Dolman Law Group is an award winning Clearwater car accident and personal injury law firm. Matthew Dolman has been selected as a Florida Super Lawyers in 2013, 2014 and 2015 by his colleagues. Mr. Dolman has been nominated as a top 100 trial attorney and top 40 under 40 by National Trial Lawyers. He is a lifetime member of both the Million Dollar and Multi-Million Dollar Advocacy Forum.
Tuesday, December 30, 2014
What Qualifies as an Emergency Medical Condition for PIP Purposes?
1, 2013, the Florida legislature1 passed changes to the laws
regarding Personal Injury Protection (PIP) insurance coverage. These
changes limited the maximum amount of settlement an injured motorist could
receive unless that motorist suffered an “emergency medical condition” in the
accident. The limits for PIP payouts are now as follows:
maximum if no emergency medical condition was suffered
maximum if a victim suffered an emergency medical condition
distinction naturally led many people to wonder: what qualifies as an emergency
medical condition under the new laws2 and how will I know if I am
eligible for a higher payout?
for emergency medical conditions
definition of emergency medical condition under Florida law is not completely
clear. The injury must have acute and severe symptoms, which may include
substantial pain or inability to move around. Additionally, an emergency
medical condition can result in one of the following if you fail to seek
immediate medical assistance:
deficiency or dysfunction of an important organ or body part
impairment to important bodily functions
serious negative implications to a victim's health
these requirements are not clear-cut. While serious and paralyzing spinal cord
injury would almost always be considered an emergency medical condition, an
equally disabling brain injury may not qualify if it does not present immediate
and noticeable symptoms.
believe you have suffered an emergency medical condition for the purposes of
PIP yet are being denied proper benefits by an insurance company, you have the
right to bring a legal claim. It will then be up to a jury of your peers to
determine whether your particular injuries were serious enough to be considered
an emergency medical condition.
the PIP laws require that a certified medical professional must agree that your
injury was serious enough to warrant immediate medical treatment. Such
documentation must come from one of the following:
registered nurse practitioner
of medical treatments, including acupuncture, chiropractic, or massage therapy,
are not acceptable forms of treatment to satisfy the emergency medical
Always seek a medical evaluation in a timely manner
additional important requirement to receive a payout for an emergency medical
condition under PIP laws is that a victimmust seek out medical treatment for the injury or condition within
fourteen days of the accident and injury. If you wait longer than two weeks to
seek medical treatment, you will likely not be eligible for any payout under PIP
insurance. For this reason, it is always important that you undergo a full
medical evaluation as soon as possible following an accident in order to
identify and document any potential serious injuries. Even if you do not
believe that your symptoms are severe, you should visit a doctor as symptoms of
many different injuries have the ability to gradually develop and/or worsen
over time without the necessary treatment.
Even if you
do seek medical attention within fourteen days, there is still a chance that
the insurance company will attempt to limit your payout to only $2,500 by
claiming that your injury was not severe enough to qualify as an emergency
If you have
only been offered a settlement that is inadequate to cover your personal injury
losses, an experienced Clearwater, Florida PIP attorney at the Dolman Law Group in Florida can help
you. We know how to negotiate with insurance companies and represent your best
interests in court if necessary. Please do not hesitate to call an experienced
personal injury lawyer at 727-451-6900 for a free consultation today.