Author: Gary Drucker

Do I have to prove a permanent injury to recover pain and suffering in a car accident in Florida?

People assume that in an accident if they have pain and if they suffer, they are entitled to pain and suffering when involved in an accident in Florida.  This is one of the more common questions that the accident attorney in Boca Raton (injury attorney in West Palm Beach, injury lawyer in Wellington, accident lawyer in North Palm Beach, accident attorney in Loxahatchee, personal injury lawyer in Palm Beach, accident lawyer in Delray Beach, injury attorney in Boynton Beach, injury lawyer in Greenacres, accident attorney in Lake Worth) at Drucker Law Offices gets. Generally, in Florida, in order to recover pain and suffering in a car accident you must prove:  1) death, 2) significant scarring 3) permanent disfigurement or 4) permanent injury.  Most people believe the important issues are how the accident happened and how much medical bills and treatment in the case but while these are also important issues, the other critical issue in an automobile accident case is whether the claimant suffered a permanent injury within a reasonable degree of medical probability.

In 1973, the Florida Legislature passed the comprehensive Motor Vehicle Act and created Personal Injury Protection (PIP) insurance, making such coverage mandatory in Florida.  PIP coverage provides their insureds with medical and employment disability insurance coverage for any injuries caused by a car crash, whether significant or not, and regardless of fault.  The concept of providing insureds with easy access to medical coverage following accidents was designed to reduce liability claims for minor injury accidents. 

This PIP requirement came with a trade-off, however, which is found in §627.737(2), Florida Statutes, which states: 

(2)  In any action of tort brought against the owner, registrant, operator, or occupant of a motor vehicle with respect to which security has been provided as required by ss. 627.730-627.7405, or against any person or organization legally responsible for her or his acts or omissions, a plaintiff may recover damages in tort for pain, suffering, mental anguish, and inconvenience because of bodily injury, sickness, or disease arising out of the ownership, maintenance, operation, or use of such motor vehicle only in the event that the injury or disease consists in whole or in part of:

(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.

(d)  Death.

Under this law, if a claimant is able to show that the other vehicle was at fault and caused the plaintiff’s injuries, they will be able to recover any out of pocket medical bills incurred (the monies owing after the PIP pays; usually PIP pays at 80 percent), any future medical bills, any lost wages, the loss of ability to earn money in the future, as well as any other out-of-pocket expenses legally shown.

The primary limitation of the law is that  pain and suffering can only be recovered if the injured person can prove death, significant scarring, permanent disfigurement or permanent injury.  Death, significant scarring and permanent disfigurement findings are obviously rare, so the most common way to seek pain and suffering damages in a car accident case is by a showing of permanent injury.  Indeed, in the industry, the permanent injury finding is called the permanent injury threshold, as unless the injured person breaches the permanent injury threshold, they are not entitled to pain and suffering.  Said another way, if the injured person has pain and suffers due to the negligence of another in a car accident, but the injury is not permanent, they cannot recover monies for the pain and suffering.

What is a permanent injury?  Obviously, it is an injury that is permanent but there must be more to it.  In court, a permanent injury is generally proven by expert testimony of the treating doctor or doctors.  If the treating doctor testifies to a permanent injury, then the plaintiff has made a prima facie case for pain and suffering but this could be rebutted by an expert for the defense.  In litigation, the defense lawyers are entitled to sending the injured person to a physician of their choice for a compulsory medical examination.  That doctor would render a decision of whether he or she believes the injured victim has a permanent injury.  If the treating doctor finds a permanent injury and the defense doctor finds that there is no permanent injury, then the jury ultimately would have to decide that issue, and they would only be allowed to award pain and suffering if they find that the injury is permanent.

Every case is different and must be judged on its merits. It is a good start to get a complementary consultation regarding an accident case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so pelase call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your case.

A person injured in a car accident may want to consider hiring a lawyer that is experienced in handling the issue of permanent in an injury case and have familiarity with the medical issue of these cases.  At Drucker Law Offices, the accident attorney in Boca Raton (permanent injury lawyer in Cutler Ridge, injury attorney in Homestead, accident lawyer in Westchester, accident attorney in Doral, injury lawyer in Miami, injury attorney in Coral Gables, personal injury lawyer in Aventura, accident attorney in North Miami Beach, injury attorney Kendall, personal injury attorney in Miami Beach) handles car wreck cases and offers a free consultation to accident victims.  Please call the satellite office in Miami 305-981-1561; the satellite office in Coral Springs 954-755-2120; the satellite office in Boynton Beach 561-265-1976; the satellite office in West Palm Beach 561-686-7070; or the main office in Boca Raton 561-483-9199.

Can I sue the Florida State government if one of its employees injures me in a car accident, a slip and fall case or a general negligence case?

I receive a lot of calls seeking advise on car accidents, slip and falls or general negligence against the State of Florida or one of its subdivisions.  As a personal injury lawyer in Boca Raton (accident attorney in Miami, injury attorney in Kendall, injury lawyer in Westchester, accident lawyer in Coral Gables, personal injury attorney in Cutler Ridge, accident attorney in Aventura, accident lawyer in Miami Beach, injury lawyer in North Bay Village, personal injury attorney Hialeah), I handle many governmental cases and I write this blog entry as a very general summary of this particular area of law.  I encourage any specific questions regarding this topic via a phone call or email and I would be glad to answer any questions on this or any injury topic. 

