Florida PIP explained: the 14-day rule, the $2,500 cap and what it really pays

The three rules that decide your claim

1. 14 days. Get first treatment within 14 days of the crash. Miss it and PIP medical benefits can be denied, even if you're hurt.
2. Emergency medical condition (EMC). A medical doctor, osteopath, dentist, physician assistant or advanced practice registered nurse has to find an EMC for you to get up to $10,000. A chiropractor can treat you inside the 14 days but cannot make the EMC finding.
3. 80/60. PIP pays 80% of reasonable medical expenses and 60% of lost income. The other 20% goes to your health insurance or to you.

What PIP pays, and what it doesn't

PIP pays	PIP doesn't pay
80% of reasonable medical bills, up to the limit	Pain and suffering
60% of lost income, inside the same $10,000	Damage to any car
Replacement services you can't do while hurt, inside the same limit	You on a motorcycle
A $5,000 death benefit, on top of the $10,000	Treatment that starts after day 14

Who PIP covers

• You and relatives living in your home, in any car or as a pedestrian hit by a car
• Passengers in your car who don't have their own PIP
• PIP does not cover you on a motorcycle

What to do after a crash, day by day

1. Day 0: get safe, call the police if anyone is hurt, take photos, and get the other driver's insurance. Text David if you want help with the next steps.
2. Days 0 to 14: see a medical doctor, an ER, an urgent care with an MD, PA or APRN, or a dentist. Tell them you were in a car crash. Ask them to note whether you have an emergency medical condition.
3. Right away: report the claim to your own insurer, even if the other driver caused it. PIP is always your own insurance.
4. Keep everything: bills, records, pay stubs for lost income, and mileage to appointments.

A worked example

You're rear-ended on US-1 and your back hurts. You go to urgent care on day 2, and a doctor finds an emergency medical condition. Your treatment costs $8,000 and you miss two weeks of work worth $2,000.

• PIP pays 80% of the $8,000: $6,400.
• PIP pays 60% of the $2,000 lost income: $1,200.
• Total: $7,600 of your $10,000 limit, minus any PIP deductible you chose.

The remaining 20% of the bills goes to your health insurance, or can be part of a claim against the other driver if your injury meets Florida's threshold.

The PIP deductible

You can choose a PIP deductible (commonly up to $1,000) to lower the price. If you have good health insurance, a higher PIP deductible can make sense. If you don't, keep it low. The deductible comes off the top of what PIP would pay.

When PIP isn't enough

$10,000 goes fast after an ER visit and imaging. That's why David always shows the price of adding bodily injury liability and uninsured motorist coverage next to PIP. Uninsured motorist is the coverage that pays you when the other driver has little or no insurance. See Uninsured motorist coverage in Florida.