Automobile Insurance in Florida

Automobile Insurance policies contain many separate types of coverage. Here we discuss two types of coverage that are particularly important to anyone injured in a motor vehicle accident. We hope you find this general information helpful and would welcome the opportunity to give you specific information based on the facts of your case.

Uninsured Motorist's and Underinsured Motorist's Coverage

Many drivers ignore motor vehicle insurance requirements, cannot afford to purchase insurance, or carry insufficient insurance. Uninsured and Underinsured Motorist coverage protects you if someone who does not have adequate insurance injures you in an automobile accident. Uninsured Motorist coverage is a form of insurance that pays compensation for bodily injury that results from an accident with a driver who is legally responsible for the injuries, but has no liability coverage. Underinsured Motorist coverage pays compensation for bodily injury that result from an accident with a driver who has liability insurance with limits that are inadequate to cover the damages sustained by the injured party. Some states require separate uninsured and underinsured motorists' coverage to be purchased, but Florida has merged both concepts into a single coverage that we refer to as Uninsured Motorist coverage (UM).

Some Underinsured Motorist policies do not require the insurance company to pay if the insured person has settled with the other driver's insurance company without first obtaining the UM carrier's permission. This can be a very costly mistake. Therefore, you should consult with a personal injury law firm experienced in dealing with automobile accident cases before you settle any portion of your claim. An attorney can provide you with the information and support you need to obtain the best result available. If you are in an accident with someone who is uninsured or underinsured, you should contact an experienced attorney before you settle with the other driver's insurance company to ensure that you do not waive valuable legal rights.

Stackable Coverage

Uninsured and Underinsured Motorist (UM) coverage may be purchased in a "stackable" or a "non-stackable" form. Stacking UM coverage may permit a person to add together either insurance coverage from several motor vehicle policies or insurance coverage for several vehicles listed on one policy. Non-stackable Uninsured Motorist coverage severely limits the coverage available to the insured. UM coverage is so important to you and your family, that the law places a special burden on Florida insurance companies. Whenever they sell policies that have either no UM coverage or coverage limits lower than the bodily injury limits, or the non-stackable form of UM, they must obtain your signature or a valid election/rejection form. If they fail to do so, they must then provide UM limits equal to the bodily injury limits you selected even though you never paid a premium for UM.

When someone says they are "fully insured" in Florida, it does not necessarily mean they have anywhere near adequate coverage for themselves or those who they injure. This is why we urge our clients to always be sure they have adequate Uninsured Motorists Coverage (UM).

No-Fault Insurance

Florida has been a "no-fault" state since the 1970's. On October 1, 2007, the No-Fault Act expired. A new No-Fault Act is effective on January 1, 2008. The no-fault concept requires each of us to self-insure for our own auto accident related medical treatment and lost wages. We do this through the purchase of Personal Injury Protection (PIP) and Medical Payments (MP) coverage as part of our auto insurance coverage.

An unusual aspect of Florida insurance law is that the state required minimum coverage includes only Property Damage (to repair someone's property when we are at fault) and PIP (to pay 80% of your medical expenses and 60% of your lost wages). Florida does not require any of us to purchase Bodily Injury Liability coverage, which is coverage that would pay for bodily injury to the other party when we are at fault.

How PIP Pays Medical Benefits

Following an auto accident, generally, PIP allows you to see any doctor of your choosing, unlike an HMO or managed care plan which may limit or dictate your choice. When you visit your treating doctor, you should advise them that you are there because of an auto accident and provide them the information on your PIP policy. When your doctor submits your bills to PIP, they will be paid 80% of the "reasonable and necessary" expenses related to your treatment. You will begin to accrue an unpaid balance of the 20% not covered by PIP.

