Florida 14 Day Rule in Personal Injury Protection (PIP)
The law that controls the 14 day rule in PIP is Florida Statute 627.736, also known as the Florida No-Fault Statute. It reads:
627.736 Required personal injury protection benefits; exclusions; priority; claims.—
(1) REQUIRED BENEFITS.—An insurance policy complying with the security requirements of s. 627.733 must provide personal injury protection to the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in the motor vehicle, and other persons struck by the motor vehicle and suffering bodily injury while not an occupant of a self-propelled vehicle, subject to subsection (2) and paragraph (4)(e), to a limit of $10, 000 in medical and disability benefits and $5, 000 in death benefits resulting from bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle as follows:
(a) Medical benefits.—Eighty percent of all reasonable expenses for medically necessary medical, surgical, X-ray, dental, and rehabilitative services, including prosthetic devices and medically necessary ambulance, hospital, and nursing services if the individual receives initial services and care pursuant to subparagraph 1. within 14 days after the motor vehicle accident. The medical benefits provide reimbursement only for:
If you are injured in a crash and do not have initial services and care provided to you, you will be barred from using your personal injury protection (PIP) coverage to cover accident-related bills. Therefore, if you are hit by a vehicle, believe you are fine and decide to not go to get checked by a doctor, and then after the 15th day go to a doctor because your back started hurting and it was the first day available, the doctor will not be able to bill your PIP insurer for the bill. No matter how badly you are hurt, you will be barred from the $10, 000 in PIP coverage under your policy.
Under the No-Fault Act (Fla. Stat. 627.736(1)(a)(1) it states:
1. Initial services and care that are lawfully provided, supervised, ordered, or prescribed by a physician licensed under chapter 458 or chapter 459, a dentist licensed under chapter 466, or a chiropractic physician licensed under chapter 460 or that are provided in a hospital or in a facility that owns, or is wholly owned by, a hospital. Initial services and care may also be provided by a person or entity licensed under part III of chapter 401 which provides emergency transportation and treatment.
You can receive initial services and care from:
- Services rendered in a hospital.
- A person who provides emergency transportation and treatment (EMT/Paramedic).
The important part is that you see one of these five (5) categories within the first 14 days of the crash. To be safe, it is important to note that every person’s body is different and reacts to trauma differently, so it is best to get checked by a medical professional just in case.
If you are in a car crash the easiest thing to do is to ask the officer or paramedic who comes to the scene to be seen by a paramedic or EMT. They can provide initial services and care at the scene of the accident and meet the 14 day rule. Make sure to get a copy of the report they create for your records and give that to your attorney as well as any medical providers you see after.
As long as you are seen within 14 days of the accident your medical provider will bill your PIP insurance and the bills should be reimbursed to the doctor’s office in a timely manner.