Florida pays for initial car accident medical bills through your own insurance regardless of who caused the crash. But suing the at-fault driver for pain and suffering requires stepping outside that system entirely, and a specific dollar figure controls whether that is even possible.
How Florida’s No-Fault System Works
Under Florida Statute 627.736, every Florida auto policy must include Personal Injury Protection coverage, generally providing up to $10,000 toward medical expenses and lost wages, regardless of who caused the accident.
The Threshold That Opens The Door To A Lawsuit
To sue an at-fault driver for pain and suffering, an injured person generally must show that the injury meets Florida’s serious injury threshold, including significant and permanent loss of an important bodily function, permanent injury within a reasonable degree of medical probability, significant and permanent scarring, or death.
Why The 80-Percent Reimbursement Rule Matters
PIP coverage generally reimburses medical providers at 80 percent of covered expenses rather than the full billed amount, meaning an injured person, or their health insurance, may end up responsible for the remaining 20 percent unless that gap is otherwise addressed. Loshak Law PLLC helps clients identify and close this exact gap whenever it appears in a case.
Why Seeking Treatment Within 14 Days Matters So Much
PIP benefits generally require that initial medical treatment begin within 14 days of the accident, and coverage can be significantly reduced or denied entirely if this window is missed. Waiting to seek treatment, even for injuries that seem minor at first, can jeopardize this coverage.
How This System Interacts With A Serious Injury Claim
Once an injury meets the serious injury threshold, a claim against the at-fault driver proceeds separately from PIP benefits, potentially recovering damages PIP does not cover, including pain and suffering and the full extent of medical expenses beyond what PIP already paid.
What Documentation Helps Support A PIP And Serious Injury Claim
Because these two tracks depend on different types of documentation, gathering the right records matters considerably:
- Records showing initial treatment began within the 14-day window
- Complete medical records documenting the nature and permanence of the injury
- PIP claim documentation showing what has already been paid or denied
- Records of any medical opinions addressing whether the injury meets the serious injury threshold
Applying This Framework To A Hollywood Car Accident
Because whether a claim can proceed past PIP benefits often comes down to meeting a specific legal threshold, tracking medical treatment and documentation accurately from the start matters considerably. A Hollywood car accident lawyer can review treatment records early to determine whether an injury is likely to meet the serious injury threshold.
What If PIP Coverage Was Denied Or Reduced
An insurer that denies or reduces PIP benefits, particularly over the 14-day treatment window, does not always have a valid basis for doing so. A Hollywood car accident lawyer can review a denial to determine whether it was properly issued under Florida’s no-fault requirements.
Florida’s no-fault system controls how a car accident claim starts, but understanding the serious injury threshold matters for anyone whose injuries go beyond what PIP alone was designed to cover. If you were hurt in a car accident in Hollywood, reach out to our office to go over your medical records and options.