If you have Medical Payments (MP) coverage on your auto policy, it will pay the 20% as it is incurred. If you have no MP coverage, the 20% becomes part of your claim against the at-fault party's Bodily Injury Liability coverage and will be included in any final settlement with the insurance company. While waiting for your case to settle, your doctor may request that you sign a letter of protection (LOP). This is an assurance by you and your attorney that the unpaid expenses will be paid out of the settlement of your claim. Any request for a LOP by your doctor should be discussed with your attorney before you sign.

How PIP Pays Lost Wages Benefits

Should you be unable to work for any period of time after your accident, your PIP will pay you 60% of your average weekly wage.

Your employer will be asked to prepare a Wage and Salary Verification form showing your gross wages for the 13 weeks preceding the accident. There are alternative ways to calculate your average weekly wage if the Wage and Salary Verification would not apply or not fairly represent average wages for you.

You must submit the completed wage verification form to your PIP carrier. It generally requires your employer's cooperation. The PIP carrier must begin providing the PIP wages within 30 days of submission of the completed wage loss application, wage and salary verification and physician off-work slips.

PIP Limits

When you purchased your auto insurance coverage, you selected your PIP limits, traditionally $10,000.00. Other limits or deductibles are available.

Every bill you incur will reduce your benefits. For that reason, be aware of what you are being charged, the necessity of the treatment and its frequency.

Request a printout of your charges on a regular basis, such as weekly or monthly. If you are not progressing in your treatment, discuss other options with your physician.

Reserving Your PIP Benefits for Wage Loss

Following an accident, your treating doctor may order you not to work because of your injuries. You may be restricted from work for an extended period of time.

It may be in your best interest to request that your PIP insurer reserves your PIP benefits to pay your wage loss before paying medical bills. Otherwise, medical expenses submitted by medical providers could be paid first and diminish or eliminate the PIP funds otherwise available to pay for your lost wages. This could create a greater financial hardship to you. This should be discussed with your attorney.

Health Insurance/Medicare

If you have a need for extensive medical treatment or a prolonged wage loss, and you exhaust your PIP benefits, you may transfer your care to your health insurance company or to Medicare, if available. You must then comply with any Medicare or health insurance plan requirements.

You have no obligation to repay Florida PIP benefits when you settle your case. That is not always so with health insurance or Medicare, should you be required to use them for your accident-related treatment.

When you settle your case, some health insurance companies or Medicare may seek reimbursement for all benefits they provided for your care. This is referred to as having a right of subrogation. Reimbursement rights differ from plan to plan. PIP carriers in Florida do not have a right of subrogation.

Settlement

You may continue to obtain treatment under your PIP, or health insurance plan/Medicare, after your case is settled. Settlement with the at-fault party or under your own uninsured/underinsured motorist policy does not terminate your right to continued treatment.

Your right to continued treatment under PIP would be limited by the amount of benefits you chose (i.e. generally $10,000.00). However, you may treat under your PIP as long as you need treatment or until your benefits are exhausted. That is why monitoring your expenses is important so that your benefits are not used unwisely and prematurely.

Insurance Disputes

Occasionally, disputes between the insured and the insurer will arise over the No-Fault Benefit. Sometimes the Insurer will claim the treatment is not reasonable or necessary and pay less than the full benefit. Sometimes they will require the insured to submit to a Compulsory Physical Examination after which, based on their doctor's report of a onetime visit they may discontinue benefits altogether. Your attorney can be of great assistance if these events arise. Filing suit to reinstate PIP benefits is common and very successful. Florida law requires the insurance company to pay your attorney's fees when you win the case. For additional information please see our page on insurance disputes.

Contact the Kane Law Firm, P.A.

If you or a loved one have been the victim of an accident or have questions about your claim, please call the Central Florida Accident Attorneys at the Kane Law Firm, P.A. in Orlando, Florida at (407) 898-9130, submit a contact form on our website, or email us at Info@KaneInjury.com.

We offer a free initial consultation, and if we agree to take your case, we will work on a contingency basis. This means we will get paid for our services only if there is a monetary award or recovery of funds.