This article applies to Florida auto accidents. Each state has different laws.
Tip: PIP adjusters are different from bodily injury (BI) liability adjusters. You do not have to give a statement to a careless driver’s bodily injury liability insurer.
Back to talking about Florida PIP claims…
Who needs to submit to an examination under oath in a PIP claim?
An insured seeking benefits under Florida’s PIP laws (ss. 627.730–627.7405), including an omnibus insured, must comply with the terms of the policy, which include, but are not limited to, submitting to an examination under oath. Florida Statute 627.736(6)(g).
What is an omnibus insured?
An “omnibus insured” is one who is covered by a provision in the policy but not specifically named or designated.
What is an examination under oath?
At an examination under oath, the PIP insurance company has an insurance adjuster or attorney ask you questions. They usually focus on:
- Who you lived with at the time of the crash
- Injuries that you had before the accident
- How the accident happened
- Injuries that you are claiming the accident caused
- Your medical treatment
They may ask you to identify pictures and documents as well. A stenographer (“court reporter”) is usually present.
What can you be asked in an examination under oath?
The scope of questioning during the examination under oath is limited to relevant information or information that could reasonably be expected to lead to relevant information.
This is a liberal standard and gives the PIP insurer a lot of leeway.
Compliance with this paragraph is a condition precedent to receiving benefits.
Where does an examination under oath take place?
It can be done over the phone. However, it is typically done at the office of the injured person’s attorney, or at the PIP insurer’s office.
Which companies are more likely to conduct an examination under oath?
The nonstandard insurance companies in Florida are more likely to request an examination under oath. Many will require that you go to their office for the examination under oath.
Some, but not all, of the Florida PIP insurers that are more likely to request an examination under oath are:
Which companies are less likely to require an examination under oath?
Other insurance companies are much less likely to conduct an examination under oath. Most of these insurers will take your statement over the phone. Some will require the statement to be recorded.
Some PIP insurers that usually don’t require an examination under oath are:
- State Farm
- United States Automobile Association (USAA)
- Travelers Home and Marine Insurance Company
- Safeco Insurance Company of Illinois (A Liberty Mutual Company)
- 21st Century Centennial Insurance Company (part of the Farmers Insurance Group of Companies)
- Infinity Insurance Company
- Nationwide Insurance Company
When are PIP insurers more likely to request an examination under oath?
Nonstandard PIP insurers are more likely to request an exam under oath. They are more prone to do this when they suspect:
- That the person who purchased the PIP policy didn’t list all the household residents on an application. (The nonstandard auto insurers are much more likely to deny coverage based on this.)
What happens if you don’t attend an examination under oath?
If you’re asked to attend a PIP insurer’s examination under oath, and you fail to attend, the PIP insurer can deny coverage. This means that they may not pay your medical bills, lost wages and mileage reimbursement.
If your claim is brought in certain counties in Florida, and you should have PIP but don’t qualify because you didn’t attend an examination under oath, the tortfeasor may get a credit for a PIP setoff.
Are you entitled to a copy of your statement?
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