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PIP Rule

#1 Rated Auto Accident Injury Clinic in Jacksonville

East Coast Injury Clinic – Auto Accident Injury Care & Chiropractic
located in Jacksonville, FL

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The Complete Over On Florida PIP 14 Day Rule

Because Florida is a no-fault state, your auto insurance company must provide coverage for your medical bills, lost wages, and other related expenses whenever you are injured in a car accident. That coverage is limited by the terms of your insurance policy, but the minimum coverage that you must purchase is $10,000. (Note that your injury might not qualify for the full $10,000 payout. It depends on the severity of your injuries.) One important caveat to receiving compensation is that you must receive medical treatment within 14 days of the accident

If you’re a Florida driver, you may have heard of the 14-day rule. Under Florida’s no-fault system, you have 14 days to seek medical attention after a car accident. The time deadline is a requirement to make a claim for compensation through your no-fault, personal injury protection insurance. All Florida drivers should be familiar with the 14-day rule so that they can take full advantage of their personal injury protection (PIP) benefits. 

The insurer may limit reimbursement to 80 percent of the following schedule of maximum charges up to 10,000

Why Does the 14-Day PIP Rule Exist?

The 14-day rule exists for two reasons: First, waiting to get medical attention can make an injury worse. The sooner you get professional medical treatment, the sooner you can minimize your injuries and prevent complications.

Second, proving the nexus between the accident and your injuries is a critical part of making an insurance claim. When you get medical treatment right away, the link between the car accident and your injuries is clear. The 14-day rule exists to help car accident victims get the treatment they need and to ensure that accident claims are valid and accurate.

According to FIRES (Florida Integrated Report Exchange System), there were more than 400,000 total reported crashes in 2017.

How Long Do You Have to File a Personal Injury Protection (PIP) Claim in Florida After A Car Accident?

How long you have to file a PIP claim in Florida depends on the terms of your insurance contract. In most cases, the insurance company gives you a significant period of time to file the claim. However, there are a few things that you need to do quickly for your claim to succeed.

First, the police must respond to the scene, or you must complete a police accident report within 10 days of the accident. Second, you must seek medical attention within 14 days of the accident. Once you’ve done both of those things, how long you have to file a PIP claim in Florida depends on what’s stated in your insurance contract.

pip rule medical coverage

Get Approved Medical Care On Time At An Auto Accident Clinic

Under the 2013 PIP law change, an accident victim must get “initial services and care” within two weeks of a crash if they want to receive benefits through their PIP coverage. Almost any type of medical attention will meet this requirement, as long as it comes from a qualified health care provider, or a qualified health care provider supervised or prescribed the care.

  • A qualified health care provider might include:
  • A medical doctor
  • A dentist
  • A chiropractor
  • An emergency medical technician

It is important to note that seeing a physical therapist, massage therapist, or other care provider not specifically listed in the statute will likely not meet the criteria if you were in a car accident based on the Florida 14 day rule. Your insurance company will likely deny your claim, and you will not receive benefits. It is always a good idea to go to the emergency department or see your doctor as soon as possible after a crash, both to ensure you are healthy and to meet this qualification as outlined in the Florida PIP 14-day Rule.

If a medical provider determines that the injured party does not meet the level of an EMC, then they are only entitled to just $2500 in PIP benefits. (75% reduction).

 

Do I Need Immediate Medical Attention After A Car Accident For My Emergency Medical Condition?

Yes, you need immediate medical attention after an accident. When adrenaline is running high after a crash, you may have serious injuries that you don’t realize. Emergency medical conditions can sometimes be slow to appear. As a rule It’s important to get medical attention quickly to address your injuries and mitigate complications, that is the reason behind PIP insurance provided by your insurer.

It’s always important to seek immediate medical care after a car accident – not just for insurance purposes. Failing to see a doctor right away can worsen your prognosis for recovery. Injuries such as those to the brain or organs require prompt medical attention for the best chance of healing.

Go to the hospital if you have an emergency medical condition, otherwise, see an accident care center for a checkup and a free consultation even if you don’t think you have any injuries. Many injuries can have delayed symptoms, including traumatic brain injuries and back/neck injuries and if by Florida rule you will lose insurance coverage for your injuries if you don’t seek care.

