Florida No-Fault law and how it affects you


By: Shane Farnsworth Special to the Boca and Delray newspapers
The Florida No-Fault law is contained in Section 627.736, Florida Statutes. In Florida an automobile insurance policy must contain personal injury protection to the named insured, relatives residing in the same household, persons operating the insured vehicle, passengers in the vehicle and people struck and injured by a motor vehicle while not an occupant of a self-propelled vehicle. Personal injury Protection (PIP) benefits are provided up to a limit of $10,000 for medical and disability benefits and $5,000 in death benefits for injuries, sickness, disease or death arising out of the ownership, maintenance, or use of a motor vehicle.
Florida is a no-fault State and regardless of who causes a motor vehicle crash, the primary insurance coverage for up to the first $10,000 of your medical benefits is covered by your PIP coverage. Even if you have medical insurance, that is secondary until PIP is exhausted. For this reason, it is important that you understand how PIP works.
If you are injured, you need to seek medical care. Under the No-Fault Law, you have 14 days to seek initial treatment following a motor vehicle crash. If you do not seek treatment within 14 days PIP benefits will not be available to you.
The next step is understanding PIP coverage. Medical benefits will be paid at 80 percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental and rehabilitative services. Reimbursement is available up to $10,000 if you are determined to have suffered an emergency medical condition. This may be found by a physician, dentist, physician’s assistant or an advanced registered nurse practitioner licensed under the appropriate chapters enumerated in the No-Fault Law. Other medical practitioners such as chiropractors cannot make an emergency medical condition determination. If you are not found to have suffered an emergency medical condition your PIP benefits will be capped at $2,500.
You are also able to recover disability benefits under your PIP coverage. You are entitled to use your benefits for 60 percent of any loss of gross income from the inability to work due to injuries sustained in an automobile crash. You may also recover the expenses reasonably incurred in hiring others to perform ordinary and necessary services that you would have performed but for your injuries.
The Florida No-Fault Law also contains a death benefit. The death benefit is in addition to the medical and disability benefits. Death benefits of $5,000 per individual may be paid by the insurer to the executor or administrator of the deceased, any of the deceased’s relatives or any person appearing to the insurer to be equitably entitled to such benefits.
The Florida No-Fault Law is complex and requires a thorough understanding for those injured in a motor vehicle crash. While this article is a basic framework as to how the law operates, it is certainly not intended to address and answer all questions or situations that may arise.
Shane Farnsworth is an attorney at Shane M. Farnsworth, P.A., in Delray Beach. He represents clients in the areas of personal injury, insurance disputes and civil litigation. His office can be reached at 561-272-8337 or shanemfarnsworth.com.