Florida has adopted many parts of the common law (common law is the law from England).  One of these laws that were adopted is sovereign immunity, although it has been adopted in a limited fashion.  Sovereign immunity, generally speaking, is the doctrine that the sovereign or state cannot commit a legal wrong and is immune from civil suit or criminal prosecution hence the saying, “the king (or queen) can do no wrong.”  In Florida, some suits are allowed and some are disallowed, hence it is limited sovereign immunity.  Florida does not generally allow suits for general negligence, like cases against the State for car accidents, slip and falls cases and general negligence.  There are some other limitations which I discuss below.

Generally, there is a cap on what can be recovered from the sovereign in Florida.  From 1981 to date, that cap was for $100,000.00 per person and a total of $200,000.00 per occurrence.  The statute dealing with this law is section 768.28 of the Florida Statutes and I have pasted certain parts of the statute below.  Interestingly, recently in what is a victory for personal injury victims the legislature agreed to raise the sovereign immunity limits of compensation from $100,000.00 to $200,000.00 per person and from $200,000.00 to $300,000.00 per occurrence. In order to recover an amount greater than these statutory sovereign immunity limits, it is required that the victim convince the legislature to pass a “claims bill,” a process which places an undue burden, with little chance of success, upon the injured victim.  Interestingly, the law limits what a plaintiff personal injury attorney can charge for governmental cases to 25 percent whether the matter is resolved pre-suit or in litigation.

Please note that all cases are different and one single fact difference can make a significant difference is any case evaluation.  Please call Drucker Law Offices or another licensed Florida lawyer if you have questions regarding any case that happened to you or a loved one.

Every case is different and must be judged on its merits. It is a good start to get a complementary consultation regarding an accident case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so pelase call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your case.

At Drucker Law Offices, the accident attorney in Boca Raton (injury lawyer in Hallandale, accident lawyer in Hollywood, personal injury attorney in Pembroke Pines, injury lawyer in Miramar, injury attorney in Plantation, accident attorney in Weston, accident lawyer in Tamarac, personal injury lawyer in Coral Springs, personal injury attorney in Parkland, accident attorney in Margate, accident lawyer in Lauderhill, injury lawyer in Deerfield, injury attorney in Pompano, personal injury lawyer in Ft. Lauderdale) handles governmental injury cases against the State of Florida and other municipalities and governmental bodies.  If you have been injured in an accident feel free to call the principal office in Boca Raton 561-483-9199, satellite office in Miami 305-981-1561, satellite office in Coral Springs 954-755-2120, satellite office in West Palm Beach 561-686-7070 or the satellite office in Boynton Beach 561-265-1976.

768.28  Waiver of sovereign immunity in tort actions; recovery limits; limitation on attorney fees; statute of limitations; exclusions; indemnification; risk management programs.

(1)  In accordance with s. 13, Art. X of the State Constitution, the state, for itself and for its agencies or subdivisions, hereby waives sovereign immunity for liability for torts, but only to the extent specified in this act. Actions at law against the state or any of its agencies or subdivisions to recover damages in tort for money damages against the state or its agencies or subdivisions for injury or loss of property, personal injury, or death caused by the negligent or wrongful act or omission of any employee of the agency or subdivision while acting within the scope of the employee’s office or employment under circumstances in which the state or such agency or subdivision, if a private person, would be liable to the claimant, in accordance with the general laws of this state, may be prosecuted subject to the limitations specified in this act. Any such action may be brought in the county where the property in litigation is located or, if the affected agency or subdivision has an office in such county for the transaction of its customary business, where the cause of action accrued. However, any such action against a state university board of trustees shall be brought in the county in which that university’s main campus is located or in the county in which the cause of action accrued if the university maintains therein a substantial presence for the transaction of its customary business.

(2)  As used in this act, “state agencies or subdivisions” include the executive departments, the Legislature, the judicial branch (including public defenders), and the independent establishments of the state, including state university boards of trustees; counties and municipalities; and corporations primarily acting as instrumentalities or agencies of the state, counties, or municipalities, including the Florida Space Authority.

(3)  Except for a municipality and the Florida Space Authority, the affected agency or subdivision may, at its discretion, request the assistance of the Department of Financial Services in the consideration, adjustment, and settlement of any claim under this act.

(4)  Subject to the provisions of this section, any state agency or subdivision shall have the right to appeal any award, compromise, settlement, or determination to the court of appropriate jurisdiction.

(5)  The state and its agencies and subdivisions shall be liable for tort claims in the same manner and to the same extent as a private individual under like circumstances, but liability shall not include punitive damages or interest for the period before judgment. Neither the state nor its agencies or subdivisions shall be liable to pay a claim or a judgment by any one person which exceeds the sum of $100,000 or any claim or judgment, or portions thereof, which, when totaled with all other claims or judgments paid by the state or its agencies or subdivisions arising out of the same incident or occurrence, exceeds the sum of $200,000. However, a judgment or judgments may be claimed and rendered in excess of these amounts and may be settled and paid pursuant to this act up to $100,000 or $200,000, as the case may be; and that portion of the judgment that exceeds these amounts may be reported to the Legislature, but may be paid in part or in whole only by further act of the Legislature. Notwithstanding the limited waiver of sovereign immunity provided herein, the state or an agency or subdivision thereof may agree, within the limits of insurance coverage provided, to settle a claim made or a judgment rendered against it without further action by the Legislature, but the state or agency or subdivision thereof shall not be deemed to have waived any defense of sovereign immunity or to have increased the limits of its liability as a result of its obtaining insurance coverage for tortious acts in excess of the $100,000 or $200,000 waiver provided above. The limitations of liability set forth in this subsection shall apply to the state and its agencies and subdivisions whether or not the state or its agencies or subdivisions possessed sovereign immunity before July 1, 1974.

