at hand. With so much to do, it can be easy to put off seeking medical treatment for injuries you sustained in the crash. However, delaying medical treatment can only hurt you and your potential injury claim.
If you’ve been in a car accident, you should seek medical care as soon as possible. This is particularly important in Florida. Personal injury protection coverage plays a major role in the outcome of most auto accident claims in the state. Florida law imposes a 14-day window of time in which you must seek medical treatment to make a valid PIP claim. It’s important to understand what that means and what you need to do to comply.
What Is PIP Insurance?
If you drive a vehicle in Florida, you are legally required to maintain two different types of auto insurance. The first, property damage liability insurance, covers damage that you or your vehicle cause to someone else’s property.
The second type of mandatory insurance is personal injury protection. If you are injured in a car accident, PIP pays 80% of your reasonable, necessary medical bills, up to certain limits. Unlike PDL insurance, for PIP coverage, it does not matter who caused the accident.
Florida law requires that drivers maintain a minimum of $10,000 of each type of insurance. Florida is among only 10 U.S. states that require PIP coverage.
What Is the 14-Day Time Limit?
Under Florida law, to be eligible to file a PIP claim, you must seek medical treatment for your injuries within 14 days after the date of the accident. This time limit, which became effective in 2013, serves two key purposes.
First, delaying medical care can make some injuries worse. By seeking professional care right away, you can minimize complications and have the best chance at a speedy recovery. Second, the time limit helps to cut down on fraudulent PIP claims that can drive up rates for everyone. An important element of any insurance claim is proving that your injuries resulted from the car accident and were not caused by some other event. Getting medical treatment as soon as possible indicates that the crash caused your injuries.
Florida Statute 627.736 requires that, for PIP coverage to apply, a person must receive his or her “initial [medical] services and care” within 14 days after the accident. This means that you must visit the emergency room or attend your first doctor’s appointment within the 14-day window. It is not enough to merely schedule the appointment. If you are not able to see your preferred medical provider in that timeframe, you should go to an emergency room or urgent care center.
What Qualifies as Medical Treatment?
The law states that, subject to policy limits, PIP insurers must cover medical treatment so long as a qualified health care provider provided, prescribed, ordered, or supervised the treatment. Typically, duly licensed physicians, medical doctors, chiropractors, registered nurses, dentists, and certain physician assistants qualify under the statute. Also, most care and services provided in an emergency room, hospital, ambulance or other EMT, urgent care center, or hospital-run outpatient facility usually qualify for PIP coverage.
Other services, such as physical therapy or massage therapy, ordinarily do not qualify as initial treatment. These services may qualify as part of a follow-up treatment plan if they are ordered, prescribed, supervised, or performed by one of the qualified care providers listed above.
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What Expenses Does PIP Cover?
So long as you began qualified medical treatment within the 14-day window, your PIP insurer must cover 80% of your reasonable and necessary medical expenses. The overall cap on what PIP insurance will pay depends on your individual PIP policy. For example, if you have the minimum state coverage of $10,000, your PIP insurer will pay up to $10,000, with an important exception.
To receive the maximum coverage under your PIP policy, the car accident must have caused an “emergency medical condition.” If you only sustained non-emergency injuries, then Florida law limits your PIP coverage to $2,500. PIP coverage also does not apply if you intentionally injured yourself or if you were injured while committing a felony.
What Counts as an Emergency Medical Condition?
Section 395.002(8) of the Florida Statutes specify what qualifies as an emergency medical condition giving rise to full PIP coverage. Under the law, a medical condition is an emergency if it causes you to suffer from acute symptoms that require immediate medical treatment to prevent impairment of a key bodily function, significant dysfunction of a body part or bodily organ, or other danger to your health and well-being. Most injuries qualify as emergency medical conditions, while many illnesses do not qualify.
If your injury resulted from a car accident, you should let your healthcare provider know. He or she can make an official determination in your medical chart that you suffered from an emergency condition. While there are no formal requirements regarding this type of determination, the notation can be helpful to avoid future litigation delays. Importantly, the statute does not require your care provider to make an “emergency condition” determination within the first 14 days. It is sufficient that you began receiving treatment within that time.
What Happens if I Do Not Get Treatment Within 14 Days?
To be clear, the 14-day window only applies to PIP coverage. If you do not begin your initial medical treatment within 14 days after a car accident, you are not eligible to file a PIP claim. However, you may still file a personal injury claim against the other driver or any party who is responsible for causing your injuries.
You must file any personal injury or property damage claims within four years after the accident.
If you’ve been injured in a car accident, contact the experienced legal team at Brian D. Guralnick Injury Lawyers. They are here to help you Demand More® for your case and will fight tirelessly to get you the compensation you deserve.
Disclaimer: You should not take any information in this blog as legal advice in any situation. If you need expertise for a specific issue of yours, contact a qualified Personal Injury attorney.
