Question: In Florida, what changes are there to the PIP coverage? I've heard a lot of talk about changes in 2013, but I don't know the details. Answer: Even with changes to Florida's no-fault insurance, car owners here are still required to purchase $10,000 worth of personal injury protection (PIP) coverage. PIP will continue pay out 80 percent of medical expenses that are found to be necessary and reasonable, regardless of fault. However, starting in Jan. 1, 2013, there are changes in Florida concerning how quickly you must receive medical treatment for your injuries and who can treat them. How much you can be paid will depend upon your medical condition -- if your injury isn't declared serious, then you can only receive up to $2,500 in PIP benefits. Under the revisions to Florida's no-fault law (Florida Statute 627.736), you must initialize medical services and care within 14 days of the accident in order for to be eligible for benefits. The law is also strict about who can see you for your initial medical treatment. Starting in 2013, your initial medical care must be:
- provided by emergency medical services personnel, or
- provided in a hospital, or
- in a facility that owns or is wholly owned by a hospital, or
- provided by a medical doctor, an osteopath, a dentist, or chiropractor.
- Ambulatory surgery center
- Medical doctor
- Physician's assistant
- Advanced registered nurse practitioner (ARNP)
- Physical therapist
- Certain health care clinics
If the appropriate health-care professional determines that you suffered from an emergency medical condition, then you can receive reimbursement for all medical services and care up to your $10,000 PIP limit. If, instead, you're found to have a non-emergency medical condition, then your PIP benefits are limited to only $2,500.Florida statute 627.732(16) defines an emergency medical condition as a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain. Without seeking immediate medical attention, your medical condition could result in any of the following:
- Serious jeopardy to your health;
- Serious impairment to bodily functions;
- Serious dysfunction of any bodily organ or part.