                   *                                     *                                     *

(8)  No attorney may charge, demand, receive, or collect, for services rendered, fees in excess of 25 percent of any judgment or settlement.

(9)(a)  No officer, employee, or agent of the state or of any of its subdivisions shall be held personally liable in tort or named as a party defendant in any action for any injury or damage suffered as a result of any act, event, or omission of action in the scope of her or his employment or function, unless such officer, employee, or agent acted in bad faith or with malicious purpose or in a manner exhibiting wanton and willful disregard of human rights, safety, or property. However, such officer, employee, or agent shall be considered an adverse witness in a tort action for any injury or damage suffered as a result of any act, event, or omission of action in the scope of her or his employment or function. The exclusive remedy for injury or damage suffered as a result of an act, event, or omission of an officer, employee, or agent of the state or any of its subdivisions or constitutional officers shall be by action against the governmental entity, or the head of such entity in her or his official capacity, or the constitutional officer of which the officer, employee, or agent is an employee, unless such act or omission was committed in bad faith or with malicious purpose or in a manner exhibiting wanton and willful disregard of human rights, safety, or property. The state or its subdivisions shall not be liable in tort for the acts or omissions of an officer, employee, or agent committed while acting outside the course and scope of her or his employment or committed in bad faith or with malicious purpose or in a manner exhibiting wanton and willful disregard of human rights, safety, or property.

How do medical bills get paid in a car accident case?

At Drucker Law Offices, I get a lot of questions about the cost of medical treatment when my clients are in car accidents.  People see explanations of benefits showing “allowable charges” from their car insurance and they are unclear as to how much treatment they are entitled to under PIP’s $10,000.00 coverage.  The accident attorney in Boca (accident lawyer in Miami, personal injury lawyer in Miami Gardens, accident attorney in North Miami Beach, injury lawyer in North Bay Village, injury attorney in Kendall, injury lawyer in Downtown Miami, accident lawyer in Aventura) will try to answer some common questions about the cost of medical treatment following a car accident. 

Generally, in a car accident case, medical bills are paid through the appropriate automobile insurance carrier.  As discussed in the last blog entry, in a Florida car accident, your own car insurance generally pays your medical bills, regardless of fault and regardless of whether you are in your car, another car or even if you are hit by a motor vehicle as a pedestrian or on a bicycle.  If you do not own a car, then if you live with a relative that owns a car, then that relative’s automobile insurance, regardless of fault and regardless of whether you were in that relative’s car or even if you were hit by a car while on a bicycle or as a pedestrian.  If you do not own a car nor live with a relative that owns a car, then you generally would qualify for PIP benefits through the car that you were in or from the car that hits you if you are on a bicycle or on foot.

The statute pertaining to the cost for treatment under Florida’s No-fault PIP laws is discussed in 627.736(5), a copy of that statute is pasted below.  Understanding the history of the bill might prove somewhat insightful.  Prior to January 1, 2008, there were no PIP fee schedules for doctors, which basically means that the doctors and hospitals could charge “usual and customary” charges.  These charges had to be reasonable and necessary and also had to be causally related to the accident but otherwise there were no fixed charges for most medical treatment (prior to 2008, a fee schedule for MRIs were already part of the statute. 

Under the current laws (post January 1, 2008), hospital charges are allowed to be at 75 percent of the usual and customary charges and then they are paid at 80 percent.  Thus, generally, if a hospital charges are $1,000.00 and the bill is submitted to an automobile PIP carrier, the bill is reduced to $750.00 and paid at 80 percent or $600.00.  Under the statute, the hospital is not allowed to charge the patient for the difference, i.e. the $250 reduction is a write off and thus after the payment of $600.00, the balance owed would be $150.00 not $400.00.  Ancillary hospital bills (emergency room physician, hospital radiology and ambulance charges) are allowed under the statute at usual and customary and thus there generally would not be a reduction for those bills. 

After the hospital, if the injured person goes to a private physician (chiropractor, primary care physician, orthopedist, neurologist, medical doctor, etc.), the charges are limited to 200 percent of the medicare fee schedule and then paid at 80 percent.  Thus if an initial visit to the doctor is charged at $500.00 (this is the doctor’s usual and customary charge), the PIP carrier would review the fee schedule and if the medicare fee schedule pays $150.00 for that particular coded visit, then the PIP carrier is allowed to reduce that charge to $300.00 (double the medicare of $150.00) and it gets paid at 80 percent or $240.00.  The balance owed would be $60.00 and not $260.00 as the $200 reduction per the fee schedule is generally not allowed to be charged against the patient per the statute.  If the PIP benefits are exhausted, i.e. the $10,000.00 has already been paid back, then the fee schedule no longer applies and the whole charge is due and owing. 

