What Does “No-Fault” Really Mean in Florida Auto Insurance Law?

What does “No-Fault” really mean in Florida Auto Insurance Law?

Florida Statute §627.730 is the Florida Vehicle No-Fault law. It has two separate effects on Florida auto insurance policies. The primary effect is that all drivers are required to carry No-Fault insurance. This insurance is called “Personal Injury Protection”. The second effect is that you must sustain a permanent injury to be entitled to money for pain and suffering from an at-fault driver in an auto accident.

What does my No-Fault insurance cover?

When an accident occurs in Florida each party, regardless of fault, is entitled to the Personal Injury Protection benefits on their own auto insurance policies. This coverage pays for 80% of your medical bills and 60% of your Lost Wages. These benefits can be received until the limits are exhausted. If you are deemed to have an Emergency Medical Condition by a physician, the limit is $10,000.00. Otherwise, the limit is $2,500.00. These funds are available regardless of fault so that all parties of an auto accident can seek medical attention after an auto accident without worrying who will be paying the medical bills. No-Fault coverage does not allow recovery for Pain and Suffering.

Is death covered under the No-Fault law?

Your Personal Injury Protection benefits will pay up to $5,000.00 death benefit.

Who is covered by my No-Fault insurance?

You, your household family members, and the insured drivers on your policy are all covered under your No-Fault insurance coverage. If a passenger in your car does not have the coverage on their own policy or in their household, they will also be covered under your policy. There are also instances where your policy may cover others, such as if you hit an uninsured pedestrian or cyclist.

Is there a time limit to seeking medical care under my No-Fault coverage?

It is extremely important that you see a medical doctor within 14 days of the auto accident to get the maximum benefits of $10,000.00. If you wait until after that time period, you can still receive up to $2,500.00. However, the longer you wait the less likely your insurance carrier will cover your medical costs, so get to a medical provider right away.

How do I use my No-Fault Benefits for medical expenses?

Simply present your auto insurance card to your medical provider’s office at the time of your medical visit. If you have your claim number, you should provide that to their office as well. Some medical provider’s offices are not equipped to handle auto accidents. You may have to submit the medical bill to your auto insurance carrier yourself.

How do I use my No-Fault benefits for Lost Wages?

Provide your insurance carrier with a disability note from your medical provider, your paycheck stubs for the last 13 weeks or other proof of income, a list of your missed dates and time, and a note from your employer that you have missed time due to the auto accident.

Can I use Health Insurance with my No-Fault Benefits?

Yes, you can provide your health insurance as secondary to your auto insurance after an accident. Deductibles, co-insurance and co-pays will still apply.

Does No-Fault coverage cover my motorcycle?

No Fault coverage does no cover motorcycles unless you specifically purchase it from your agent or insurance company for your motorcycle.

It wasn’t my fault, why does my auto insurance company have to pay my bills?

In the State of Florida, your insurance carrier is required to pay the first $10,000.00 of your medical bills if you have an Emergency Medical Condition, or the first $2,500.00 if you don’t. You cannot elect to have the defendant carrier pay these medical bills in their place. This is not allowed under Florida law if you wish to make a claim against the at fault driver.

Can I file a claim with the at-fault party if I use my No-Fault benefits to pay my medical bills?

YES!  You can still file a claim against an at-fault driver after using your No-Fault benefits. You are entitled to make a claim for your unpaid medical bills that are reasonable, necessary, and related to the accident.  When you hire an attorney, they make a claim to the at-fault driver’s insurance policy as soon as you have reached MMI (Maximum Medical Improvement) or have otherwise determined it is the right time to file the claim.

What about my pain and suffering?

Florida Law allows you to make a claim for pain and suffering if you can prove you have sustained a permanent injury.  This is one of the damages you will be seeking when your attorney makes a claim against the person who hit you while or after you are using your Florida No-Fault insurance to pay your initial medical bills.

What is a permanent injury?

Florida Law states that a permanent injury must have one of the following components: significant and permanent loss of an important bodily function; permanent injury within a reasonable degree of medical probability; significant and permanent scarring or disfigurement; or death. Proof of a permanent injury includes continued medical care as well as the opinion of your medical provider.

Do I need an attorney to help me with my No-Fault benefits?

Insurance benefits after an accident can be complicated. It is recommended that you hire an attorney to assist you. In some cases your insurance company may refuse to pay your benefits properly, in which case you will need an attorney to assist you.

So are you basically saying the person who hits me gets away with it?

Not at all!  You have a right to make a claim against their insurance and should hire an attorney to do so.  Just be aware, that regardless of fault, the first $10,000 of your MEDICAL BILLS will be paid for by your auto insurance pursuant to Florida law.  However, you can (and should!) still make a claim against the person who hit you.  They may have insurance coverage that you can recover from for your pain, suffering, lost wages and additional medical bills over the $10,000 that was paid for by your PIP.

It’s very important to hire the right personal injury attorney to make the claim against the person who hit you to receive all of the compensation you are legally entitled to.  If you have been in an auto accident in Florida, call Personal Injury Attorney Chelsie M. Lamie at 727-501-3464. While our main office is in Clearwater, we we handle cases across the entire state. [/column]

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