Seek Care After an Accident – The 14-Day Rule

The Florida Personal Injury Protection Statute (PIP) requires anyone injured in a vehicle accident to seek medical care within 14 days of the accident. Failure to do so means that you cannot apply the financial protection of PIP law.

If you or someone you know was injured in a motor vehicle accident, it is paramount that you go to a doctor as soon as possible. Even if you don’t believe you were injured you should still seek care. Some injuries don’t show up for days, or even weeks, after an accident. If you haven’t been seen by a medical professional within two weeks, your claim will likely be denied by insurance.

Seek Medical Care Soon

The PIP law was changed in 2013 to require an accident victim to seek “initial services and care” within two weeks of the accident in order to be covered by the PIP coverage of their vehicle insurance. Seeking the attention of nearly any type of medical care provider will meet this requirement as long as they are a qualified medical care provider.

Some qualified medical providers include:

• Emergency Department Doctors
• Your Primary Care Physician
• An EMT
• Dentists
• A Chiropractor

Some care providers do not qualify. Physical therapists, massage therapists, and other similar providers may not meet the criteria listed in the statute. If you don’t see one of the qualified care providers lists, the insurance company is likely to deny your claim and you will not receive the benefits allowed.

After an accident, you should seek medical attention from a doctor. Going to the Emergency Department of the hospital, an Urgent Care facility or even your personal physician is the recommended option. They will ensure you’re healthy and you will also meet the qualifications as outlined in the Florida 14-Day PIP Rule.

What are the Florida PIP Payout Limits?

The PIP Statute in Florida establishes limits on the benefits for an insurance claim. If you have received medical treatment from a qualified provider within the 14 day period, then you can qualify for PIP to pay for some or all of that treatment. Payout limits are:

• $10,000 or more to cover any “emergency medical condition” you may have suffered.
• A maximum of $2,500 to cover any non-emergency injury treatments

Car insurance carries a minimum of $10,000 in coverage for PIP, but depending on your policy you may be carrying more. 

What is an “Emergency Medical Condition”?

An “Emergency Medical Condition” is defined by Florida Statute §395.002 under sub-section 8.

(8) “Emergency medical condition” means:

(a) A medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:

1. 1. 1. Serious jeopardy to patient health, including a pregnant woman or fetus.
      2. Serious impairment to bodily functions.
      3. Serious dysfunction of any bodily organ or part.

Your healthcare provider will determine whether your injuries qualify as an “emergency medical condition” and will note that in your charts. This determination does not have to occur in the first 14 days, but you do need to seek out medical attention in that period to ensure you are covered by PIP.

How do you get PIP to Cover your Bills?

Sometimes insurance carriers will attempt to avoid paying out your claims properly. They will likely claim your accident-related injuries don’t meet the requirements of PIP. They may claim:

• Your injuries are unrelated to the accident
• The injuries don’t qualify as “emergency medical conditions”
• Medical attention wasn’t sought out in the 14 day period

If that is the case, you need to have an accident injury attorney who understands the PIP rules. The attorneys of Chad Barr Law fight for the rights of our clients and have experience representing both individuals and their medical providers in cases covered by the Personal Injury Protection statute. Call us today for a free consultation on your case: 407-599-9036.