While generally it takes $12,500.00 to exhaust PIP benefits (presuming a no deductible, $10,000.00 PIP policy paying at 80 percent), you can see that it is not so easy to figure out when PIP benefits have exhausted in a case.  Many automobile insurance companies will send explanation of benefits to their insureds, and from this the patient can see approximately where there benefits are at certain points of treatment but again it is not so easy as the doctors do not necessarily bill right after each treatment.  There are even companies that will allow people with online access to check their available PIP benefits but again with delayed billing, this is not necessary updated with all billing to that moment. 

Every case is different and must be judged on its merits. It is a good start to get a free consultation regarding an accident case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so please call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your case.

It is difficult to analyze available PIP benefits in a case but at Drucker Law Offices, the accident attorney from Boca (injury lawyer in Delray Beach, personal accident attorney in Northlake, injury attorney in Loxahatchee, injury lawyer in Royal Palm Beach, accident attorney in Wellington, accident lawyer in Boynton Beach, personal injury attorney in Lake Worth, injury lawyer in Lake Park, injury attorney in West Palm Beach, accident attorney in the Acreage, accident lawyer in Palm Beach) helps client with these issues and offers a free consultation to people that have been involved in any sort of accident where they believe someone else caused the accident.  Please call with any questions at the principal office in Boca Raton 561-483-9199, satellite office in Miami 305-981-1561, satellite office in Coral Springs 954-755-2120, satellite office in Boynton Beach 561-265-1976 or the satellite office in West Palm Beach 561-686-7070.

(5)  CHARGES FOR TREATMENT OF INJURED PERSONS.–

(a)  Any physician, hospital, clinic, or other person or institution lawfully rendering treatment to an injured person for a bodily injury covered by personal injury protection insurance may charge the insurer and injured party only a reasonable amount pursuant to this section for the services and supplies rendered, and the insurer providing such coverage may pay for such charges directly to such person or institution lawfully rendering such treatment, if the insured receiving such treatment or his or her guardian has countersigned the properly completed invoice, bill, or claim form approved by the office upon which such charges are to be paid for as having actually been rendered, to the best knowledge of the insured or his or her guardian. In no event, however, may such a charge be in excess of the amount the person or institution customarily charges for like services or supplies. With respect to a determination of whether a charge for a particular service, treatment, or otherwise is reasonable, consideration may be given to evidence of usual and customary charges and payments accepted by the provider involved in the dispute, and reimbursement levels in the community and various federal and state medical fee schedules applicable to automobile and other insurance coverages, and other information relevant to the reasonableness of the reimbursement for the service, treatment, or supply.

(b)1.  An insurer or insured is not required to pay a claim or charges:

a.  Made by a broker or by a person making a claim on behalf of a broker;

b.  For any service or treatment that was not lawful at the time rendered;

c.  To any person who knowingly submits a false or misleading statement relating to the claim or charges;

d.  With respect to a bill or statement that does not substantially meet the applicable requirements of paragraph (d);

e.  For any treatment or service that is upcoded, or that is unbundled when such treatment or services should be bundled, in accordance with paragraph (d). To facilitate prompt payment of lawful services, an insurer may change codes that it determines to have been improperly or incorrectly upcoded or unbundled, and may make payment based on the changed codes, without affecting the right of the provider to dispute the change by the insurer, provided that before doing so, the insurer must contact the health care provider and discuss the reasons for the insurer’s change and the health care provider’s reason for the coding, or make a reasonable good faith effort to do so, as documented in the insurer’s file; and

f.  For medical services or treatment billed by a physician and not provided in a hospital unless such services are rendered by the physician or are incident to his or her professional services and are included on the physician’s bill, including documentation verifying that the physician is responsible for the medical services that were rendered and billed.

2.  Charges for medically necessary cephalic thermograms, peripheral thermograms, spinal ultrasounds, extremity ultrasounds, video fluoroscopy, and surface electromyography shall not exceed the maximum reimbursement allowance for such procedures as set forth in the applicable fee schedule or other payment methodology established pursuant to s. 440.13.

3.  Allowable amounts that may be charged to a personal injury protection insurance insurer and insured for medically necessary nerve conduction testing when done in conjunction with a needle electromyography procedure and both are performed and billed solely by a physician licensed under chapter 458, chapter 459, chapter 460, or chapter 461 who is also certified by the American Board of Electrodiagnostic Medicine or by a board recognized by the American Board of Medical Specialties or the American Osteopathic Association or who holds diplomate status with the American Chiropractic Neurology Board or its predecessors shall not exceed 200 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year’s changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor.

4.  Allowable amounts that may be charged to a personal injury protection insurance insurer and insured for medically necessary nerve conduction testing that does not meet the requirements of subparagraph 3. shall not exceed the applicable fee schedule or other payment methodology established pursuant to s. 440.13.

5.  Effective upon this act becoming a law and before November 1, 2001, allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services shall not exceed 200 percent of the allowable amount under Medicare Part B for year 2001, for the area in which the treatment was rendered. Beginning November 1, 2001, allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services shall not exceed 175 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year’s changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor for the 12-month period ending June 30 of that year, except that allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services provided in facilities accredited by the Accreditation Association for Ambulatory Health Care, the American College of Radiology, or the Joint Commission on Accreditation of Healthcare Organizations shall not exceed 200 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year’s changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor for the 12-month period ending June 30 of that year. This paragraph does not apply to charges for magnetic resonance imaging services and nerve conduction testing for inpatients and emergency services and care as defined in chapter 395 rendered by facilities licensed under chapter 395.