In Florida, you must go to the hospital or an accident care injury care center and have a medical professional diagnose you with an “emergency medical condition” within 14 days to receive personal injury protection insurance benefits. Otherwise, you will not be eligible for PIP coverage and you will not be able to use your PIP policy to file a PIP claim. All car insurance companies in Florida off this injury care as part of their insurance coverage.

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What Is A Common Car Accident Injury?

Whiplash. When you see that word, what do you picture? Many people immediately associate the word with auto accidents, and for good reason. Every single car crash will induce some level of whiplash. Pain is expected after an accident, but the cause–whiplash–needs to be brought to light and dealt with as the seriousness it is. This is often underestimated because a person will often brushed off as “simple” neck pain but in all seriousness it is a chronically complex issue and that is why you should see an car crash specialist for a free consultation.

Contact us today to get you on the road to recovery

Getting Medical Attention After a Florida Car Accident

Florida law 627.726 [1] creates the rules for getting medical care after a auto accident The law says that the insurance company must provide compensation under the insurance agreement with a driver as long as the victim gets initial medical services and care within 14 days of the accident. You can get medical care from any of the following:

  • Primary care doctor
  • Specialist doctor
  • Dentist
  • Chiropractor
  • Medical services provided in a hospital
  • Urgent care
  • Emergency room
  • Outpatient facility run by a hospital
  • EMTs (emergency transportation and management)

Treatment is essential to your health as well as your case.

Even a minor impact can jar the body and cause injury. It is vital for you to seek medical care, in person, to receive PIP benefits.

Local urgent cares and emergency rooms are taking extra precautions to ensure that you and your loved ones are safe.

Many providers are offering telehealth options to help schedule your first appointment within the first 14 days of your accident.

Time Deadline to File a PIP Lawsuit Against the Insurance Company

You can claim injury after a traffic accident in Florida for 14 days . For minor injuries, you have 14 days to seek medical care. If you don’t get medical treatment within 14 days of the accident, you can no longer claim injury and lose personal injury protection benefits. When you have serious injuries that may prompt a third-party claim, you have four years from the date of the accident to claim injury by initiating your lawsuit for compensation.

If your insurance company doesn’t pay you fairly, you have the option to bring a lawsuit against your own insurance company . Essentially, your claim is a claim to enforce the contract between you and the insurance company. In Florida, the statute of limitations for breach of contract is five years with insurance companies. The time limit is listed in Florida law 95.11(2)(b) .

When the insurance company doesn’t pay you fairly, and you’ve done everything that you were supposed to do to make the claim, you can bring a lawsuit to require your own insurance company to honor the contract. You can have representation from a Florida personal injury attorney to bring your claim on your behalf. This case is greatly assisted if you received medical attention within 14 days.

The Florida PIP 14-Day Rule and Payout Limits

When Florida passed the amendment to its PIP rule, the new statute also established limits on the benefits available through a PIP claim especially for medical benefits. Under the new rules, if you received treatment within 14 days from a car collision in florida, and:

Suffered only non-emergency injuries (non emergency medical condition), you can only receive $2,500 in benefits.

Suffered an “emergency medical condition,” you can receive the maximum payout available from your PIP coverage as long as you seeked medical attention within 14 days.

You should have at least $10,000 in coverage available to you. This is the state’s minimum amount of PIP coverage required; however, you might carry a larger policy. It is best to check with your insurer as different insurance companies will have different claim compensation payout for the drivers.

According to the Florida Office of Insurance Regulation, the justification for the change is to decrease PIP fraud. According to them, PIP fraud was/is a $600 million problem in the state of Florida. The hope was that if PIP fraud went down, premiums will go down with no fault insurance coverage. The way the two week PIP guideline helps with this is by assuming that those who are really injured will seek medical attention right away and make a claim.

Those who find out about all the coverage they’re missing later may make something up possibly leading to a fraudulent claim. Of course, this is not always the case. In fact, most PIP claims are from perfectly honest, legitimate victims who are injured and need medical support and financial relief.

As to whether the change has caused premiums to go down? I think most would agree they haven’t. It should be noted however that some articles claim that premiums have gone down by as much as 15%.

Florida Law 395.002(8) and Emergency Medical Conditions

This the the PIP insurance coverage that convers the compensation the insurer must cover as part of personal injury protection coverage after being in a crash. These are the rules the injury center healthcare provider offices and legal groups will follow to insure you get your care and compensation you deserve.

