Understanding No-Fault Insurance in Miami: Guidance from Car Accident Lawyers

June 27, 2023

Photo of Rear End Car Accident

While “no-fault” may sound like there is no one at fault for a car accident or no one can be held liable, that is not what it means at all. If you are a licensed driver in Florida, you need to understand what type of insurance the state requires, what no-fault insurance covers, and how it works and when you should contact a Miami personal injury lawyer after a car accident.

The purpose of no-fault insurance is for every driver to carry their own minimum auto insurance in Florida and to ensure that after a car crash, victims would not have to waste time proving the other driver was at-fault, allowing them to get compensation much more quickly. 

If you need help navigating your no-fault insurance, contact 1-800-Injured for a free case evaluation.

Key Elements of No-Fault Insurance

There are currently twelve states that require no-fault insurance, and each state sets its own requirements for the minimum auto insurance you need. Florida requires every driver to have a minimum of $10,000 of personal injury protection (PIP) and $10,000 of property damage liability (PDL).

After a crash in Miami, Florida, each insured driver would cover their own damages. No-fault insurance is otherwise known as personal injury protection (PIP) because when you are involved in a car crash, your PIP insurance covers certain damages up to your policy limits, regardless of who was at fault for the accident.

PIP Insurance and Medical Expenses in Miami 

Personal injury protection insurance covers certain damages after a car crash. After being involved in a car accident, your PIP insurance covers 80% of all reasonable and necessary medical expenses up to your policy limits. For example, if you have $20,000 in medical costs, your PIP insurance would cover $16,000 of those expenses. 

The only caveat is that these medical expenses must only be for emergency medical conditions. In order to be considered an emergency, it would need to:

  • Put a victim’s health in jeopardy
  • Severely impair a person’s bodily function
  • Cause  serious dysfunction of any body part or organ

If your injury does not qualify as an emergency medical condition, the PIP insurance only covers up to $2500 of incurred medical expenses.

Personal injury protection will only cover the medical expenses if the condition you seek treatment for is by a licensed hospital, dentist, or physician. 

PIP Insurance and Property Damage in Miami

PIP insurance is for more than just covering your medical expenses. A PIP insurance policy is also available to cover a portion of wages lost if you become disabled due to the car crash.

Your insurance company will look at your earned income from the thirteen weeks leading up to the accident to determine the income you will be losing.

Regardless of who the at-fault driver was, if someone dies in an accident, PIP insurance will cover up to $5000 in death benefits.

Filing a No-Fault Insurance Claim in Miami 

The following outlines the step-by-step process for filing a no-fault insurance claim in Miami.

  • Step 1: Your insurance company must be notified immediately of the accident and you need to let them know you are filing a PIP claim. Your claim is then assigned to an insurance adjuster and they will give you a claim number.
  • Step 2: Your insurance company will request that you explain the events of the accident to the insurance adjuster. If they ask you to make a recorded statement, be careful what words you choose. Despite the insurance claim going through your own insurance company, they are still a business looking out for their bottom line and do not want to pay more than they have to for your claim.
  • Step 3: You will provide your insurance company with medical records that support your claim. You should not sign a “general release” form that gives access to all your medical history.
  • Step 4: Submit proof to your insurance company of all related expenses. You can provide receipts for any out-of-pocket expenses like bandages and OTC pain medications. If you hired outside help to handle things such as mowing the lawn, or shoveling snow from your driveway while you recovered, get a receipt or invoice from the provider. Your employer can provide you with a statement of lost wages that you can submit.
  • Step 5: When all your documentation and medical records are reasonable for the severity of your injuries, you should receive prompt payment from the insurance company with little to no discussion. 

It is possible that you may need to negotiate your settlement if the insurance adjuster has questions regarding the amount of time you were unable to work, any inconsistencies in your records or about any pre-existing conditions.

Important PIP Deadlines In Miami 

Florida has a PIP 14-day rule which requires that you seek medical attention from a qualified provider no more than 14 days after a car crash in Miami. In order to qualify for these benefits under PIP coverage, you must meet this 14-day deadline, or your PIP car insurance claim will be denied by the insurance company.

Limitations of No-Fault Insurance in Miami

There are some limitations to no-fault insurance, including the following:

  • No coverage for pain and suffering 
  • No coverage for emotional distress
  • Coverage, only up to the stated limits, may not cover severe injuries.
  • Only covers property damage if you carry collision coverage
  • You must seek medical attention within 14 days, or your claim will be denied

Benefits of No-Fault Insurance in Miami

There are many benefits to having no-fault insurance, including:

  • With PIP no-fault insurance, you do not have to go after the at-fault driver to cover your injury expenses up to the policy limit. The insurance company will review your claim and process it without requiring proof of the liable party.
  • The process of filing a car injury claim with the no-fault system is typically quicker, allowing you to receive your compensation faster.
  • Since there is no proving fault, you avoid the hassle of having to go to court for lawsuits and stressful litigation in order to receive your compensation.

PIP insurance covers more than just the policyholder. If your vehicle is registered in Florida and you hold PIP insurance, your policy will cover the following:

  • Your dependent children
  • Other household members
  • Passengers involved in the car accident

In addition, your PIP insurance provides coverage for your damages if you are injured in another person’s vehicle or are walking or biking and are hit by a car.

Common Challenges and Disputes

Though filing a no-fault claim can be quicker and easier, insurance companies can dispute paying out benefits. When this happens, you might have to pursue an arbitration against your insurance company. Arbitration can result in delayed claim compensation.

An insurance company can argue that the medical treatment you received or the expenses incurred are unnecessary or unrelated to the car accident.

The typical turnaround for resolving a PIP claim is 30 days from the date the insurance company was notified of the damages you incurred. However, if there is any dispute or if the insurance company feels your claim is fraudulent, it may take an additional 60 days for them to verify your damages and investigate the accident. 

Role of Car Accident Lawyers

Filing a no-fault insurance claim is fairly straightforward, and if there are no serious injuries or disputes with the insurance company, you should receive compensation within 30 days. 

Florida limits your ability to file a lawsuit against the other driver unless you have suffered severe or permanent injuries. You may have to file a personal injury lawsuit against the at-fault driver to receive the compensation you need to cover your medical expenses. Severe injuries that may require a lawsuit include the following: 

  • Spinal cord injuries
  • Traumatic brain injuries
  • Amputations
  • Paralysis
  • Permanent scarring or disfigurement

With the help of a Miami car accident lawyer, you can take legal action and file a lawsuit to recover compensation for the additional lost wages, medical expenses, pain and suffering, emotional distress, mental anguish, loss of consortium, property damage, and loss of future earning capacity.

If the at-fault party tries to argue that the injuries you sustained are not severe enough for a personal injury lawsuit, your attorney can help you prove that the injuries are permanent and severe enough for you to obtain the compensation you rightfully deserve.

Contact 1-800-Injured for At-Fault Insurance Claims in Miami 

If you have been injured in a Miami car accident, you will want to notify your insurance company immediately to let them know you are filing a PIP claim. You want to ensure you receive medical attention within 14 days of the accident so your claim cannot be denied. 

If you sustain injuries that are severe or permanent, it is time to seek legal counsel in order to receive help in gaining the compensation needed to cover your full damages. 1-800-Injured is an attorney and medical directory service that helps connect injured victims to knowledgeable and experienced attorneys in the Miami area. Contact us today at 888–530–7475 or online for a free consultation.