No Fault, Their Fault or Your Fault? The Future of Florida’s PIP Statute.


Since 1971, those injured in a motor vehicle accident have been eligible for $10,000 worth of medical benefits under our current personal injury protection (PIP) statute. PIP was created to eliminate the finger-pointing after a collision and provide immediate medical benefits to any injured person. It wasn’t necessary to prove that you didn’t cause the collision to get your benefits. It was automatic and swift.

Over the years, PIP has come under fire from special interest lobbyists because they claim either the PIP system is wrought with medical fraud or attorneys were taking advantage of the prevailing party fee provision by collecting large fees when they prevail over the insurance company who wrongfully denied a claim. On the contrary, many insurers want to protect PIP because of the large volume of premiums they collect from this mandatory insurance. Hospitals and walk-in clinics also want to preserve PIP because there is a special carve-out reserved especially for them – up to 50% of your total benefits.

Most health insurance programs can be exploited by unscrupulous medical providers. PIP is no more susceptible to provider fraud than any other insurance program. What’s different is that the current PIP statute provides protections for the insurance companies to legally deny claims that haven’t complied with strict statutory requirements, but also includes penalty provisions when insurance companies wrongfully deny proper claims. It seems to be a balanced statute penalizing any party that runs afoul of the law.

The Florida legislature wants to repeal mandatory PIP, substituting mandatory bodily injury coverage instead. This coverage pays for medical bills and pain and suffering caused by the at-fault driver. To be reimbursed for your medical bills and pain and suffering, you cannot be at fault for the accident. If you are, your motor vehicle insurance company will pay the other party up to the minimum $25,000 for their medical bills and pain and suffering while you’re left to pay your own.

Under the old system, both parties’ medical bills would be paid up to $10,000 within 30 days of submission of the bill. If the Governor signs the bill to repeal the PIP system, even the party who wasn’t at fault may have to wait months or years to have their medical bills paid from a settlement or a verdict at trial. The new proposed statute includes safeguards for insurance companies, allowing them to delay or deny valid claims while limiting the power of attorneys for injured people to contest wrongful denials.

Worst of all, there is no expectation that your premiums will go down. In fact, some researchers have shown the potential average increase of premiums to be up to 5.3%. These consultants also say more motorists could be forced to drive without insurance because they will be unable to afford the premiums for the newly required bodily injury coverage. Imagine increasing the current rate of uninsured drivers in Florida from 26.7% to higher!

If you have suffered injuries because of an accident, speak with an experienced personal injury attorney to discuss your options.


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Written by Michael Brehne

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