Does Health Insurance Cover Car Accidents in Florida?

Health insurance may cover car accidents in Florida; however, you must first exhaust your personal injury protection (PIP) coverage with your auto insurance provider since Florida is a no-fault state. Your potential coverage also depends on your specific health insurance policy. 

If you suffered severe injuries, you may be able to file a personal injury lawsuit against the liable party, as well. A lawsuit allows you to seek additional compensation you cannot access through an insurance claim, such as pain and suffering. 

A Fort Lauderdale car accident lawyer will determine your legal options and help you seek compensation. An attorney will guide you through the claims process while you focus on your health.

Florida’s No-Fault Insurance System and PIP Coverage

Florida operates under a no–fault insurance system, which means that after a car accident, drivers are required to seek compensation for their injuries from their own insurance provider, regardless of who is at fault. This system was designed to streamline the claims process and reduce the number of lawsuits arising from car accidents.

A Fort Lauderdale personal injury lawyer will review your case to determine whether you meet the qualifications to step outside this no-fault system. 

Personal Injury Protection (PIP) Coverage

As part of Florida’s insurance requirements, all drivers must carry Personal Injury Protection (PIP) insurance. This coverage is essential because it provides benefits for medical expenses and lost wages without needing to establish fault. Here are some key details about PIP coverage:

• Minimum coverage requirements: Florida law mandates that drivers maintain a minimum of $10,000 in PIP coverage. This amount is intended to cover immediate medical expenses and a portion of lost wages following an accident.
• Medical expenses: PIP typically covers 80% of medical expenses related to injuries from the accident, including hospital bills, doctor visits, and rehabilitation services. However, certain types of treatments or services may be limited.
• Lost wages: PIP can compensate for up to 60% of your lost wages due to your inability to work as a result of the accident. This benefit can help alleviate some financial stress while you recover.
• Death benefits: If a person dies as a result of a car accident, PIP can provide a death benefit to the deceased’s beneficiaries, typically up to $5,000.

Limitations of PIP Coverage

While PIP provides essential benefits, it does have limitations:

• Coverage caps: The $10,000 cap may not be sufficient for severe injuries that require extensive medical treatment or long-term care.
• Non-economic damages: PIP does not cover non-economic damages such as pain and suffering, emotional distress, or loss of enjoyment of life. This is where filing a personal injury lawsuit may become necessary if you experience severe injuries.

Your Options if Your Health Insurance doesn’t Cover a Car Accident in Florida

Even if your health insurance covers a car accident in Florida, there’s a chance your financial losses will exhaust it, along with your PIP coverage. This is when you should consider filing a personal injury lawsuit. 

To pursue a lawsuit, your injuries must meet Florida’s serious injury threshold, as outlined in Florida Statutes § 627.737. Some examples of serious injuries defined in this statute include significant and permanent loss of an important bodily function, severe scarring or disfigurement, or death. For example, a traumatic brain injury (TBI) may qualify you to step outside this system. 

Filing a personal injury lawsuit allows you to seek compensation for a wider range of damages, including:

• Full medical expenses: This includes current and future medical costs that exceed what PIP covers.
• Lost wages: Compensation for income lost due to your inability to work, including future earning potential.
• Non–economic damages: You can seek compensation for pain and suffering, emotional distress, and loss of enjoyment of life, which PIP does not cover.

Determining if Your Health Insurance Will Cover Your Car Accident

If you are wondering whether your health insurance covers auto accidents in Florida, you will have to look at your specific policy. Factors such as deductibles, co-pays, and coverage limits play a key role in determining how much you will ultimately pay for medical treatment and recovery.

Deductibles

A deductible is the amount you must pay out of pocket before your health insurance begins to cover costs. If your deductible is high, you will need to pay that amount for medical expenses related to the accident before your insurance starts covering any costs.

If your medical bills exceed your deductible, your insurance will cover the remaining costs, but you will still be responsible for the deductible amount.

Co-Pays

Co-pays are fixed amounts you pay for specific services or treatments, such as doctor visits or prescription medications. After a car accident, co-pays can affect your overall expenses in the following ways:

• Frequent visits: If your recovery involves multiple doctor visits or ongoing treatment, these co-pays can add up quickly, increasing your total out-of-pocket costs.
• Specialist consultations: Seeing specialists, such as orthopedic surgeons or physical therapists, may have different co-pay amounts that can contribute to your overall medical expenses.

Coverage Limits

Health insurance policies often come with coverage limits, which can restrict the amount your insurer will pay for certain types of care or over a specific period. If your policy has a cap on benefits for certain treatments, you may reach that limit quickly, especially if you require extensive care due to serious injuries.

While most policies have an out-of-pocket maximum that limits what you will pay in a given year, reaching that maximum could still lead to significant expenses before your insurance covers anything beyond that point.

Call Us to Learn More About Whether Health Insurance Covers Car Accidents in Florida

At The Schiller Kessler Group, our attorneys will explore your legal options for seeking compensation after an auto collision. We will determine whether your health insurance will cover your car accident expenses and discuss other options for seeking the financial recovery you deserve. 

We have over three decades of experience, and we are ready to fight for your recovery. Call us today for a free consultation.