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PIP stands for Personal Injury Protection, a type of no-fault insurance coverage that pays medical bills and lost wages in the event of a Florida accident. Understanding a Personal Injury Protection claim and PIP law in Florida are key, since this is the main form of insurance coverage for drivers of motor vehicles.
How does PIP work? Is there PIP coverage?
While there are a variety of situations to explore, here are some of the most common that a typical provider is often confronted with.
Was the patient treated within 14 days of the crash?
Practice tip for providers – Make sure your intake forms and patient consultation covers whether or not the patient followed up with a primary care physician, hospital, walk-in clinic, or received roadside emergency service. Even if your patient did not go to the hospital via EMS, initial services and care provided by a person or entity who provides emergency transportation and treatment qualifies as establishing treatment within 14 days. See Florida Statute 627.736 (1)(a)1.
If the patient did receive treatment within 14 days, then you will want to know whether or not the patient owned a car. If they did own a car, PIP coverage applies and the claim must be made with your patient’s PIP insurance carrier.
If they did not own a car, you will want to know:
Practice tip for providers – Not all patients will have an attorney or want representation, so you need to make sure your intake forms are complete and thorough to establish insurance coverage. You can establish insurance coverage by asking the basic questions above.
How does PIP work? Is there PIP coverage?
While there are a variety of situations to explore, here are some of the most common that a typical provider is often confronted with.
Was the patient treated within 14 days of the crash?
- If no, automatically no coverage applies.
Practice tip for providers – Make sure your intake forms and patient consultation covers whether or not the patient followed up with a primary care physician, hospital, walk-in clinic, or received roadside emergency service. Even if your patient did not go to the hospital via EMS, initial services and care provided by a person or entity who provides emergency transportation and treatment qualifies as establishing treatment within 14 days. See Florida Statute 627.736 (1)(a)1.
If the patient did receive treatment within 14 days, then you will want to know whether or not the patient owned a car. If they did own a car, PIP coverage applies and the claim must be made with your patient’s PIP insurance carrier.
If they did not own a car, you will want to know:
Does the patient live with a relative (blood or spouse) who owns a car?
- If so, then PIP coverage applies and you will make your claim with the patient’s relative’s insurance carrier. Even if the patient was a passenger in another vehicle, they are covered, as long as they either own a vehicle or reside with someone who own a vehicle.
- If not, was the patient a passenger in a vehicle that was involved in the accident? If so, then coverage should apply through the host vehicle and your claim should be submitted to them.
Are pedestrian and bicyclists covered under PIP?
The short answer, it depends. Even if your patient was a pedestrian or bicyclist, you will want to know if they own a car:- If they do, then they are covered under their own policy.
- If the patient does not own a car, but resides with a relative, then they are still covered.
- If the patient does not own a car, nor resides with a relative who does, only then do they receive PIP coverage from the at-fault driver’s insurance.
Practice tip for providers – Not all patients will have an attorney or want representation, so you need to make sure your intake forms are complete and thorough to establish insurance coverage. You can establish insurance coverage by asking the basic questions above.
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