The foundation of the Florida No-Fault Act, codified in Florida Statute § 627.736 is to provide swift and virtually automatic payment so that the injured insured may get on with his or her life without undue financial interruption. Indeed, Personal Injury Protection (“PIP”) insurance benefits are disbursed by the first-party insurance company regardless of the fault of the individuals involved in causing the injury. Covered individuals include the named insured, relatives residing in the same household of the named insured, individuals operating the insured motor vehicle, passengers in the motor vehicle, and other persons struck by the motor vehicle and suffering bodily injury while not an occupant of a self-propelled vehicle themselves.
Injured individuals falling into the above-described categories may receive up to $10,000 in PIP benefits, which can be used to compensate for 60% of lost wages, 80% of medical bills, including out-of-pocket prescription costs, dental expenses, and rehabilitative services, mileage reimbursement to and from doctor’s offices, 100% of replacement services, and $5,000 worth of death benefits. However, to qualify for these benefits, with the exception of death benefits, you must seek medical treatment within the 14 days of the accident.
PIP insurance benefits are overdue if they are not paid within 30 days after the insurer is furnished with written notice of the covered loss and the amount of the same, which may be presented in the form of medical billing, invoices, receipts, and wage loss reports. An insurance company may extend the 30-day time frame, which is provided by Fla. Stat. § 627.736(4) to an additional 60 days to investigate the claim if the insurer has a reasonable belief that a fraudulent insurance act has been committed and specifically notifies the claimant in a writing citing to Florida Statute §627.736(4)(i). If the bill is not denied within one of these two time frames, the bill is automatically ripe for payment with interest.
PIP payments are supposed to be quick and virtually automatic, but the case law changes almost daily and is often applied differently between the various Florida counties and even the individual judges within the counties. These payments, or lack there of may pose a significant hurdle to your livelihood and even a potential bodily injury case. If you’re involved in an automobile accident please discuss your no-fault benefits with a qualified no-fault attorney.
COHEN LAW GROUP
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