There is no time limit within which you must get medical treatment after a Florida auto accident to have a case. However, there are time limits that may affect:
- Whether Personal Injury Protection (PIP) insurance will pay your medical bills
- The settlement value of your case
Will PIP insurance pay for your medical bills if you get medical treatment within 14 days of a motor vehicle accident?
Yes, assuming that you are covered by PIP. PIP should pay eighty percent of all reasonable expenses for medically necessary:
- Medical, Surgical, X-ray and Dental
- Rehabilitative services
- Prosthetic devices
- Ambulance, hospital and nursing services. Florida Statute 627.736(1)(a)
PIP pays to a limit of $10,000.
Mike is opening his car door in Coconut Grove, Miami-Dade County, Florida. A car crashes into him. He fractures his tibia (lower leg bone).
An ambulance takes him to the hospital. Since he was getting into his car, he is covered by PIP. He got treatment within 14 days of the crash, so PIP will pay for 80% of his ambulance, ER doctor and hospital bill.
PIP will pay up to a limit of $10,000. I settled a case with these facts for $325,000.
Will PIP insurance pay medical benefits if you don’t get medical treatment within 14 days after a motor vehicle accident?
No. If you are covered by PIP, it won’t pay medical benefits if you don’t get treatment within 14 days after a motor vehicle accident.
Take the facts from the above example, except Mike didn’t get treatment until 15 days after the accident. PIP will not pay anything to the hospital, ambulance company or ER doctors.
How does not treating within 14 days hurt your net settlement?
Take the example above where Mike doesn’t get treatment within the 14 days. This can be problematic if the parties that Mike can sue have limited liability insurance.
Let’s say that the only available bodily injury liability insurance is from the car that hit Mike. Assume that State Farm insures that car and the limits are $10,000 per person.
Let’s assume that:
- The billed charges from the hospital are $10,000.
- Mike’s case is worth more than $10,000.
State Farm sends Mike a $10,000 check for the BI settlement. Since Mike didn’t get medical treatment within 14 days, Mike owes the hospital $10,000.
This would mean that Mike’s entire settlement, which is $10,000, would go to paying the hospital bill.
How treating within 14 days can help your net settlement
If Mike would have treated within 14 days, the PIP insurer would have paid the hospital $8,000. Mike would owe the hospital $2,000.
Mike’s net settlement (after his medical bills are paid) would be $8,000.
You can see how Mike would get more money in his pocket if he gets medical treatment within 14 days after the car accident.
Waiting more than 14 days makes it tougher to prove injuries are related
The longer you wait to get medical treatment, the tougher it is to prove that the car crash caused your injury.
Even with immediate treatment, the at fault insurer will often argue that the accident didn’t cause your injury. This often happens if you’re claiming that the crash caused your herniated disc, rotator cuff or labrum tear, torn meniscus or a host of other injuries.
That being said, I settled an ankle tear case for $25,000 where my client didn’t get treatment until 21 days or so after the accident.
That wasn’t an auto accident case, but the premise is the same.
Will PIP pay your lost wages if you don’t get treatment within 14 days of a motor vehicle accident?
Yes. There is no law that says that PIP won’t pay your lost wages if you don’t get medical treatment within 14 days of a car or truck crash. PIP pays 60% of your lost wages to a limit of $10,000.
However, expect the PIP insurer to argue that the crash didn’t cause you to miss work since it wasn’t serious enough for you to get medical treatment within 14 days of it.
Does the 14 Days Include the Date of The Accident?
The 14 days does not include the date of the accident. Morey v. Eytchison & Hoppes, Inc., 338 So.2d 558 (Fla. 2d DCA 1976). This is because Fla. R. Civ. P. 1.090(a) says that “in computing any period of time prescribed or allowed by these rules, by order of court or by any applicable statute, the day of the act, event… from which the designated period of time begins to run shall not be included.”
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