What Happens When PIP Is Exhausted After a Florida Car Accident?
What You Need to Know PIP running out does not automatically mean your car accident claim is over. Ask your insurance company for a written breakdown of what PIP paid, denied, reduced, or still has pending. Other possible sources may include bodily injury coverage, UM/UIM coverage, MedPay, health insurance, or another responsible party. If the driver who caused the crash has no bodily injury coverage, do not assume there is nothing left to investigate. Before accepting a settlement, know your unpaid bills, available insurance, and expected future treatment. Had a bad day? Call The Reyes Firm at 833-4 BAD DAY ((833) 422-3329). SCHEDULE A FREE CASE REVIEW Your treatment is not finished. The bills keep coming. Then your insurance company tells you your PIP benefits are exhausted. Now you are trying to figure out what happens when PIP is exhausted in Florida. Who pays the next medical bill? What happens if the driver who hit you has no bodily injury coverage? What if you do not have uninsured motorist coverage either? The first thing to understand is simple: PIP being exhausted does not automatically mean your injury claim is exhausted. It means one source of payment may be gone. Now you need to find out what was paid, what is still owed, and what other coverage or responsible parties may exist. If you are still trying to understand how the pieces fit together after a crash, our Florida car accident guide explains how PIP, liability insurance, medical expenses, lost income, and other damages can affect a Tampa car accident claim. What Does It Mean When Your Florida PIP Is Exhausted? Your PIP is exhausted when you’ve used all the benefits available under your policy. That does not mean your treatment has to stop or that every part of your injury claim is finished. It means PIP may no longer pay additional covered expenses, so the next step is finding out what other payment sources may apply. Florida Statute § 627.736 provides up to $10,000 in PIP medical and disability benefits, subject to the law’s requirements and limits. PIP generally pays 80% of reasonable and medically necessary covered medical expenses. Initial medical treatment generally must begin within 14 days of the crash. There is another part many people do not realize. Having $10,000 in PIP coverage does not mean you automatically have access to the full $10,000 for medical treatment. Florida law can limit medical benefits to $2,500 if the required emergency medical condition determination is not made. Edward Reyes, Esq., explains why Florida drivers may not automatically have access to the full $10,000 in PIP medical benefits after a crash and why the 14-day treatment rule matters. That is why the first question should not simply be: “How much PIP do I have left?” You also need to ask: “What happened to the benefits I had?” Ask for a PIP payment breakdown Do not rely only on someone telling you, “Your PIP is gone.” Ask your insurance company for a PIP payment ledger, payout log, or another written accounting showing: How much PIP has paid Which medical providers were paid Which bills are still pending Which charges were reduced Which bills were denied The date the insurer says your benefits became exhausted There is also a major difference between PIP exhausted and PIP denied. A bill may have been rejected, reduced, or still be under review. That doesn’t necessarily mean you’ve used all available benefits. ⚠️ Warning: Florida Has a 14-Day PIP Treatment Rule Florida Statute § 627.736 generally requires initial medical services and care within 14 days after a motor vehicle accident to qualify for PIP medical benefits. If your crash was recent and you have not been evaluated, do not wait simply because you hope the pain will go away. Who Pays Your Medical Bills After PIP Runs Out in Florida? No single automatic payer takes over when PIP runs out. The next source can depend on the insurance policies involved, who caused the crash, your health insurance, and the facts of the case. The goal is to identify every available source before assuming the remaining bills are yours alone. Here is the basic picture: Possible Source When It May Matter Remaining PIP If your benefits have not actually been fully exhausted MedPay If your policy includes medical payments coverage At-fault driver’s BI coverage If the responsible driver carries bodily injury liability insurance UM/UIM coverage If applicable, uninsured or underinsured motorist coverage is available Health insurance May cover eligible medical treatment under your plan Another responsible party If another driver, owner, employer, or business shares responsibility At-fault person’s assets May be evaluated in appropriate cases This is why the insurance card you saw at the crash scene may not tell you the whole story. For example, if the driver who hit you was working, making a delivery, or driving a company vehicle, the investigation may need to look beyond that driver’s personal policy. Our guide to commercial vs. personal insurance after a Florida crash explains why another policy may become relevant when a driver was using a vehicle for work. The important point is: PIP exhaustion is not the same as exhausting your entire injury claim. đź’ˇ Did You Know? Florida does not require every private passenger vehicle owner to carry bodily injury liability coverage in the same way it requires PIP and property damage liability coverage. That is one reason an injured driver can sometimes find out after a crash that the at-fault driver has no BI coverage available. What If the At-Fault Driver Has No Bodily Injury Coverage? If the driver who caused your crash has no bodily injury coverage, recovering compensation can be harder, but the investigation shouldn’t automatically stop. Fault and insurance coverage are separate questions. You need to confirm the actual policies involved and identify every person or business that may share responsibility for the crash. This is the part that can feel especially unfair. Someone else caused the crash. You are
