Recently, I was meeting with a potential new client that had been injured in an automobile accident that occurred seven months prior. The impact involved several vehicles and was very significant and resulted in extensive property damage.
The client felt pain immediately at the scene but did not request or receive treatment at that time. Within a day or two after the accident, the pain was not improving. The client went to see a chiropractor and now has been receiving consistent treatment ever since.
What the client found out the hard way was that the PIP carrier was only going to provide $2,500 in PIP benefits vs. the $10,000 in PIP benefits that the client paid for when they purchased the automobile policy and what she continues to pay for today.
In 2012, the Florida legislature enacted several important changes that could impact the amount that your automobile carrier is required to pay for medical expenses you incur. As of January 1, 2013, there are two available limits for no-fault personal injury protection benefits and they are as follows:
- $10,000 per person for loss resulting from bodily injury, sickness, or disease arising out of the ownership, maintenance, or use of a motor vehicle if a physician, dentist, physician assistant, or advanced registered nurse practitioner has determined that the injured person had an emergency medical condition.
- $2,500 per person for loss resulting from bodily injury, sickness, or disease arising out of the ownership, maintenance, or use of a motor vehicle if a physician, dentist, chiropractic physician, physician assistant, advanced registered nurse practitioner, physical therapist or person licensed to provide emergency transportation and treatment has determined that the injured person did not have an emergency medical condition.
Emergency medical condition is defined as follows:
- A medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any one of the following: serious jeopardy to patient health, serious impairment to bodily functions and/or serious dysfunction of any bodily organ or part.
We have stressed before and will continue to stress that if you are injured in an automobile accident and feel pain at the scene, be evaluated at the scene by paramedics. One could argue under the new PIP law, that being evaluated at the scene and for example being found to have increased blood pressure could constitute an “emergency medical condition.” At a minimum, it is imperative that you be evaluated by a medical doctor or by a family doctor within 14 days of an automobile accident due to the PIP law that was effective as of January 1, 2013 requires an individual to seek medical treatment within 14 days of the motor vehicle collision. Failure to do so will result in ZERO PIP benefits being afforded.
In my client’s situation a medical examination took place within just a few days of the accident with a chiropractor. This means that she is entitled to either $2,500 or $10,000 in PIP benefits. However, a chiropractor cannot make the determination under the new PIP statute that someone sustained an “emergency medical condition.” If the chiropractor would have referred the client to an orthopaedic doctor, a neurologist, pain management doctor or a family doctor that would be a different story and within the first 14 days the “emergency medical condition” criteria would have been satisfied and $10,000 in PIP benefits would have been available.
It is guaranteed that there will be extensive litigation over years to come regarding the new PIP statute and the interpretation of the statute. But for now, if you are injured in an automobile accident and feel pain at the scene please be evaluated at the scene by paramedics and transported to the hospital. At a minimum be evaluated by a doctor within 14 days to preserve your entitlement to PIP benefits.
As in my client’s case and as in most cases, there are many valid reasons why people refuse transportation to the hospital. However, if you are not in a position to be transported. please see a medical doctor as soon as possible after your motor vehicle accident and certainly within 14 days of your accident to put yourself in the best position to be afforded $10,000 in PIP benefits.
If you have any questions about this topic or any other matters, please call one of the attorneys at Wieland, Hilado & DeLattre at 407-841-7699. For additional resources, keep checking our blog, LIKE us on Facebook and follow us on Twitter at @whdjustice for more helpful hints and to always be informed about your rights.