Florida PIP and insurance claim rights explained for drivers in Miami-Dade, Broward and Duval
How Florida no-fault coverage really works
Florida is a no-fault state, and the phrase misleads nearly everyone who hears it for the first time. It does not mean nobody was at fault for the crash. It means the first coverage to respond is your own, regardless of who caused it. Every registered vehicle here must carry $10,000 in Personal Injury Protection alongside property damage liability, and PIP follows the person rather than the car: you are covered driving, riding as a passenger in someone else’s vehicle, walking, or cycling when a motor vehicle strikes you. Resident relatives in your household are generally covered under the same policy even when they were nowhere near you. The coverage is mandatory, and almost none of it works automatically.
This page exists to explain that system before an adjuster explains it to you. It is written for people in Miami-Dade, Broward and Duval who have a claim number, a stack of bills and a letter they cannot decode. What follows is the statute as it gets applied day to day, with the traps marked: read the parts that match your situation and skip the rest. It is general information rather than advice about your particular claim. Nothing here is a pitch, and if reading it means you handle your own claim and never call anyone, that is a good outcome.
PIP does not pay the whole bill. It pays 80 percent of reasonable and necessary medical expenses and 60 percent of lost wages, and both draw from the same $10,000 rather than separate pots. Any deductible you chose to lower your premium comes off the top. The statute adds a death benefit above that limit. Massage and acupuncture are excluded outright, whoever prescribes them.
The deadline that ends the most claims is the 14-day rule. Initial services must be received within 14 days of the crash, from a licensed physician, osteopathic physician, dentist or chiropractor, or from a hospital or ambulance provider. Miss that window and PIP owes nothing at all, however real the injury. Soreness that turns serious in week three is the classic loss: nothing hurt enough on day two to justify a clinic visit, and by then the coverage had closed.
The second trap is the $2,500 cap. The full $10,000 is available only if a qualifying provider determines you had an emergency medical condition. A physician, osteopathic physician, dentist, physician assistant or advanced registered nurse practitioner can make that finding; a chiropractor cannot, which catches out people whose entire course of care has been chiropractic. Without it in the file, the insurer limits benefits to $2,500.
Insurers also manage the money on the way out. Clinics usually bill directly under an assignment of benefits, so you may never see the ledger until it runs dry. The company can require you to attend a compulsory medical examination, and failing to appear can end benefits. Bills are denied as not reasonable, not related or not medically necessary, often on a paper review by a doctor who never examined you. Before anyone sues a PIP insurer, the statute requires a written pre-suit demand.
None of this touches pain and suffering. To recover non-economic damages from the driver who hit you, Florida requires you to cross the injury threshold: significant and permanent loss of an important bodily function, permanent injury within a reasonable degree of medical probability, significant permanent scarring or disfigurement, or death. Economic losses past your PIP limit, including the unpaid 20 percent and future care, can be pursued against the at-fault driver directly. Two cautions. Florida does not require ordinary drivers to carry bodily injury liability coverage, which is exactly what uninsured and underinsured motorist coverage on your own policy exists for. And a negligence claim accruing on or after 24 March 2023 must be filed within two years.
How a PIP claim is actually processed
Report the crash to your own insurer promptly and get a claim number, even before you decide about treatment. Return the application for benefits the company mails you, because an unreturned form is a common reason a file sits unpaid. Once providers submit bills, the insurer generally has 30 days from written notice of a covered loss to pay or deny, and overdue benefits carry interest. Ask for the payout log every few weeks: it shows how much of the $10,000 is left, and once benefits exhaust the insurer owes nothing further. Wage loss needs a disability slip from a treating provider plus a wage statement from your employer. Keep every explanation of benefits, because a denial is easier to reverse in month one than in month nine.
Frequently asked questions
What does PIP actually pay for after a Florida crash?
Medical care at 80 percent of what is reasonable and necessary, lost income at 60 percent, and certain related expenses, all from a single $10,000 limit reduced by your deductible, plus a death benefit. It does not pay for pain and suffering, it does not repair your car, and it does not pay the other driver. In practice $10,000 disappears quickly once imaging and specialists are involved.
Why was my PIP claim cut off at $2,500?
Because nothing in the records establishes an emergency medical condition. The statute gives you the lower figure by default and the full limit only when a qualifying provider documents that finding. It is not a judgment about your pain level; it is a determination only certain providers may make, and a chiropractor is not one of them. If all of your care has been chiropractic, ask to be evaluated by a qualifying provider.
When can I sue the other driver instead of using my own insurance?
For medical bills and wage loss beyond what PIP covers, you can pursue the at-fault driver once your damages exceed those benefits. For pain and suffering you must also meet the permanent-injury threshold above. Both depend on that driver carrying bodily injury coverage or having assets, and in Florida neither is guaranteed. Check your own declarations page for uninsured and underinsured motorist limits before concluding there is nothing to claim.
All three offices answer coverage questions at no charge: Broward on (954) 529-9377, Miami-Dade on 305-631-1911, Duval and St. John on (904) 800-5297.
The attorney behind this page
Jaime Suarez has spent over 24 years on the side of people trying to make an insurer pay what a policy promised. He graduated from the University of Miami School of Law with highest honors, and his practice covers collision injuries, spinal and head trauma, falls, medication mistakes, on-the-job injuries and fatal-accident claims. A large share of the daily work is unglamorous coverage analysis: reading policies, tracking benefit exhaustion and challenging denials line by line.
He practices alongside Andres G. Montero, who has obtained more than $20 million in verdicts and settlements. The firm is located in Florida and has recovered millions for its clients.
Get a straight answer about your coverage
Read your policy limits to us over the phone. We will tell you what the insurer owes and what it does not.
FOURTEEN DAYS
Initial treatment has to begin within two weeks of the crash or PIP benefits are lost entirely
THE $2,500 LINE
Without an emergency medical condition finding from a qualifying provider, only a quarter of your benefits is available
DENIALS ARE REVERSIBLE
Bills rejected as unrelated or unnecessary can be challenged, and the statute sets out how that starts
Read your declarations page before an adjuster tells you what it says.
The Law Offices of Suarez & Montero answer coverage and claim questions for drivers in Miami-Dade, Broward and Duval. Asking costs nothing, at any hour of the day. The Miami-Dade number is 305-631-1911, and e-mail works if you would rather send documents first. Our fees come out of a recovery, never out of your pocket.