Auto Insurance Without Fault
An individual who causes a car accident is liable to the other party for damages or injuries that are sustained as a result of the accident. There are variations in liability rules in each state that affect which party is responsible for paying for the damages that occur when a motor vehicle collision occurs.
No-fault liability statutes have been enacted in approximately half of the states in the United States. Under no-fault liability legislation, each individual who is involved in an automobile accident is expected to pay for their own damages.
Regardless of liability, no-fault insurance reimburses the insured individual for losses that were caused. Many jurisdictions, however, provide an exemption to no-fault liability statutes when an individual suffers a serious bodily injury or property damages that totals more than a specific sum.
States that have at-fault liability rules provide that the party who is responsible for the accident will compensate all of the parties involved.
What Is Covered by PIP?
Personal injury protection (PIP) coverage typically includes medical costs that result from an automobile accident. These costs typically include the typical expenditures, such as:
- Medical bills
- Prescription charges
- Surgical costs
Every state may have a different definition of medical expenditures for the purposes of PIP. For example, acupuncture may be covered by PIP in Florida but not in other states, such as California.
PIP may also cover other types of costs, such as lost wages that result from the accident. For example, if an individual is wounded in an automobile accident and misses work because they have to go to the hospital, PIP may compensate them for their lost wages.
Special Guidelines for Owners of No-Fault Policies
As previously noted, no-fault insurance compensates an insured individual for losses that were caused, regardless of fault. Generally, no-fault insurance shields individuals from standard culpability if they injure another individual in an accident.
Regardless of which individual would be held liable under conventional at-fault liability laws, no-fault coverage covers bodily injuries to the insured individual and their passengers that result from an automobile collision.
In smaller accidents, no-fault insurance coverage eliminates injury responsibility claims as well as lawsuits in return for the direct payment of medical expenses and lost earnings by the injured individual’s own insurance company, regardless of fault. Vehicle damage claims are typically not covered by no-fault insurance.
This means that an individual has to file a liability claim against the individual who caused the accident, or they must use their own collision insurance. Although not required in all jurisdictions, no-fault insurance is typically accepted as being helpful.
It can cover an individual’s family’s medical costs, the costs of the individuals who were riding in the car, as well as the costs for any pedestrians who were injured in an accident. PIP protections are for medical benefits and do not cover any type of property damage.
For injuries that meet the required standard, a claim for pain and suffering compensation is allowed in a required no-fault jurisdiction. Each state has different minimums for this.
A state that has a monetary threshold requires that a certain dollar amount be claimed in order to qualify for relief. The injured party has to show a normatively determined level of injury, for example, severe and permanent in a state with a verbal threshold.
There are eight states that use hybrid systems. With a hybrid system, third-party liability insurance is supplemented by no-fault coverage.
In these states, there are no case filing restrictions. All of the current no-fault systems permit claims and recovery against at-fault drivers to pay economic losses in excess of the individual’s no-fault benefits.
The Florida PIP Law
In 2013, the State of Florida implemented new legislation that introduced additional PIP coverage restrictions in an attempt to decrease insurance fraud. An automobile accident victim now has to seek medical attention for their injuries within 14 days after a collision.
Florida’s New PIP Law
A lawsuit was filed by a group of massage therapists, chiropractors, and acupuncturists that contested the following provisions of the new law discussed above:
- An individual must be identified as having an emergency medical condition (EMC) in order to be eligible for $10,000 in PIP benefits;
- An individual can only get $2,500 in PIP compensation if they are not identified as having an emergency medical condition (EMC);
- Only the medical professionals listed below can diagnose an emergency medical condition (EMC):
- Medical expert (MD);
- Dentist and osteopathic physician (DDS);
- A doctoral-level registered nurse practitioner.
Acupuncture and massage services are no longer covered by PIP compensation for wounded individuals. The constitutionality of these issues is being decided by a Florida court.
As a result of this litigation, a temporary injunction has been issued for these clauses, meaning that they are currently not in effect.
What Is an Emergency Medical Condition (EMC)?
An emergency medical condition (EMC) is defined as “a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that it is reasonably anticipated that failure to seek immediate medical attention will seriously jeopardize the patient’s health or seriously impair bodily functions or seriously dysfunction any bodily organ or part.” In other words, if the individual’s symptoms are severe enough to suggest that they require immediate medical attention, they will be considered to have an emergency medical condition.
What Legal Matters Should PIP Beneficiaries Take Into Account?
PIP usually works for the benefit of the uninsured because their insurance company will cover losses regardless of fault. In most cases, the individual’s insurance company will be compensated by the opposing party’s insurance company, which aids in the parties’ ability to avoid a direct conflict.
Personal injury protection legislation varies greatly by state. It is important to be aware that what one state considers to be a valid expense may not be covered by PIP in another state. There are also other factors that may influence the range of coverage.
For example, PIP may be accessible in certain jurisdictions even if an accident is subject to an active worker’s compensation claim. This may not be permitted in certain states.
As a result, if an individual has any questions regarding the PIP rules in their state, they should consult with a local attorney. It can be a challenging process to determine what is covered and what is not covered by insurance if an individual has incurred costs as a result of a vehicle accident or other type of personal injury.
Further legal action may be required in order to resolve issues related to costs that are not covered by insurance. For example, a formal lawsuit may be necessary to obtain punitive damages for malicious injuries or other damages.
Should I Seek Legal Advice?
If you have any issues, questions, or concerns regarding PIP benefits in Florida, it is essential to consult with a Florida auto accident lawyer. Your lawyer can advise you of the current Florida legislation and help you determine the best steps to take to obtain compensation.
If you have been injured in an accident, it is important to consult with an attorney as soon as you can to ensure your case is filed in a timely manner. Your attorney can also work with all of the insurance companies involved to ensure you receive fair compensation.