201610.27

Who pays your medical expenses if you are in a car accident in Florida?

An issue our clients often ask us is who pays their medical expenses in the event they are involved in a motor vehicle accident in Florida. You may recall from an earlier posting that under Florida law, drivers are required to carry a minimum of $10,000 in personal injury protection (or PIP) insurance. This amount applies regardless of who is at fault in an accident and covers, among other things, medical expenses incurred for treatment of injuries sustained in an accident (as well as a portion of loss of income you may suffer as a result of the accident.) However, this amount is often subject to a deductible the motorist must pay before the PIP insurance kicks in. Under Florida law, PIP typically also only covers 80% of your medical bills up to the $10,000 PIP limit a motorist may choose. Therefore, if a motorist with a $1,000 deductible has suffered exactly $10,000 in medical expenses, then her PIP coverage would not cover $3,000 of her medical expenses due to (1) her PIP deductible and (2) the 20% of her medical bills that PIP is not required to cover. Instead, she would be left to either pay the remaining $3,000 herself or else seek to recover from some other source.

PIP Insurance Relating to Medical Expenses Associated with an Accident

As is evident from the discussion above, one of the shortcomings of PIP insurance is that an individual’s entire medical expenses associated with an accident may not be covered by his or her insurance. PIP by law covers 80% of those expenses, leaving 20% for either the individual or some other source to cover. Remember that PIP coverage is available for a portion of your losses of both income as well as medical expenses suffered as a result of an accident. Therefore, to the extent that you are also out of work and have income loss due to the motor vehicle accident in which you were injured, the amount of medical bills covered by your PIP insurance might be reduced because you are using the PIP to pay you for lost wages. PIP pays 60 of lost income suffered as a result of an accident. Sometimes clients have good health insurance and will instruct the PIP carrier to reserve the PIP benefits to be applied to lost income. If you don’t have good health insurance but need the money lost from being unable to work, you have no benefits to pay for medical care.

MedPay Coverage: A Wise Investment for Florida Drivers

Obviously, the above can be discouraging news for someone who is involved in a Florida motor vehicle accident and has medical bills which are not fully covered by his or her PIP insurance. You might wonder what you can do to reduce the amount of your medical bills that may not be covered by your PIP insurance if you are involved in an accident in Florida. An optional coverage available under many Florida automobile insurance policies is medical payment coverage, or Med-Pay, as it is more commonly known. Med-Pay benefits operate with PIP to cover your medical expenses associated with injuries suffered in a car accident. Importantly, Med-Pay carries no deductible or co-pay. Therefore, the individual in the example above would be able to tap her Med-Pay benefits if her automobile insurance policy included Med-Pay to cover the 20% that PIP is not required to cover under Florida law. Assuming the driver in the hypothetical above had a $10,000 PIP policy as well as $5,000 in Med-Pay benefits, she thus would end up paying zero out of pocket for her accident because Med-Pay along with PIP would cover all of the bills incurred due to the accident. Therefore, by purchasing the Med-Pay coverage, the driver in the example above would pay $0 out of pocket by choosing to purchase $5,000 in Med-Pay coverage.

Med-Pay coverage can therefore be a wise choice for Florida drivers when purchasing an automobile insurance policy because it will help to make the financial consequences of any accident less severe by reducing your potential uncovered medical expenses. Do keep in mind, however, that Med-Pay coverage will only operate to cover any medical bills that are not covered by your PIP policy. It will not provide reimbursement for lost wages or other types of financial losses you may suffer. It will also increase the total amount of your automobile premium, but typically not by more than several dollars per $1,000 of Med-Pay coverage you add to your PIP coverage. Med-Pay can provide some extra peace of mind when dealing with damages from a car accident.