I had 100 percent coverage with my Florida PIP and now i have to use some of my settlement to pay it back; why?

Generally, Florida no fault or PIP (personal injury protection) coverage pays 80 percent of medical bills up to $10,000.00. When your insurance pays that, there is no right of subrogation which means that they cannot ask you to repay the $10,000.00 or whatever the PIP paid and they cannot even ask for that money back from the other, at fault driver or the insurance of the at fault driver. The Florida PIP has to pay the bills and they do not get the monies back. Generally, to have 100 percent coverage you can purchase something called “medical payments” coverage. That pays the 20 percent balances at the doctors and any monies over and above the $10,000.00 limit (usually medical payment coverage provides an additional $5000.00 of coverage but can be a higher or lower amount). The insurer is allowed to seek subrogation or reimbursement for the medical payment coverage from their insured.

Why do I have to repay my health insurance (what they paid my doctors that treated me for the accident) from my Florida personal injury settlement?

Generally, if health insurance pays your doctors that treated you for an accident AND you make a claim against someone for that accident, you must also seek to get those medical bills paid in the case and must repay the health insurance. This subrogation right of the health insurance company is generally by contract or statute. With medicare or medicaid, for example, the right to reimbursement is by statute. With health insurance, the right to reimbursement is by contract. It is possible that the health insurance contract does not contact the proper language and if not then the health insurance is not entitled to subrogation generally but for the most part the health insurance contracts to have reimbursement provisions and thus entitled to repayment IF THERE IS A RECOVERY.

I am missing work due to pain from my Florida car accident; who is responsible to pay my lost wages?

Generally, in Florida, everyone that owns a car is required to have no fault or PIP (personal injury protection) insurance. That insurance pays for 80 percent of medical bills and 60 percent of wages, up to a total of $10,000. And since this is no fault insurance, it does not matter if you are at fault or the other car is at fault or there is a dispute as to fault. The bottom line is that your own insurance pays 60 percent of your lost wages, when sufficient proof is submitted (generally a disability note from your doctor and a wage verification form from your employer). If the other car is at fault, you can seek, as part of a settlement or verdict, the other 40 percent of unpaid wages.

Why do I need to go to a doctor to get money for a car accident in Florida? Doesn’t the other person owe me money solely because they caused an accident?`

Under Florida law, the person who causes an accident can be sued for damages. The damages that one can generally seek are medical bills past and future, lost wages past and future, and non economic damages (generally pain and suffering) past and future. If someone does not go to a doctor, then they would not have past medical bills and obviously obtaining future medical bills would be difficult in that scenario. If someone did not go to the doctor, they likely would not have lost wages. Most people focus on the “pain and suffering” or “inconvenience” when they ask this sort of a question. However, under Florida law, a permanent injury (or death, significant scarring or permanent disfigurement) is required to be entitled to any sort of non economic damages like pain and suffering. A permanent injury is generally proven by medical testimony and thus a doctor is necessary. Someone generally cannot prove a permanent injury with their own testimony. Thus, doctors and medical treatment is generally required to have a case for injuries in a car accident in Florida.

In Florida, if the No-Fault PIP pays the medical bills, why is the lawyer using some of my settlement or verdict to pay medical bills?

Generally, Florida no fault PIP (personal injury protection) pays for 80 percent of medical bills and up to $10,000. Thus, there is generally 20 percent of unpaid medical bills AFTER PIP pays. Plus, if you have more than $12,500 of medical bills (80 percent of $12,500 is $10,000), then any billing after that would be due and payable. Thus, part of the claim against the person that caused the accident would be for the 20 percent unpaid medical bills plus any of the medical bills that go over and above the PIP. And therefore part of the settlement is to pay those bills and are to be paid from the settlement/verdict.

Do all of my medical bills get paid by No-Fault Insuance in Florida?

Generally, in Florida, no-fault insurance (personal injury protection or PIP) pays 80 percent of medical bills, NOT 100 percent. Also, no fault PIP coverage pays up to $10,000 of medical bills. This is the minimum PIP coverage that the law requires. In my experience, this is the coverage that the vast majority of people in Florida purchase. However, it is possible to buy more than $10,000 of PIP and you can also buy something called medical payment coverage which pays the other 20 percent and any monies over and above the $10,000. Most commonly medical payment coverage is for $5,000 but sometimes it is for $10,000 or even more.