Who is to pay your medical bills following a car accident – by the injury attorney from Boca Raton (Boynton, West Palm Beach, Coral Springs, Miami)

One of the more confusing issues in a car accident is whose insurance pays the medical bills.  Section 627.736 of the Florida Statutes discusses this issue and specifically section 627.736(4)(d) addresses it, a copy of that section is put below at the bottom of this blog entry.  This is a common question asked to the personal injury lawyer in Boca Raton (accident lawyer in Deerfield Beach, injury attorney in Parkland, injury lawyer in Tamarac, accident attorney in Plantation, accident lawyer in Miramar, personal injury attorney in Coconut Creek). 

In general, if you own a car, your own insurance pays for your medical bills when you are involved in a car accident.  This includes situations when you are in your own car that is in an accident, if you are in someone else’s car that is involved in an accident or even if you are hit by a car as a pedestrian or on a bicycle.  If you do not own a car, then you would get PIP benefits (which would pay 80 percent of allowable medical bills and 60 percent of proven lost wages) through a resident relative.  So if you live with your mother that owns a car and you are in an accident in your mother’s car, you would get the PIP through your mother’s automobile accident insurance.  Similarly, if you were in a friend’s car (but did not own a car and you lived with your mother), then you would get the PIP coverage through your mother’s car.  Similarly, if you were hit by a car as a pedestrian or hit on a bicycle by a car (and you did not own a car but lived with your mother), you again would qualify for PIP benefits with your mother’s car insurance.  If you do not own a car and you do not live with any relatives that own a car, then you would get PIP benefits from the car that you were in or the car that hit you while you were on a bicycle or as a pedestrian. 

These cases are very fact specific and I am assuming here that these cars are registered in Florida.  It is important to have these situations analyzed by someone that is familiar with insurance policies.  At Drucker law offices, the attorney helps clients that are involved in car accidents.  If you have any questions about a car accident, please call the principal office in Boca Raton at 561-483-9199 or at the Boynton Beach satellite office 561-265-1976 or at the West Palm Beach satellite office 561-686-7070 or at the Coral Springs satellite office 954-755-2120 or at the Miami Satellite office 305-981-1561 for a free consultation. 

627.736

(4)(d)  The insurer of the owner of a motor vehicle shall pay personal injury protection benefits for:

1.  Accidental bodily injury sustained in this state by the owner while occupying a motor vehicle, or while not an occupant of a self-propelled vehicle if the injury is caused by physical contact with a motor vehicle.

2.  Accidental bodily injury sustained outside this state, but within the United States of America or its territories or possessions or Canada, by the owner while occupying the owner’s motor vehicle.

3.  Accidental bodily injury sustained by a relative of the owner residing in the same household, under the circumstances described in subparagraph 1. or subparagraph 2., provided the relative at the time of the accident is domiciled in the owner’s household and is not himself or herself the owner of a motor vehicle with respect to which security is required under ss. 627.730-627.7405.

4.  Accidental bodily injury sustained in this state by any other person while occupying the owner’s motor vehicle or, if a resident of this state, while not an occupant of a self-propelled vehicle, if the injury is caused by physical contact with such motor vehicle, provided the injured person is not himself or herself:

a.  The owner of a motor vehicle with respect to which security is required under ss. 627.730-627.7405; or

b.  Entitled to personal injury benefits from the insurer of the owner or owners of such a motor vehicle.

Who pays for your medical bills in a car accident ? from the Florida accident lawyer

Many common questions that I get as an accident lawyer in Boca Raton (also injury attorney in Miami, accident attorney in Kendall, injury lawyer in Coral Gables, injury attorney in North Miami, accident lawyer in North Miami Beach, injury attorney in Miami Beach) are about which insurance company is responsible to pay for the medical bills in an accident. Generally, in Florida, in a car accident, your own car insurance pays for your medical bills (at 80 percent of allowable charges to a total of $10,000.00; note:  the $10,000.00 encompasses 80 percent of allowable medical bills and 60 percent of wages to a total of $10,000.00 for both).  This is called Personal Injury Protection or PIP coverage and every car in Florida is required to have this coverage.

The basic concept of PIP insurance is “no fault” meaning that no matter whose fault the accident, you own insurance pays your medical expenses.  This does not make sense to many clients who ask, “if everyone is in agreement, including the car that hit me, that the other car is at fault, why should my insurance get involved at all?”  And this common question does make sense except that the idea of the no fault laws was that the government wanted to be sure that people were able to get medical treatment and thus the law was put in effect to give everyone the ability to get treatment in a car accident, regardless of fault.  While many people in Florida have health insurance, many others do not have health insurance and the legislatures wanted to be sure that everyone had the ability to get treatment and thus the PIP laws were enacted to help get people treated and get medical providers paid for said treatment. 

