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Injured? PIP, the 14-Day Rule, and EMC: Seek Treatment Immediately to Preserve Your Rights

Man Having Neck Pain

In Florida, all drivers are required to carry Personal Injury Protection (PIP), which covers drivers and other qualified persons involved in motor vehicle accidents regardless of fault. This is often also referenced as “No-Fault” insurance wherein a person involved in a motor vehicle accident is entitled to payments to medical providers for 80% of medical expenses up to $10,000, 60% of lost wages, and a $5,000 death benefit. However, simply because one is covered under a PIP policy does not mean that coverage is automatic. Coveat Emptor, conditions do apply.

PIP and the 14-Day Rule

Effective for accidents in 2013, PIP is a qualified coverage. Prior to 2013, there was no condition on the timeliness of seeking medical treatment. However, amendments to the PIP statute have made it necessary to seek medical treatment immediately. There is now a 14-Day Rule in which a victim must seek medical treatment from either a hospital facility, emergency transport, medical doctor, doctor of osteopathy, chiropractor, or a dentist. If a victim of a motor vehicle accident does not seek treatment from a qualified professional, then they forfeit the $10,000 coverage. Oftentimes, the denied benefits bring significant hardship to the victim with burdensome medical expenses that must be paid out-of-pocket.

The resolution is a simple one. If you are involved in a Florida motor vehicle accident, then seek medical attention immediately and within 14-days to qualify for the full benefits of PIP coverage. Even if you are only experiencing slight symptoms, those symptoms may be a sign of a greater injury. There is no need to wait until the pain is unbearable and the 14-day window has passed. So be on the safe side … see a PIP qualified medical professional immediately after involvement in a Florida motor vehicle accident.

PIP and the Emergency Medical Evaluation

Additionally, if involved in a motor vehicle accident and injured, there is a requirement that a qualified medical professional evaluates you for an Emergency Medical Condition to receive full PIP benefits. Specifically, as defined by statute, an Emergency Medical Condition is a condition “manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following: serious jeopardy to patient health; serious impairment of bodily functions; and/or, serious dysfunction of any bodily organ or part.” Since 2014, a victim of a motor vehicle accident must have an Emergency Medical Condition assessed to have access to the full $10,000 PIP coverage. Unlike the 14-Day Rule for seeking treatment, the Emergency Medical Condition may be assessed at any time after the accident as the statute is silent on time restrictions. Nevertheless, it is prudent that the victim secures an Emergency Medical Condition assessment in close proximity to the accident to avoid non-payment, or lower PIP payment, issues. If an Emergency Medical Condition is not assessed, then PIP payments are limited to $2,500.

If you or a loved one is experiencing issues relating to Florida’s PIP requirements, then seek the assistance of counsel. You can reach the personal injury attorneys at The Watson Firm twenty-four hours a day, seven days a week. The Watson Firm has a team of dedicated professionals here to assist you with your personal injury cases. Our team consists of attorneys, investigators paralegals, and case managers who work as a team to win your personal injury case. We pride ourselves on giving individual attention to every client. Call us today for a free consultation.