PIP Benefits Are Exhausted: What Do I Do?

Florida law requires drivers to have a minimum amount of no-fault insurance (Personal Injury Protection) coverage. The minimum coverage amount of PIP insurance is $10,000 in medical and disability benefits and $5,000 in death benefits. 

PIP benefits cover specific damages caused by an automobile accident, regardless of who caused the crash. Each driver files a claim against their coverage. PIP benefits include:

  • 80 percent of reasonable expenses for medically necessary services
  • 60 percent of loss of income 

When your PIP benefits run out, your no-fault insurance provider is not obligated to pay any additional claims. However, car accidents often result in medical bills and lost wages that total more than $10,000. 

In addition to PIP benefits, Medical Payments (Med Pay) Benefits coverage may apply. Med Pay benefits depend on the contract you have with the insurance provider. Generally, Med Pay covers the 20 percent of medical bills that PIP does not cover. In addition, Med Pay pays 100% of the medical bills when PIP runs out until the Med Pay coverage runs out. 

What Should You Do When Your Insurance Provider Tells You That Your Benefits Are Exhausted? 

Do not accept the insurance company’s word that your insurance coverage expired. Instead, request a copy of your insurance policy to verify policy limits and terms of coverage. 

Demand detailed accounting of all providers paid under your policy and the amounts paid to each provider. The payments should total the maximum policy limits of your insurance contract. Furthermore, you should compare the amount the insurance company paid against the amount the provider billed to identify overpayments, duplicate payments, or payment errors.

The insurance company should not overpay for services that should be discounted or pay bills that are submitted past legal deadlines for submitting bills. If the insurance company is guilty of these actions, you should send a demand letter to the insurance provider demanding a resolution. You may also want to contact a Gainesville personal injury attorney to review your rights and options for pursuing claims through the court.

I Still Require Medical Care and Have Other Damages, but My PIP Coverage is Exhausted.

Accident victims in Florida do not have the automatic right to sue the at-fault driver for damage following a car crash. However, the insurance laws in Florida permit lawsuits against the at-fault driver when victims sustain serious injuries. 

Therefore, if your accident injuries meet or exceed the serious injury threshold, you may pursue a claim against the driver who caused the crash.

If the driver has bodily injury liability car insurance, you can file a claim against the driver’s insurance coverage. The liability insurance company investigates your claim to determine several key factors:

  • Was their insured at fault for the cause of the accident?
  • Did you sustain serious injuries?
  • Were your injuries caused by the car accident?
  • Did you have any pre-existing conditions before the accident?
  • Did your actions contribute to the cause of the car accident (contributory fault)?

If the insurance company accepts liability for the claim, it may provide a settlement offer. But, beware! Initial settlement offers are often much lower than the value of your damages. So, instead of accepting an initial offer, talk with a personal injury lawyer in Gainesville to determine if the settlement offer is in your best interest.

The insurance company could dispute liability for the claim or allege that your injuries do not meet the serious injury threshold. If so, you need to prepare for a fight. You have the burden of proving the elements of a negligence case. An attorney can handle those matters for you and fight to get you the highest amount possible for your injury claim.

What Happens if the At-fault Driver Does Not Have Insurance Coverage?

Florida does not require drivers to purchase bodily injury liability insurance. It does, however, require drivers to have $10,000 in property damage liability (PDL) insurance. Suppose, an uninsured driver hits your car and injures you. In this case, you could sue the driver in court for a personal judgment. An attorney can help you decide if it is worth the time and money to file a personal injury lawsuit.

Another option might be a claim against your uninsured motorist (UM) coverage, where your insurance provider stands in for the uninsured driver. Likewise, if the at-fault driver has insurance, but the coverage does not pay your claim, you could file a claim against your underinsured motorist (UIM) coverage policy. 

You could receive additional compensation for damages from your insurance provider in both situations. Remember, you must prove that the other driver caused the accident and your injuries before your insurance company pays your UM or UIM claim. 

The types of damages you could receive by filing a third-party claim or a claim against your UM or UIM policy exceeds the damages in a no-fault insurance claim. You could receive total compensation for economic damages and non-economic damages. Talk with a car accident lawyer to ensure you pursue each claim that could result in money in your pocket after a car crash. 

Contact Our Car Accident Law Firm in North Central Florida

If you need legal assistance, contact the Gainesville car accident lawyers at Allen Law Firm at your nearest location to schedule a free consultation today.

We have two convenient locations in North Central Florida:

Allen Law Firm, P.A. – Gainesville office
2550 SW 76th St #150
Gainesville, FL 32608
(877) 255-3652

Allen Law Firm, P.A. – Ocala Office
112 S Pine Ave
Ocala, FL 34471
(352) 351-3258