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You may be aware that after a car accident injury, your personal injury protection (PIP) insurance can cover much or your medical bills that result from diagnosing and treating your injuries. However, this coverage does not kick in automatically after a crash and you must instead take certain steps to receive payments from your PIP insurer.

PIP policies have strict requirements for an insured driver to make a claim. First, there is a 14-day window after a crash during which you must contact your insurance. If you are unaware of this time limit or if you otherwise fail to inform your insurance company of the accident within 14 days, you will no longer have the opportunity to seek payments for medical bills stemming from that accident.

Next, you must be evaluated and diagnosed by a qualified medical provider to have your costs of treatment covered. Medical providers can include hospitals, hospital-owned facilities, emergency medical technicians (EMT), medical doctors (M.D.), chiropractors (D.C.), or osteopathic doctors (D.O.). If you do not have such a diagnosis, your insurance will likely not cover your expenses.

A medical provider should determine whether your injuries constitute an emergency medical condition, commonly called an “EMC” in the insurance policy. There are specific criteria to decide whether you have an EMC and this determination is very important to your PIP claim – specifically to the amount of compensation that may be available for you. For example, the following limits commonly apply:

  • Emergency Medical Condition – $10,000 maximum benefits
  • Non-emergency Medical Condition – $2,500 maximum benefits

Once you have a proper diagnosis, it is critical that you call – or have an experienced Florida PIP insurance attorney call for you – your insurer to make your claim as soon as possible.


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