Written by attorney Jesse Houston Clark

Florida Automobile Insurance Explained

Florida Insurance Explained

This information pertains only to Florida Automobile Insurance as of January 1, 2013. This information is taked directly from Florida Statutes. For more information, please contact my office for a free consultation.

No Fault Insurance: This means that regardless of who is at fault for an automobile collision, your own insurance is principally responsible for medical bills, lost wages, out of pocket prescription costs, and mileage expenses for travel to and from your doctor’s office.

Required: $10,000 Personal Injury Protection

$10,000 Property Damage(Pays for damage to another’s car if you cause an accident)

$ 5,000 Death Benefits

Optional: Bodily Injury (Pays for injuries to another if you cause an accident)

Collision Coverage (Pays for damage to your vehicle in the event of an accident.)

Comprehensive Coverage (Pays for other damages to your vehicle unrelated to an auto accident.)

Uninsured/Underinsured Motorist (Pays for your injuries if the person who caused the accident did not have insurance, did not have Bodily Injury coverage, or if that person is unknown.)

  • UM must be specifically rejected via a signed consent form

  • UM coverage must be equal to or less than than BI coverage.

  • "stacked" UM simply means that the coverage amount is multiplied by the number of vehicles on the policy

Per person/Per accident: Coverages are commonly listed with separate limits, for example:

10/20 PIP, 10/20 BI, 10/20 UM, COL&COMP 500D, RENTAL

Sources of PIP (in order of priority)

1) Your auto insurance

2) A resident relative’s auto insurance (if you do not own a car)

3) The auto insurance policy of the car you were in

4) The auto insurance policy of the car that hit you (if you were a pedestrian or bicyclist)

PIP Limits

1) Initial services within 14 days for “emergency medical condition:" $10,000

a. Emergency condition: Acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to patient health, serious impairment to bodily functions, or serious dysfunction of a body organ or part

b. Emergency condition must be determined by physician, osteopathic physician, dentist, physician’s assistant or advanced registered nurse practitioner.

c. Initial services may only be provided by licensed physician, licensed osteopathic physician, licensed chiropractic physician, licensed dentist, or must be rendered in a hospital, a facility that owns or is owned by a hospital, or a licensed emergency transportation and treatment provider

2) Initial services within 14 days or for a “non-emergency condition:" $2,500

3) Initial services 14+ days after accident: $0

PIP Payments

1) 80% of medical expenses

  • calculated ay 200% of Medicare B fee schedule

2) 60% household necessities

  • Household necessities include paying someone to mow the lawn, paying someone to pick up kids from school.

3) 60% of Lost Wages

  • Calculated as average of previous 13 weeks' earnings

  • often requires a doctor's note

  • Must be paid at least every two weeks by insurer

4) Mileage reimbursement (rates vary)

a. Keep Mileage Chart to and from doctor’s office each day, no matter where you were coming from or where you are going to.

b. Includes specialist visits

5) Massage and acupuncture are not reimbursable

Examinations Under Oath and Independent Medical Examinations

1) EUO compliance is a condition precedent for receiving benefits

2) An insurer that unreasonably requests EUOs as a general business practice, as determined by the Office of Insurance Regulation (OIR), is subject to s. 626.9541, F.S. of the Unfair Insurance Trade Practices Act

3) If a person unreasonably fails to appear for an independent medical examination (IME), the carrier is no longer responsible for benefits

4) Refusal or failure to appear for two IMEs raises a rebuttable presumption that the refusal or failure was unreasonable.

Attorney’s Fees

1) Insurers may recover reasonable costs and attorney’s fees (from date of offer) if the plaintiff’s recovery is at least 25% less than insurer’s settlement offer or if judgment is of no liability.

2) Plaintiff may only recover reasonable costs and attorney’s fees (from date of offer) in addition to damages if judgment exceeds insurer’s settlement offer by 25%.

3) Where defendant-insurer’s costs and attorney’s fees total more than the judgment, the court shall enter judgment for the defendant against the plaintiff for the amount of the costs and fees, less the amount of the plaintiff’s award

4) See RULE 4-1.5 for Florida Bar Rules regulating personal injury contracts and contingency fees.

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