Thursday, March 31, 2016

Fourteen (14) Day Rule In Personal Injury Protection (PIP); Why It Is So Important To Get Checked Out After a Crash

The law that controls the 14 day rule in PIP is Florida Statute 627.736, also known more widely 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:


Why is it important to be seen within 14 days?

If you are injured in a crash and do not have initial services and care provided to you, you are barred from using your PIP coverage. Meaning if you are hit by a vehicle, believe you are ok, and then one the 15th day you 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.

        
Who can I see for initial services and care?

            At this point you may be asking yourself, “Do I have to go to the emergency room after every crash?” The simple answer is NO. 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:
1.     Physician.
2.     Dentist
3.     Chiropractor
4.     Services rendered in a hospital.
5.     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.  My recommendation would be to err on the side of caution. Every person’s body is different and reacts to trauma differently.

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.


Will I have to pay for the initial services and care at the scene of the accident, hospital or chiropractors office?

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 fashion.


If you have been in a car crash and need legal advice, please reach out to a team of experienced legal professionals like the Dolman Law Group. We have big firm results, but small firm attention. Please call our office at 727-451-6900 today.
Dolman Law Group
800 North Belcher Road
Clearwater, FL 3375

(
727) 451-6900