“I Don’t Understand, Why Does My Insurance Company Have to Get Involved if it Wasn’t My Fault?”

Our clients often ask why they have to report their accident to their own insurance company for the initial payment of their medical bills when it wasn’t their fault that the accident occurred. The simple answer is, Florida law requires it to be done this way. In the 70s, the insurance companies lobbied the Florida Legislature to pass a law that they hoped would reduce lawsuits over car accidents. The idea behind the law was that if someone was involved in an accident, they should get their initial bills paid under their own policy of insurance with the hope that they would heal from their injuries, and if their bills were paid, then they would have no reason to care about fault, and thus, no reason to sue anyone. Safeguards were put in place through the no-fault coverage litigation. These safeguards require a medical finding of a permanent injury, permanent disfigurement, or death for a claim to exist against the “at-fault party” for more than the injured victim’s out-of-pocket medical expense and lost wage reimbursement.

The no-fault legislation named this required coverage, Personal Injury Protection coverage, and now makes it mandatory that everyone who owns a vehicle in Florida must carry $10,000 in Personal Injury Protection coverage, P.I.P. for short, which pays your bills at 80% and your wage reimbursement at 60% up to that $10,000. Currently, you are allowed to contract for a $1,000 deductible and buy only $9,000 in Personal Injury Protection coverage, but then you are self-insuring for $1,250 in medical expenses as P.I.P. is responsible for only 80% of those bills. In other words, your medical debts will be applied to your deductible at 80% until that deductible is met before your insurance company becomes responsible to pay for any of your medical bills. Sarah and I do not recommend the purchase of a deductible under your Personal Injury Protection coverage, as it is rarely beneficial in the long term. Additionally, Personal Injury Protection coverage under your own policy of insurance covers you in your vehicle, while in someone else’s vehicle, while on a bicycle, or even as a pedestrian. It does not, however, cover you on a motorcycle as these types of vehicles have been excluded from the no-fault law/Personal Injury Protection coverage.

If you should have any questions concerning this or any other legal matters, please feel free to contact us at your convenience. Sarah and I are always here for you!

Chuck