What Is the 14-Day Rule for Florida PIP Claims?

How the rule works

Florida is a no-fault state. Under Fla. Stat. 627.736(1)(a), your own PIP coverage pays first for medical care and lost wages after a motor vehicle crash regardless of who caused it. The Legislature conditioned that benefit on prompt treatment: initial services and care must be lawfully rendered within 14 days after the motor vehicle accident. There is no good-cause exception written into the statute, and Florida courts have enforced the deadline strictly.

The 14 days run from the date of the crash, not the date pain became noticeable. Soft-tissue and concussion symptoms frequently surface on day three or day ten, which is exactly why the practical advice after any Miami collision is to be seen the same week even if you feel functional.

Which providers count

• Hospitals, hospital-owned facilities and emergency transport services.
• Licensed physicians (MD or DO), dentists, chiropractors and physician assistants or advanced practice registered nurses supervised by a qualifying provider.
• Follow-up care must be consistent with the underlying condition and referred by a qualifying provider.
• Massage therapy and acupuncture are excluded from PIP reimbursement by statute, no matter who prescribes them.

The emergency medical condition determination

PIP pays up to $10,000 only if a qualified provider determines that the injured person had an emergency medical condition as defined in Fla. Stat. 627.732. Without that determination, the benefit is capped at $2,500. Chiropractors are not permitted to make the EMC determination, which is a common and expensive surprise for patients who begin care at a chiropractic clinic only.

PIP generally pays 80 percent of reasonable medical expenses and 60 percent of lost wages, subject to the policy limit and any deductible you selected. Because $10,000 is exhausted quickly by an emergency room visit and imaging, PIP is a floor, not a remedy. Health insurance, medical payments coverage, letters of protection, and the at-fault driver's bodily injury liability coverage fill the gap.

Getting past PIP to the at-fault driver

To recover pain and suffering damages from the driver who caused the crash, Florida requires you to meet the serious injury threshold in Fla. Stat. 627.737(2): 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. Economic damages such as medical bills beyond PIP and lost income are not subject to the threshold.

Comparative fault then applies. Under Fla. Stat. 768.81(6), a plaintiff found more than 50 percent at fault recovers nothing; at 50 percent or less, recovery is reduced by the plaintiff's share.