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Car Accident in Florida? What is the 14-Day Rule?

The Florida Persona Injury Protection (“PIP”) 14-Day Rule stipulates that all accident victims must seek medical treatment within 14 days. If you suspect you have sustained injuries, it is imperative that you seek medical attention immediately. If you do not seek medical attention within two weeks of an accident, your insurer will likely deny your claim for PIP benefits and in turn, when you settle your personal injury claim, those medical expenses will need to be deducted from your settlement. Even if you are unsure whether you sustained injuries, you should seek medical attention. Many injuries do not manifest for hours or even days.

Obtain Approval for Medical Care Promptly

Under the 2013 PIP law change, an accident victim must obtain “initial services and care” within two weeks of an injury in order to receive PIP benefits. As long as the medical care comes from a competent healthcare practitioner, or if a qualified healthcare provider supervised or prescribed the care, the care will satisfy this criteria.

A qualified medical professional may include:

• A medical doctor
• A dentist
• A chiropractor
• A EMT (“emergency medical technician”)

Seeing a physical therapist, massage therapist, or other treatment professional not specifically named in the Act will likely not satisfy the requirements. Consequently, if you only see one of those disciplines within those 2 weeks, your insurer will likely refuse your claim for PIP benefits. It is always a good idea to visit the emergency room or your doctor immediately to make sure you are “ok” and to satisfy the Florida Persona Injury Protection (“PIP”) 14-day Rule.

The 14-Day Rule and Payout Limits

When Florida amended its PIP law, the new laws also imposed limits on the benfits available through a PIP claim. According to the new regulations, if you received care within 14 days and:

If you have suffered only non-emergency injuries, you are limited to $2,500 in benefits. If you suffer from a “emergency medical condition,” you are eligible to collect the maximum reimbursement under your PIP policy.

You should have at least $10,000 in available PIP coverage. This is the minimum PIP coverage required by the state.

Defining an “Emergency Medical Condition”

Florida Statutes § 395.002(8) defines an “emergency medical condition” as it applies to PIP insurance claims in the state. The statute outlines this as a situation where victims suffered from acute symptoms that require immediate attention to prevent:

• Endangering their health and wellbeing
• Impairment of a major body function
• Serious dysfunction of any organ or body part

Discussing all your symptomology with your doctor is advisable since he or she can mark in your medical records whether you suffered an emergency medical condition or not. This may be beneficial to your case. It is not, however, crucial that this determination be made within the first 14 days following an accident. As long as you seek medical attention within the first two weeks from a qualified provider, you should be eligible for compensation from your PIP insurance carrier.

What Does PIP Cover?

If you receive the necessary medical attention within 14 days, your insurance should cover up to 80 percent of your accident-related medical expenses up to the maximum amount.

Examples include, but are not limited to:

If you have to take an ambulance or undergo emergency surgery.

Assistive devices: Canes, crutches, wheelchairs, and any other equipment that helps you live your life should be covered, regardless of how long you require them.

Appointments with your doctor to evaluates your condition, removes sutures, or for the recommendation of additional treatments.

• Medications
• A portion of lost wages.
• PIP insurance also provides death benefits if the policyholder is killed in an accident.

What Does PIP Not Cover?

PIP does not pay for your pain and suffering caused from the accident, it only cover some expenditures associated with treatment for your bodily injury up to $2,500 or $10,000. As a result, you may need to rely on other types of insurance to cover additional expenses like health insurance, casualty insurance for car repairs, and in some cases, pay certain amounts out of pocket or through a Letter of Protection. In these circumstances, it is advisable to hire a lawyer to counsel you as to your options and to examine the accident, determine who is at fault, and discuss whether you should make a claim or sue the responsible party.

In a lawsuit or demand to the at-fault driver’s insurer, you can seek any and all financial damages as well as for non-economic damages (physical and emotional), such as:

Scarring as a result of burns, surgery, or other injuries.

Diminished relationship with your spouse due to the accident.

Future costs for activities of daily living, like cleaning, cooking, dishwashing and potentially configuring your home to accommodate your injuries.

Emotional trauma: The accident itself might produce psychological trauma, for which you may require therapy, medication, or alterations to your lifestyle.

Dealing with insurance companies can be challenging and time-consuming, especially if you are still recovering after an auto accident. You may benefit from engaging a car accident attorney to explain your rights, determine what your policy covers, and negotiate a fair settlement with the culpable party’s insurance carrier.

Talk to a Florida Car Accident Attorney

You do not have to face these difficulties alone. The Miami Auto Accident attorneys at The Farber Law Firm can assist you in all aspects of your Auto Accident and help to secure you the necessary compensation you deserve.

The legal team at The Farber Law Firm offers free case evaluations and consultations. Call us today – 305-774-0134.