This will be my first of a series of blogs to explain automobile insurance coverage in a way that a consumer can make informed decisions for their needs.
We often hear potential clients say that they have “full coverage” when asked what kind of auto insurance they have. While it feels good to say this, it is really so vague that nobody really knows what it means. Let’s begin reviewing the basic coverages required by Florida law.
The Florida Motor Vehicle No- Fault Law states that if you own or register a motor vehicle with four or more wheels, you are required to have $10,000 in personal injury protection (PIP) and $10,000 property damage liability (PDL) coverage.
Regardless who is a fault in a crash, PIP is primary to pay your medical bills and lost wages up to $10,000. Your PIP covers:
- You and family household members that do not own a vehicle or have their own PIP while in your vehicle or a vehicle owned by others;
- Passengers of your vehicle that do not own a car or have PIP;
- You and family household members injured as a pedestrian or on a bicycle by a motor vehicle operated by someone else;
- Other people that are not family household members injured as a pedestrian or on a bicycle by your motor vehicle operated by you, a household family member, or someone you gave permission to drive your vehicle; and
- Your child while riding a school bus.
Property Damage Liability insurance pays for damage to property owned by others that you or household family members are legally liable to pay as a result of a motor vehicle crash.
So – here’s the problem. When someone says/believes he or she has “full coverage”, it may be because an agent or company selling the insurance told them they have all the coverage which is required (PIP and PDL). But, that is nowhere near the coverage that they need. Important coverages such as bodily injury liability, uninsured motorist, and others will be discussed in later blogs.
For now, let’s focus on the potential problems with these two required coverages.
Personal Injury Protection (PIP)
Some important limitations and requirements of PIP include:
- Insurance companies are allowed to sell this coverage with a deductible up to $1,000;
- PIP only pays 80% of “reasonable” expenses that are “medically necessary”;
- Care must begin within 14 days after the crash;
- A medical doctor, osteopathic physician, nurse practitioner, physician assistant or dentist must determine that you suffered an “emergency medical condition” (EMC) or your PIP benefits will be limited to $2,500. (This law prevents a chiropractor from giving an EMC opinion);
- Massage therapy and acupuncture are not covered by PIP;
- PIP pays 60% of your gross lost wages if you are disabled from the crash (part of $10,00 limit);
- PIP pays all expenses “reasonably incurred” for “ordinary and necessary service” you would have performed for your household (part of $10,000 limit);
- PIP pays a $5,000 death benefit per individual that dies in a crash (in addition to medical and disability benefits);
- Your insurance company has the right to have you examined by a doctor of their choosing to determine if they will continue paying benefits or not;
- Florida law prevents you from collecting for pain, suffering, mental anguish, and inconvenience because of bodily injury, sickness, or disease unless you can prove that you suffered “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”; and
- PIP coverage does not apply to you operating or riding a motorcycle.
A lot of people are shocked that their insurance has to pay for their medical bills when that are not at-fault. Some of the most important points to consider are that you must begin treatment within 14 days after a crash, your benefits are limited unless a certain type of medical provider determines you suffered an “Emergency Medical Condition”, and you can’t collect for intangible damages like pain and suffering if you do not prove you have suffered a permanent injury, loss of important bodily function, significant scarring or disfigurement, or death.
Property Damage Liability (PDL)
As stated before, if you are at-fault in a crash (either totally or partially), and cause damage to the property of others, this coverage will pay damages you are legally liable to pay up to your policy limits. This includes any property of others, or the loss of use of that property. Again, Florida only requires you to have $10,000 in coverage. There is no provision in the law that prevents a party whose property was damaged or destroyed from pursuing litigation and obtaining a judgement against you to collect anything over $10,000. Imagine if you cause an automobile crash resulting in the other vehicle to be a total loss. In most cases, the cost to replace that vehicle, and provide a rental car until that claim is paid, will easily exceed that limit. We recommend that you purchase as much PDL coverage as you can afford to be adequately protected.
Mark R. Myers Investigator,
Lilly, O’Toole & Brown, LLP Lakeland, Florida