Please note that this does not mean that all issues in a car accident fall under the “no fault” system.  This only applies to the medical treatment.  For example, in terms of getting your car fixed, the other person’s property damage coverage will fix your car, if they are at fault, so the property damage is clearly a fault system (Note:  even if you are at fault, you may be able to get your car fixed through your own collision coverage policy, if you have that on your car).  Similarly, obtaining money for bodily injury is also a fault system and thus you cannot get compensated for your own injuries if you were at fault but instead I can only collect monies for clients that were in accidents where they were not at fault (and thus claim is being made against the other car or if the client was a passenger in a car, then against the driver of the car they were in).

The particular Florida law that deals with PIP coverage is 627.736 and the statute that requires all vehicle to have PIP coverage is 627.736(1), a copy of which is below.  If you or a loved one has been in an car accident and you would like a free consultation about your rights, please feel free to call 561-483-9199 (Boca – Principal office), Boynton Beach satellite office (561-265-1976), West Palm Beach satellite office (561-686-7070), Coral Springs satellite office (954-755-2120), or Miami satellite office (305-981-1561).  The accident lawyer in Boca Raton (injury lawyer in Delray Beach, injury attorney in Boynton Beach, accident attorney in Wellington, accident lawyer in Greenacres, injury lawyer in West Palm Beach, injury attorney in Royal Palm Beach, accident attorney in Palm Springs, accident lawyer in Lake Worth, accident attorney in Lake Park, injury lawyer in Loxahatchee, injury attorney in the Acreage, accident lawyer in Palm Beach, accident attorney in West Boca) is ready to answer any questions.

(1)  REQUIRED BENEFITS.–Every insurance policy complying with the security requirements of s. 627.733 shall provide personal injury protection 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, subject to the provisions of subsection (2) and paragraph (4)(d), to a limit of $10,000 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 as follows:

(a)  Medical benefits.–Eighty percent 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. Such benefits shall also include necessary remedial treatment and services recognized and permitted under the laws of the state for an injured person who relies upon spiritual means through prayer alone for healing, in accordance with his or her religious beliefs; however, this sentence does not affect the determination of what other services or procedures are medically necessary.

(b)  Disability benefits.–Sixty percent of any loss of gross income and loss of earning capacity per individual 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. All disability benefits payable under this provision shall be paid not less than every 2 weeks.

(c)  Death benefits.–Death benefits of $5,000 per individual. The insurer may pay such benefits to the executor or administrator of the deceased, to any of the deceased’s relatives by blood or legal adoption or connection by marriage, or to any person appearing to the insurer to be equitably entitled thereto.

Only insurers writing motor vehicle liability insurance in this state may provide the required benefits of this section, and no such insurer shall require the purchase of any other motor vehicle coverage other than the purchase of property damage liability coverage as required by s.627.7275(a) as a condition for providing such required benefits. Insurers may not require that property damage liability insurance in an amount greater than $10,000 be purchased in conjunction with personal injury protection. Such insurers shall make benefits and required property damage liability insurance coverage available through normal marketing channels. Any insurer writing motor vehicle liability insurance in this state who fails to comply with such availability requirement as a general business practice shall be deemed to have violated part IX of chapter 626, and such violation shall constitute an unfair method of competition or an unfair or deceptive act or practice involving the business of insurance; and any such insurer committing such violation shall be subject to the penalties afforded in such part, as well as those which may be afforded elsewhere in the insurance code.

PIP laws – What does it pay for? What does PIP mean? – by the Florida accident lawyer

As a personal injury lawyer in Boca Raton (also Plantation  injury lawyer , Pompano Beach accident lawyer, Fort Lauderdale accident attorney, Parkland injury lawyer, Tamarac accident lawyer, Lauderhill injury attorney), I get a lot of clients injured in accidents with concerns such as:  how will I get my medical bills paid and what about reimbursement for the time if missed from work.  

Generally, in  Florida, every owner of an operable motor vehicle must have personal injury protection insurance (PIP) and this insurance applies to that owner, to that owners resident relatives who do not own a car and to anyone occupying their car who does not own a car or live with any relatives that own a car.    Generally, PIP coverage pays for 80 percent of your medical bills relating to a car accident and 60 percent of lost wages, both to a total of $10,000.00.   Under laws passed effective January 1, 2008, many medical bills are subject to a fee schedule.  Hospital charges are subject to a 25 percent of usual and customary reduction.  Other ancillary hospital bills (ambulance, ER physician, ER radiologist, etc.) are paid at usual and customary.  Physicians that you see after the hospital are subject to a very specific fee schedule that is tied to the medicare fee schedule.  Essentially, they are paid in general at 200 percent of the medicare fee schedule.   Wages are paid at 60 percent.  A wage verification form is required and a disability note from the treating physician is also needed.   You are allowed to elect a PIP deductible of up to $1,000.00.   You are allowed to elect to reject the wage aspect of a PIP policy to reduce the premiums.   PIP pays these medical bills and wages that are related to a motor vehicle accident.  

If you have been in an accident, please feel free to call the injury lawyer from Boca Raton (also accident attorney from Delray Beach, accident lawyer from Boynton Beach, injury lawyer from North Palm Beach, accident attorney from West Palm Beach, accident lawyer from Loxahatchee, personal injury lawyer from Palm Springs, personal injury attorney from Palm Beach, accident lawyer from Royal Palm Beach, accident attorney from the Acreage) for a free consultation at any of the convenient location in West Palm Beach, Boynton Beach, Boca Raton (principal office), Coral Springs or Miami.  The office works on a contingency fee basis which means that fees and costs are only charged if money is recovered for you.

