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PIP coverage explained

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The state of Florida has enacted new changes to the law known as " No Fault " for automobile accidents. The new statutory changes generally take effect on July 1, 2012 but the majority of the provisions takes effect on January 1, 2013. No Fault simply means if you are in an automobile accident in Florida, regardless of which driver is at fault for the collision, you look to your own automobile insurer to pay a portion of your medical expenses and wage loss under your PIP ( Personal Injury Protection ) coverage caused by any bodily injuries you sustained in the accident. This PIP coverage protects you against any losses you sustained as a result of injuries from an automobile accident and pays 80% of reasonable, necessary and accident related medical expenses and 60% of your gross wage loss for time missed from work due to your accident related injuries.

On January 1, 2013, a standard PIP policy is limited to $10,000 in coverage if the injured person has medical treatment within 14 days of an accident and if deemed to be suffering from an emergency medical condition and covers your medical expenses, gross wage loss and mileage costs for your transportation to and from doctor appointments. You can also elect a deductible under your PIP coverage of up to $1,000 which means you would be self-insured for the deductible amount as you would have to pay this amount out of your own pocket before your PIP coverage would start paying. Once your $10,000 in PIP benefits are used up or exhausted then your PIP insurer has no further obligations to pay any more benefits under your PIP policy.

However, under the new PIP law other claimants will only be covered for $2,500 in PIP coverage if they did receive medical treatment within 14 days of the accident but did not sustain an emergency medical condition. Under the new PIP law chiropractors may not make this emergency medical condition determination. Also massage therapy and acupuncture are no longer covered under the new PIP law. If you did not receive medical treatment within 14 days of the automobile accident then you are excluded from any PIP coverage.

After an automobile accident, in order to be eligible for your PIP benefits, your automobile insurer needs to be put on notice of the accident. This means you need to call your automobile insurer and inform them about the accident so they can open a claims file on your behalf and assign a claims number for your file. You will need to complete a PIP application form regarding your injuries, any medical providers you are or have treated with, how the accident happened and your employment information, if applicable. This PIP application form includes authorizations signed by you allowing your PIP insurer to obtain medical records and bills, as well as employment confirmation and information before your PIP insurer is legally and contractually obligated to pay 80% of your accident related medical expenses and 60% of your accident related gross wage loss for time missed from work due to your injuries.

Unlike some health insurance plans, you do not need pre-approval or pre-authorization from your PIP insurer before initiating medical treatment and are free to choose treatment with any licensed medical provider (other than massage therapists and acupuncturists) whether it's an M.D. (Doctor of Medicine), D.C. (Doctor of Chiropractic), D.O. (Doctor of Osteopathy), P.T. (Physical Therapist), or any other non-excluded licensed medical provider or specialist.

If you have been involved in an automobile accident in Orlando, Kissimmee, Altamonte Springs, Leesburg, Ocala or other Florida cities and sustained bodily injuries and have any questions regarding your PIP coverage and benefits, please call The Nuebel Law Firm today at 407-703-5999 for a free consulation.

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