Florida law 395.002(8) [2] defines an emergency medical condition as a medical condition with acute symptoms. The condition requires treatment to prevent endangering health and well-being. It may cause the impairment of a major bodily function or dysfunction of any organ or body part. If you meet the qualifications under Florida law 395.002(8) for an emergency medical condition , the minimum of $10,000 applies to cover your medical treatment.

Source: State Of Florida

Source: leg.state.fl.us

Source:FLA. STAT. § 627.726 (2019)

Source: FLA. STAT. § 395.002(8) (2019)

Source:FLA. STAT. § 95.11(2)(b) (2019)

 

personal injury protection

Summary

Getting immediate medical attention after a collision could improve your outcomes. It would also give emergency room staff or the medical clinic staff an opportunity to assess your injuries and decide if you had an injury. Aside from the ER doctors, various types of medical professionals have the authority to make this diagnosis to support the PIP rule.

Many excellent chiropractors run auto injury centers that focus on holistic care and getting you back to peak health. They are also normally PIP insurance experts and can assist you in filing the right Florida PIP paperwork. In any case, please consider your health first if there is any doubt. You can contact the team a East Coast Injury In Jacksonville Fl today for a free consultation on your potential injuries to help get started on your healing process. . Call us today to for help.

There’s one catch: In order to collect for any person to collect benefits, you must be examined by a qualified physician, dentist or chiropractor within two weeks after the event. If you don’t receive medical services and care within 14 days following your motor vehicle crash, you will not be entitled to collect any PIP from your insurer. After you have suffered from an automobile wreck you can call us today to get the care you need.

This is one of the reasons why we stress that our clients seek medical care, most healthcare provider at an injury care center will offer a free consultation, as soon as possible after being involved in an auto collision, even if they feel “fine.” In some circumstances, it can take days for symptoms of neck, back and head injuries to appear. If you decide not to see a doctor because you don’t think you’ve been hurt, and then on the 15th day after the accident you begin to experience pain, under the law your insurer will not have to pay your claim even if you go to see a law group. You will be stuck having to pay your medical bills out of pocket plus any compensation may have been able to get from your injuries.

Never ignore neck pain, especially after an auto crash. The pain may seem small and you ignore it thinking this will be acute, short lived, and fixable with some ibuprofen. However, so many chronic problems arise after a collision that end up being “resolved” with surgery, medication, or more involved though unwanted additions to our lives. Visiting a chiropractic office to assess and care for the pain could be the difference of a life restored to full capacity or one full of physical setbacks and discomfort.

Concussion Care – We On The Same Page

 

 

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Southside's Top-Rated JTB & Auto Accident Chiropractor

East Coast Injury Clinic - Chiropractor & Neurologist is located on 9889 Gate Parkway N Suite 305, Jacksonville. From Jacksonville International Airport (JAX) head northwest on Yankee Clipper Dr and use the 2nd from the right lane to stay on Yankee Clipper Dr. Then slight left and keep right. Next, continue straight onto Dixie Clipper Dr and continue straight to stay on Dixie Clipper Dr. After that keep left to stay on Dixie Clipper Dr and continue onto Airport Rd. At this point turn right to merge onto I-95 S toward Jacksonville and merge onto I-95 S. Take exit 362A to merge onto I-295 S and head straight for 10.5mi. Then keep left to stay on I-295 S and use the right 2 lanes to take exit 53 to merge onto FL-202 W/Butler Blvd. Next, take the Gate Parkway exit and keep right at the fork, follow signs for St Johns Town Center and merge onto Gate Pkwy N. Finally, merge onto Gate Pkwy N, turn right and East Coast Injury Clinic - Chiropractor & Neurologist will be on your left. We are open Monday Friday 9am - 6:00pm. For additional questions you can call us at (904) 513-3954 or you can find us on Yelp. Our Jacksonville chiropractor is waiting on your call. There is no reason to live with chronic pain due to you work or auto injury.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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East Coast Injury Clinic, Jacksonville, FL
Phone (appointments): (904)-513-3954 | Fax: (904) 212-0223
Address: 9889 Gate Parkway N, Suite 305, Jacksonville, FL 32246

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