Florida’s Personal Injury Protection, commonly called PIP, is the insurance coverage every registered driver is required to carry. The minimum is ten thousand dollars. For many accident victims, it’s also the maximum, because the Florida legislature built the system to push routine injury claims away from the courts and into the insurance companies.
What most drivers don’t learn until they need it is how many strings come attached to that ten thousand.
What PIP actually pays
PIP pays:
- 80 percent of reasonable and necessary medical expenses up to the policy limit
- 60 percent of lost wages for time missed from work
- $5,000 death benefit on top of the $10,000 medical/wage limit
All of this is subject to the $10,000 cap unless you purchased higher limits. PIP pays regardless of who caused the accident. That is the “no-fault” part. It pays for you, your resident relatives, and most passengers in your car. It does not pay for property damage; that is a separate coverage.
The 14-day rule almost nobody talks about
Florida Statute 627.736(1)(a) says an accident victim must seek “initial services and care” within 14 days of the accident to be eligible for any PIP benefits. Wait longer than 14 days and PIP pays nothing, even if your injuries turn out to be serious.
“Initial care” does not have to be an emergency-room visit. A primary-care visit, a chiropractic evaluation, or a visit to an urgent-care clinic is enough. But it has to happen inside the 14-day window, and the provider has to document it in a way that withstands later scrutiny.
The “emergency medical condition” trap
Even if you meet the 14-day deadline, PIP coverage is capped at $2,500 unless a qualifying medical professional (an MD, DO, dentist, physician’s assistant, or advanced practice nurse) determines you have an emergency medical condition. The determination has to be in writing and has to appear in the medical record.
This matters because insurance carriers routinely deny or limit benefits on the grounds that no EMC determination was made in time. If that happens to you, it is reviewable, but the clock is unforgiving.
When the $10,000 isn’t enough
For anything beyond $10,000, you need a separate claim. Depending on the facts, that means:
- Your own Medical Payments (MedPay) coverage, if you purchased it
- Your own health insurance
- A bodily-injury claim against the at-fault driver, which requires you to clear Florida’s serious-injury threshold
- A claim against the at-fault driver’s BI coverage, if they carried it (Florida does not require drivers to carry BI)
- Uninsured/underinsured motorist coverage on your own policy, if you carried it
Florida’s system is designed to make most claims stop at PIP. Getting past the PIP layer for a serious injury is exactly where representation starts to matter.
What to do right now, if you’re in the window
If you’ve been in an accident in the last 14 days and haven’t yet been seen by a provider, go today. That single step preserves your right to PIP benefits regardless of how the rest of the case unfolds. Then call an attorney to talk through what’s next.
