How does Florida's PIP no-fault system work?
| Type of Loss | PIP Coverage | Coverage Cap |
|---|---|---|
| Medical & surgical expenses | ✓ Covered | 80% of reasonable & necessary expenses, up to policy limit |
| Rehabilitation services | ✓ Covered | 80% of reasonable & necessary expenses, up to policy limit |
| Lost wages / lost income | ⚠ Partial | 60% of lost wages, up to the policy limit |
| Death benefit | ✓ Covered | $5,000 (separate from medical/wage sub-limits) |
| Pain & suffering | ✗ Not Covered | PIP never covers pain and suffering |
| Property damage (vehicle repair) | ✗ Not Covered | Handled through separate property damage coverage |
| Future medical care beyond initial treatment | ✗ Not Covered | Requires claim against at-fault driver |
⚠ The 14-Day Rule: Miss This Deadline and You Lose Your PIP Benefits Entirely
Florida law is unambiguous on this point. Under Florida Statute § 627.736, you must seek initial medical treatment within 14 days of your accident to qualify for PIP benefits. This does not mean you must complete treatment within 14 days. It means you must have your first medical visit within that window. Waiting even one day past that deadline, even if you have a valid reason or were genuinely not in severe pain at the time, can result in your insurer legally denying your entire PIP claim. Get checked out within 14 days. No exceptions.
✓ Injuries That May Meet the Threshold
- Herniated or bulging discs requiring surgery
- Traumatic brain injury (TBI)
- Fractured bones
- Torn ligaments requiring surgical repair
- Nerve damage with lasting effects
- Significant scarring or disfigurement
- Permanent restriction of movement
- Any injury resulting in death
✗ Injuries That Typically Don't Meet the Threshold
- Mild whiplash that fully resolves
- Soft tissue sprains with complete recovery
- Minor cuts or bruising with no lasting effects
- Temporary pain that resolves without ongoing treatment
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1
Seek Medical Treatment Within 14 Days
Visit an emergency room, urgent care, or physician within the 14-day window. This preserves your PIP eligibility. Do not wait to see if symptoms improve on their own. Adrenaline and inflammation can mask serious injury for 24–72 hours post-accident.
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2
Report the Accident to Your Own Insurance Company
Notify your insurer of the accident and initiate a PIP claim. This is separate from any claim against the at-fault driver. Under Florida's no-fault system, your own PIP is the first source of payment.
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3
Document Everything
Keep every medical bill, every explanation of benefits from your insurer, every receipt for out-of-pocket medical expenses, and a running record of days missed from work. This documentation is the foundation of any future claim beyond PIP.
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4
Consult with a Personal Injury Attorney
Once your initial treatment is underway, a Florida personal injury attorney can assess whether your injuries meet the serious injury threshold, evaluate the at-fault driver's insurance coverage, and advise on what additional compensation you may be entitled to pursue.
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5
Pursue a Third-Party Claim if the Threshold Is Met
If your injuries qualify, your attorney will pursue a bodily injury claim against the at-fault driver's liability insurance, seeking compensation for pain and suffering, future medical expenses, lost earning capacity, and other damages that PIP doesn't cover.
"Florida's PIP system was designed to be simple. In practice, the 14-day rule, the Emergency Medical Condition distinction, and the serious injury threshold have created a system where the difference between a fully covered claim and a denied claim can come down to a single phrase in your medical records."
Not Sure Whether Your Injuries Qualify for a Claim Beyond PIP?
Florida's serious injury threshold is evaluated case by case. An experienced Florida personal injury attorney can review your medical records and the specifics of your accident to give you an honest assessment of your options, with no cost and no obligation.
Get a Free Case Evaluation