Blog by personal injury lawyer – The Florida Safety Belt Law

As a personal injury lawyer in Boca Raton (also Deerfield Beach accident lawyer, Pompano Beach injury attorney, Fort Lauderdale accident attorney, Hallandale accident lawyer, Hollywood injury lawyer, Miramar accident lawyer, Pembroke Pines injury attorney, Plantation injury lawyer, Tamarac accident lawyer, Lauderhill injury attorney), I commonly get asked the question about the requirement of wearing a seat belt and how this plays out in an accident.

The seat belt statute provides, in part:

(4) It is unlawful for any person
(a) To operate a motor vehicle unless each front seat passenger of the vehicle under the age of 16 years is restrained by a safety belt or by a child restraint device pursuant to s. 316.613, if applicable, or
(b)To operate a motion vehicle in this state unless the person is restrained by a safety belt.
(5) It is unlawful for any person 16 years of age or older to be a passenger in the front seat of a motor vehicle unless such person is restrained by a safety belt when the vehicle is in motion.

Subsection ten (10) of F.S. 316.614 discusses how the seat belt statute should be used in a civil action:

A violation of the provisions of this section shall not constitute negligence per se, nor shall such violation be used as prima facie evidence of negligence or be considered in mitigation of damages, but such violation may be considered as evidence of comparative negligence, in any civil action. 

Clearly, this statute requires the use of a seat belt and makes some penalties if you do not wear the seatbelt.  However, while the statute does not make the failure of wearing a seatbelt negligence automatically, it can be used as evidence of comparative fault, in any civil action.

An example would be as follows.  Robert is a front seat passenger in a vehicle.   As a result of the negligence of the other vehicle, there is a car accident.  Robert is not wearing his seat belt.  He goes through the front windshield, causing significant scarring to his face along with some other injuries caused solely from the impact.  The other front seated person was wearing their seat belt and has minor injuries.  The defense may argue in the case that had Robert been wearing his seat belt, that he would not have gone through the front windshield and would not have the scarring on his face.  The suggestion by the defense would be that the jury should not award Robert the damages for his scarring but only the damages for the other injuries, due to his comparative negligence.  Of course, this would ultimately be decided by a jury and the facts of every case are different.

Common sense suggests that everyone should wear their seat belts.  There are cases reported in the newspapers where in major accidents when people where seat belts, the injuries are generally much less.  There are accidents where the only people in major car accidents with life changing injuries are those who were NOT wearing their seat belts.

If you have been in an accident, please feel free to call the injury lawyer from Boca Raton, Gary J. Drucker, (also accident attorney from Aventura, accident lawyer from North Miami, injury lawyer from Miami, accident attorney from Downtown Miami, accident lawyer from South Miami, accident lawyer from Opa Locka, accident attorney from Coconut Grove) for a free consultation at any of the convenient location in West Palm Beach, Boynton Beach, Boca Raton (principal office), Coral Springs or Miami.  I work on a contingency fee basis which means that I only charge a fee or recoup costs if money is recovered for you.

Three car rear end collisions – who is at fault? Can more than one car be at fault in an accident?

Another very common type of car accident is the three car rear end collision.  There is a lot of confusion as to whether one or two cars are at fault and who you can sue.  This blog entry will discuss some of these issues.  Bear in mind that every case is case specific and it is important to have these cases analyzed.  At Drucker Law Office, the injury attorney in Boca Raton (also accident lawyer in Delray Beach, accident attorney in Boynton Beach, injury lawyer in West Palm Beach, accident lawyer in Lake Worth) helps clients analyze their car accident cases and helps clients recover monies from the at-fault owner/driver or owners/drivers when they are injured in an accident. 

Generally, the three car rear end collision happens in two different ways.  First car in front is stopped; second car behind is stopped; third car crashes into second car which causes second car to crash into first car in front.

In this first scenario, the third car is generally at fault.  If the second car was just stopped behind the first car, then the second car of course would generally not be at fault.  Similarly, if the first car was stopped at a light, then it would not generally be at fault either.  So, in this scenario the third car is at fault.  Oftentimes, I will be asked by the person in the first car if they can sue or make a claim against the second car and generally the answer is no, as the second car is not at fault.  In this scenario, the second car was stopped and the only reason it hit the first car was because the third car hit it from behind.

The second way these accidents can happen is as follows.  First car in front is stopped; second car behind crashes into first car in front; third car crashes into second car which causes second car to crash again into first car in front.

In this second scenario, both the second car and third car are generally at fault.  The first car, presuming it was stopped at a red light for example, would generally not be at fault.  From the perspective of the first car, he would have a claim against both the second and third car for his or her injuries.

Of course, every case is unique and has to be judged on its individual merits.  In order to evaluate these cases, a jury will listen to the testimony of the drivers of the car, any passengers, any witnesses and the policeman (although his testimony would be limited to only what he saw, not to any conversations with the drivers; see the accident report privilege blog from earlier) and to look at pictures of the cars and the intersection and any other evidence brought in by the parties.

