No PIP Set-Off. No Problem.
Prompt medical treatment is undoubtedly one of the keys to a successful car accident case in Florida. In most situations, this treatment is covered by the patient’s Personal Injury Protection (“PIP”) coverage under their auto insurance policy. Despite the fact that bodily injury or uninsured motorist coverage is not required under Florida law, PIP is required to be included within every auto insurance policy.
As such, following a car accident, it is typically the lawyer’s responsibility to educate his or her client regarding PIP and the importance of getting treatment within 14 days after the accident. However, if a person does not obtain treatment within the necessary time period prescribed by Florida law, then the full $10,000 of PIP benefits may be denied by the insurance company. Consequently, the injured person would then be responsible for the entirety of his or her medical expenses.
In most instances, a car accident leads to a claim against the third party driver’s insurance company. This is typically a claim for damages related to the accident and is separate and apart from any PIP claim for medical benefits. Yet, PIP plays a large role in any potential settlement involving a third party driver’s insurance company, such as Geico, Progressive, Allstate, or State Farm.
Following a verdict for damages against a third party driver, a $10,000 statutory PIP set-off applies. Ultimately, this means that should a jury render a verdict for damages totaling $30,000, then prior to collection, $10,000 must be deducted from that amount due to this PIP set-off. While no personal injury lawyer can speak for the Florida Legislature, it can be inferred that the philosophy behind this law is that a plaintiff should not be entitled to “collect twice” on a verdict. Presumably, the injured person’s auto insurance had already paid up to $10,000 of benefits separate and apart from the jury verdict.
As a result of this Florida law, all insurance companies are instructed to deduct $10,000 from any total valuation of a particular claim to account for the statutory set-off for PIP. Nevertheless, this statutory set-off should not be assumed, for an accounting of the PIP benefits must be considered by the lawyer. And if PIP was denied or the patient’s benefits were cut-off for a certain reason, then this information should absolutely be considered by the third party insurance adjuster when assessing the value of the claim.
However, case law is split on whether this set-off applies if the injured person did not receive any PIP benefits and is therefore accountable for all outstanding medical bills. For accident and injury lawyers, the argument must always be made that the set-off does not apply, thus resulting in an increased personal injury settlement.
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