Florida No-Fault Law and PIP Insurance: What Drivers Need to Know

Florida is a no-fault auto insurance state. After most car accidents, your own insurance pays first for medical bills and lost wages, no matter who caused the crash. That coverage is called Personal Injury Protection (PIP).

No-fault rules move quickly and have strict limits. Below, our Miami car accident lawyers explain what PIP pays, the deadlines that can cost you benefits, and when you can go beyond PIP and bring a claim against the driver who caused the crash.

What “No-Fault” Means in Florida

In an at-fault state, an injured driver files a claim against the other driver’s insurer from the start. In Florida, you generally turn first to your own PIP coverage, even if someone else rear-ended you at a red light.

PIP is governed mainly by Fla. Stat. § 627.736. The no-fault system was designed to get people medical benefits quickly and keep smaller injury claims out of court. The trade-off is that PIP benefits are limited, and you can only sue the at-fault driver for pain and suffering if your injury meets a legal threshold.

What PIP Pays

Under Fla. Stat. § 627.736(1), PIP generally pays:

Benefit	What PIP generally covers
Medical	80% of reasonable expenses for medically necessary care
Disability (lost income)	60% of lost gross income and earning capacity
Combined limit	$10,000 for medical and disability benefits together
Without an emergency medical condition	Medical benefits limited to $2,500
Death benefit	$5,000, in addition to the $10,000

Example: $10,000 in medical bills would generally produce $8,000 in PIP medical payments (80%), leaving $2,000 of the $10,000 limit for lost wages. A single emergency room visit with imaging can use up much of that.

The 14-Day Rule

To receive PIP medical benefits, you generally must receive initial services and care within 14 days after the accident (Fla. Stat. § 627.736(1)(a)). That first care must come from a qualified provider, such as a physician, dentist, chiropractic physician, or advanced practice registered nurse, or in a hospital or ambulance setting.

Many injuries, such as soft tissue damage, concussions, or herniated discs, do not show clear symptoms right away. Getting checked promptly protects both your health and your benefits, even if you feel fine.

The $2,500 Limit: Emergency Medical Condition

The full $10,000 is generally available only if a qualified provider determines you had an emergency medical condition. If a provider determines you did not, medical reimbursement is limited to $2,500 (Fla. Stat. § 627.736(1)(a)4.).

PIP medical benefits also do not include massage therapy or acupuncture.

When You Can Sue the At-Fault Driver

You can recover damages for pain, suffering, mental anguish, and inconvenience from the at-fault driver only if the injury includes, in whole or in part (Fla. Stat. § 627.737(2)):

• Significant and permanent loss of an important bodily function
• Permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement
• Significant and permanent scarring or disfigurement
• Death

Whether an injury qualifies depends on the medical evidence, which is why consistent treatment records matter. If the threshold is met, a claim against the at-fault driver may include medical costs beyond PIP, lost earnings, and pain and suffering.

Most of these claims must be filed within two years for accidents after March 24, 2023 (Fla. Stat. § 95.11(5)(a)). See how long you have to file a personal injury claim in Florida.

PIP Does Not Cover Motorcycles

Florida’s no-fault law defines a “motor vehicle” as a self-propelled vehicle with four or more wheels (Fla. Stat. § 627.732(3)). Motorcycles do not qualify, so motorcyclists do not have PIP benefits after a crash and are not bound by the no-fault threshold.

That cuts both ways: riders can pursue the at-fault driver from the start, but they do not have automatic PIP medical benefits. Our motorcycle accident lawyers can explain the options.

When PIP Runs Out

Because PIP is capped, benefits often run out before treatment ends. Other sources may include:

• Health insurance, Medicare, or Medicaid, subject to copays and deductibles
• Medical payments (Med-Pay) coverage, if you bought it on your auto policy
• Uninsured/underinsured motorist (UM) coverage: Florida auto policies with bodily injury liability coverage must include UM coverage unless it is rejected in writing (Fla. Stat. § 627.727). It may help when the at-fault driver has no insurance, too little insurance, or cannot be identified. See our uninsured motorist claims page.
• A claim against the at-fault driver, if the injury threshold above is met

Common PIP Disputes With Your Own Insurer

Because PIP is your own coverage, many people are surprised when their insurer pushes back. Common disputes include:

• “Not medically necessary”: the insurer argues that treatment was excessive or unrelated to the crash.
• The emergency medical condition finding: the insurer argues the $2,500 limit applies.
• Late payment: PIP benefits are generally overdue if not paid within 30 days after the insurer receives written notice of the claim (Fla. Stat. § 627.736(4)(b)).
• Fee schedule reductions: payments to providers are reduced under the statute’s fee schedules.

How Fault Affects a Claim

Under Fla. Stat. § 768.81(6), an injured person found more than 50% at fault generally cannot recover damages from others. At 50% or less, recovery is reduced by your share of fault. For example, $100,000 in damages with 20% fault would generally be reduced to $80,000.

Steps to Take After a Crash

1. Get medical care right away, and within 14 days at the latest to protect PIP benefits.
2. Report the accident to your insurer and cooperate as your policy requires.
3. Keep records of medical visits, bills, prescriptions, and missed work.
4. Talk to a lawyer about whether your injury may qualify for a claim beyond PIP.

Hurt in a car accident? Call Connect Attorneys at 1-833-77CONNECT or contact us online for a free consultation. No fees or costs unless we recover compensation for you. Hablamos Español.