At Drucker Law Offices, the accident lawyer in Boca Raton (also injury attorney in Deerfield Beach, injury lawyer in Pompano, accident attorney in Fort Lauderdale, injury attorney in Hallendale, injury lawyer in Hollywood, accident lawyer in Miramar, accident attorney in Pembroke Pines, injury lawyer in Plantation, accident attorney in Davie, accident lawyer in Tamarac, accident lawyer in Coral Springs, injury attorney in Parkland, accident lawyer in Lauderhill, injury attorney in Lauderdale Lakes, injury lawyer in Margate, accident lawyer in Coconut Creek) helps to analyze all injury cases including three car rear end collisions.  If you or a loved one has any questions about an injury case, please call the Boca Raton office 561-483-9199 or the Coral Springs satellite office 954-755-2120 or the Miami office 305-981-1561.

Rear End Collisions – who is at fault from the accident attorney office

One of the most common types of two-car, car accidents is the rear end collisions accident.  A common question the injury lawyer in Boca Raton (also accident attorney in Delray Beach, injury attorney in Boynton Beach, accident attorney West Palm Beach, personal injury lawyer Deerfield Beach, accident lawyer Coral Springs, injury attorney Fort Lauderdale) gets in car accidents cases is whether the car from behind is automatically at fault. 

In Florida, there is a presumption that in a two car rear end collision, the car from behind is at fault.  This means that the jury should presume the car from behind is at fault unless there is other evidence that rebuts the presumption.  There are several ways to rebut the presumption; for example, if the car in front comes to an abrupt and sudden stop, without purpose, this could rebut the presumption.  Another obvious presumption would be that if there was some evidence that the car in front put the car in reverse and in fact struck the car in back, then that would arguably rebut the presumption.  Often, in these cases, there is a difference in the testimony from the two parties.  The car in front says they came to a normal stop and the car from behind says the car in front came to a sudden and abrupt stop and thus the jury has to decide who is at fault.

In most rear end collisions, one car is stopped at a light or at a stop sign or in traffic and the car from behind is not paying attention and strikes the car from behind.  In these scenarios, which is likely the majority of these cases, there is agreement as to who is at fault and the presumption holds that the car from behind is at fault. 

To sum up, in most cases the car from behind is at fault in a rear end collision case.  There usually is agreement between the parties about who is at fault.  There is a presumption under Florida law that the car from behind is at fault but this presumption is rebuttable.  Thus, fault is not automatic but instead is presumed but the presumption can be rebutted by evidence like the car in front abruptly stopped without purpose or that the car in front backed into the car from behind. 

If you have been in an accident and would like advice regarding your rear end collision car wreck or another type of accident, please feel free to call Drucker Law Offices at 561-483-9199.  The injury attorney in Boca Raton (also injury lawyer in Deerfield beach, accident attorney in Pompano, injury lawyer in Boynton Beach, accident attorney in Kendall, Florida) will be glad to answer any questions that you may have regarding your automobile accident case or other injury case.

The accident report privilege – thoughts from the Boca Raton, Boynton Beach, Coral Springs personal injury attorney

In my experiences as a personal injury attorney in Boca (also accident attorney in Delray Beach, injury lawyer in Boynton Beach, injury attorney in West Palm Beach, accident attorney in Miami, accident lawyer in Kendall, injury attorney in Dadeland area), more often than not, there is agreement as to who is the cause of an accident.  In the most common type of car accident, a rear end collision accident usually the person who hits the other from behind agrees that he or she is at fault. 

However, there are many accidents where the parties are in disagreement as to how it happened.  In some of these accidents, the police describe the accident but do not make a determination as to who caused the accident.  The reason for this may be because there are no witnesses and no way to determine who is at fault. In other accidents, for one reason or another, the police actually cites one car as the cause of the accident.  In those cases, I commonly get calls asking the question above:  if I was found at fault by the policeman, is there any way to fight this to recover monies for my injuries from the other insurance company. 

Florida Statute section 316.066 is called the accident report privilege statute.  This statute makes it that any statements made by someone to the police investigating a crash is inadmissible in a civil case and further the report cannot be used as evidence in a civil proceeding also.  Thus, even though the police find one party at fault in a police report, in terms of presenting a case to a jury, this finding would not be able to be used in a civil court case.  

As a result of this statute, the police report is far from final in terms of determining who is at fault in an accident.  Using common sense, policeman investigate accidents regularly and likely are correct in finding accidents, as they have had the opportunity to talk to the parties involved in the accident and any witnesses.  But in the case where the policeman does not understand the accident or misunderstands a witness or just makes a mistake in finding fault against one party, there would be recourse for the person who thinks they were wrongfully found at fault in an accident from the standpoint of pursuing an injury case with an accident lawyer. 

If you have been involved in an accident, please call the accident attorney, injury lawyer for a free consultation regarding your car accident case.  Drucker Law Offices handles cases in Palm Beach County – Boca Raton, Delray Beach, Boynton Beach, West Palm Beach, Lake Park, Lake Worth, Loxahatchee, Wellington, Broward County – Deerfield Beach, Pompano, Fort Lauderdale, Hallandale, Hollywood, Pembroke Pines, Miramar, Coral Springs, Margate, Lauderhill, Parkland; and Miami-Dade County – Miami, Aventura, Hialeah, Miami Lakes, Coral Ridge, Homestead, South Miami, and Coral Gables.