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.

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