Filing a Florida PIP claim after a crash you did not cause should not raise your premium. Florida Statute 626.9541(1)(o)3.a. makes it an unfair trade practice for an insurer to impose an additional premium on a motor vehicle liability, personal injury protection, medical payment or collision policy, or to refuse to renew it, solely because you were involved in a motor vehicle accident, unless the insurer's file contains information from which it determines in good faith that you were substantially at fault.
That is the short answer. What follows is what PIP actually pays in Florida, when a surcharge is allowed anyway, and when you can step outside the no-fault system and sue the other driver.
Coverage And Benefits Of No-Fault Insurance
Florida is a no-fault state. Every vehicle registered here has to carry Personal Injury Protection (PIP), and Florida Statute 627.736(1) sets the limit at $10,000 in combined medical and disability benefits plus $5,000 in death benefits. PIP pays 80 percent of reasonable expenses for medically necessary treatment under section 627.736(1)(a), and 60 percent of lost gross income and lost earning capacity under section 627.736(1)(b).
Two limits catch Florida drivers out. You have to receive initial services and care within 14 days of the crash or PIP pays nothing at all, and the 14 days run from the date of the accident rather than from the day symptoms appear. If no physician, dentist, physician assistant or advanced practice registered nurse finds that you had an emergency medical condition, Florida Statute 627.736(1)(a)4. caps the medical benefit at $2,500 instead of $10,000.
PIP also pays replacement services, which is the part most people miss. Section 627.736(1)(b) covers what you reasonably spend having someone else do the ordinary and necessary household tasks you would have done yourself, such as childcare or housekeeping, when the injury stops you doing them.
Differences Between No-Fault And At-Fault Insurance
No-fault and at-fault systems differ in who pays first and in what has to be proven before anybody pays.
Comparing Policy Structures
With at-fault insurance, the driver who caused the accident must pay for the damage. This includes paying for the other party's medical expenses, repairing the vehicle, and additional costs. As a rule, the liability insurance of the person responsible for the accident covers these payments.
In no-fault insurance schemes, each party's insurance covers their medical costs and losses, regardless of who caused the accident. This type of insurance often includes Personal Injury Protection (PIP), which helps cover medical costs, lost wages, and other injury-related expenses.
Impact On Liability And Claims
The at-fault driver’s insurance rates may increase significantly after an accident. Liability insurance dictates who pays for the damages. Disputes may arise if parties disagree on who was at fault, potentially delaying claims.
With no-fault insurance policies, each driver contacts their insurer, reducing the time and effort needed to resolve the accident. Since fault isn't a factor, insurance premiums may not rise purely from claims being filed. However, the overall insurance cost can be higher in no-fault states due to mandatory PIP coverage.
With at-fault insurance, drivers might face legal battles to settle liability disputes. This can lead to long resolution times and higher legal fees. On the other hand, no-fault insurance minimizes this likelihood, offering a smoother, more predictable claim experience.
How A No-Fault Accident Affects Your Insurance
Experiencing a no-fault accident can influence various aspects of your insurance, including premium adjustments and considerations for at-fault drivers.
Premium Adjustments
In Florida the rule is specific rather than general. Florida Statute 626.9541(1)(o)3.a. bars a surcharge or a nonrenewal on a motor vehicle liability, PIP, medical payment or collision policy solely because you were in an accident, unless the insurer's file supports a good faith determination that you were substantially at fault.
If an insurer surcharges you anyway, section 626.9541(1)(o)3.b. requires it to tell you, along with the premium notice, that you get the money back by showing any one of eight things. Those include that you were lawfully parked, that you were struck in the rear by a vehicle headed the same way and were not convicted of a moving violation, that you were hit by a hit-and-run driver and reported it within 24 hours, or that you got a citation that was later dismissed or nolle prossed. Section 626.9541(1)(o)5. also lets you demand the insurer's proof of fault.
Considerations For At-Fault Drivers
If you caused the crash, PIP still pays your own medical bills, but it never pays for the other driver's car. That is what property damage liability coverage is for. Florida Statute 627.7275(1) says a policy providing PIP may not be issued unless it also provides property damage liability coverage as required by Florida Statute 324.022, which sets the amount at $10,000 for damage to the property of others in any one crash.
The at-fault accident will be noted on your driving record, affecting your insurance rates. A driving record with multiple at-fault accidents will likely result in higher premiums and lower eligibility for safe driver discounts.
Insurance providers may also categorize you as a high-risk driver, making it more difficult to find affordable coverage. It's important that you're aware of how these factors can affect your overall insurance costs and that you take steps to maintain a clean driving record.
Claims Process In No-Fault States
The claims process can be unique in no-fault states because each driver relies on their insurance policy. This system helps expedite payments and reduce litigation but requires special procedures.
Filing A No-Fault Claim
Notify your insurance company immediately after a car accident. Give details such as the date and location of the accident and any injuries sustained. You will be assigned an adjuster to guide you through the process and give you a claim number for reference.
Prepare a detailed report of the accident for your adjuster. Although the question of fault is not the primary issue, accurate information will help assess your claim, and you can request a signed statement. Document all medical treatment, lost wages, and other accident-related expenses which will be important to your claim.
Legal Actions And No-Fault Insurance
Some legal avenues and restrictions govern your ability to sue after a car accident. These rules aim to simplify the insurance process but may affect your ability to obtain compensation through lawsuits.
Right To Sue Under No-Fault Laws
In Florida the threshold is set by Florida Statute 627.737(2). You may recover damages for pain, suffering, mental anguish and inconvenience from the at-fault driver only where the injury consists in whole or in part of significant and permanent loss of an important bodily function, permanent injury within a reasonable degree of medical probability other than scarring or disfigurement, significant and permanent scarring or disfigurement, or death. The serious bodily injury definition used elsewhere in Florida law is a different test and does not decide this question.
Injuries that result in significant disfigurement or permanent impairment can meet it. The size of the medical bill does not. Florida Statute 627.737(2) is about permanence, and a physician has to give that permanency opinion within a reasonable degree of medical probability.
A car accident attorney can help you determine if you can take legal action in your situation. Lawsuits involve economic damages, such as medical expenses beyond primary care, and non-economic damages, such as pain and suffering.
How Your Own Share of Fault Changes What You Recover
Florida is a modified comparative negligence state. Under Florida Statute 768.81(6), a plaintiff found greater than 50 percent at fault for their own injury recovers nothing at all. At 50 percent or less, the award is cut by your percentage of fault rather than barred.
The filing deadline is just as unforgiving. Florida Statute 95.11(5)(a) gives you two years from the date the cause of action accrues to bring a negligence suit for a crash occurring after March 24, 2023.
Schedule A Free Case Review With A PIP Attorney
If you’ve been injured in a car accident and need help navigating the claims process, the experienced car accident lawyers at Weinstein Legal Team are here to help. We can help you with everything from documenting your injuries to filing your claim and negotiating with the insurance company so that you can focus on your recovery.
Call us today at 888-626-1108, or click here to schedule your free case review with an attorney today.
