PIP Benefits

The required limit for the package of PIP benefits in Florida is $10,000 per person per accident.  As a severe example, if the PIP coverage has already paid $8,000 in medical benefits, then the injured person dies, that only leaves $2,000 available to be paid as the death benefit.

Personal Injury Protection (PIP) in Florida offers coverage that has four categories of benefits:

  1. Medical
  2. Work loss
  3. replacement services
  4. death

PIP medical benefits pay for 80% of the reasonable expenses for necessary medical, surgical, X-ray, dental and rehabilitative services, including prosthetic devices, necessary ambulance, hospital and nursing services and necessary remedial treatment and services permitted by law for an injured person who relies on spiritual means through prayer alone for healing, in accordance with religious beliefs.

Work loss benefits reimburse for 60% of loss of gross income or earning capacity and 100% of the cost for having household services performed by others, which the injured person would normally have done but for the injury.  The death benefit is $5,000.

Other PIP Requirements in Florida

The law requires that certain forms of modified coverage be offered, at the time of original application and at each renewal.  First, insureds must be offered deductibles of $250, $500, and $1,000.  These deductibles are subtracted from the total medical expense before the percentage of payment is applied for a claim and do not reduce the total $10,000 maximum benefit by the deductible amount.

Insurers must offer coverage with work loss benefits excluded.  In return for excluding work loss benefits the insured receives a premium reduction.  Insureds with no earned income sources, such as retirees who receive social security and/or a company pension, are candidates for such reduction in coverage.

Primary/Excess

PIP is primary against all the other forms of medical and disability insurance coverages, except worker compensation benefits.  Florida courts have held PIP is excess over WC.  To eliminate duplicate recoveries, the law prohibits anyone who has received PIP from recovering the same amounts from others in legal liability actions.

Who is Covered

Persons entitled to the PIP benefits which an owner has secured as to a specific motor vehicle may be outlined as follows:

  1. Injuries to a name insured
  2. Injuries to a relatives of named insured who reside with named insured
  3. Persons other than named insured and relatives

Exclusions

  • Named insureds and relatives are not covered while occupying a motor vehicle owned by the insured and not covered under the insured’s policy.
  • Persons operating the insured’s automobile without the insured’s consent.
  • There is no coverage for anyone that intentionally inflicts self-injury or who are are injured during the commission of a felony (no surprise here.)

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