Florida PIP and no-fault insurance, explained

The short answer

Florida is a no-fault state for the first layer of crash costs. Every car policy that meets the state's security requirements must include personal injury protection, which pays up to $10,000 for medical and disability benefits and $5,000 in death benefits, no matter who was at fault. To get the medical part, you generally must receive your first treatment within 14 days of the crash. A claim against the at-fault driver for pain and suffering is a separate step, and it opens only if your injury meets a legal threshold.

Key takeaways: see a doctor or go to the emergency room within 14 days; expect PIP to cover 80% of reasonable medical bills and 60% of lost income, up to $10,000 in total; and know that PIP does not decide who is responsible for the crash.

What PIP pays for

Section 627.736 of the Florida Statutes sets the required benefits. In plain terms:

• Medical bills. PIP pays 80% of reasonable expenses for medically necessary care, including hospital, surgical, X-ray, dental, rehabilitative and ambulance services, but only if you start treatment within 14 days.
• Lost income. PIP pays 60% of gross income you lose because the injury keeps you from working, plus reasonable costs of hiring others to do ordinary household services you would have done yourself.
• Death benefit. $5,000 per person, paid in addition to the medical and disability benefits.

All three share the same $10,000 pot for medical and disability benefits. A hospital stay can use that up quickly, which is why the rest of this guide matters.

Who gets PIP benefits

You do not need to be the driver. The statute covers the named insured, relatives living in the same household (with some exceptions), people driving the insured car, passengers, and pedestrians the insured car strikes. If you own a car and are hurt as a pedestrian or while riding in someone else's car, your own policy is usually the first place to turn.

The 14-day rule

This is the part that costs people money. The 80% medical benefit applies only if you receive initial services and care within 14 days after the crash. Waiting for the pain to "settle down" can forfeit the benefit entirely.

The statute also limits who can provide that first round of care. It lists physicians (medical and osteopathic), dentists, chiropractic physicians, advanced practice registered nurses, hospitals and facilities owned by hospitals, and licensed emergency transport. Follow-up care generally needs a referral from one of those providers. The statute states that massage therapy and acupuncture are not covered medical benefits.

The $2,500 cap and the "emergency medical condition"

The full $10,000 is available for medical care only if a qualifying provider determines you had an emergency medical condition. The statute names physicians, dentists, physician assistants and advanced practice registered nurses as the providers who can make that call. If a provider finds you did not have one, medical benefits are limited to $2,500.

This is why the paperwork from your first visit matters. Ask the provider whether an emergency medical condition determination was made, and keep a copy of the record.

How and when PIP gets paid

• PIP benefits are generally due within 30 days after the insurer receives written notice of the covered loss and its amount. Late payments accrue interest.
• Bills must be submitted on standard forms, and there are filing windows for medical providers. A provider's missed deadline is not supposed to become your bill, but it can delay payment.
• If the insurer denies or reduces a bill, it must give you an itemized explanation. Before anyone can sue the insurer over PIP, a written "demand letter" must be sent, which gives the insurer 30 days to pay.
• The statute says a demand letter pauses the limitations period for 30 business days.

Disputes with your own insurer are a different kind of claim from a claim against the at-fault driver. They follow different rules and different deadlines.

What PIP does not do

PIP is a first-layer benefit, not a full recovery. It does not pay for pain and suffering. It does not replace the income you lose beyond 60%. It does not cover damage to your car; that is a property damage claim. And it stops at $10,000 for medical and disability benefits.

When you can claim against the other driver

Florida limits when an injured person can recover damages for pain, suffering, mental anguish and inconvenience from a driver whose vehicle carried the required security. Section 627.737(2) allows that recovery only if the injury consists in whole or in part of one of the following:

1. significant and permanent loss of an important bodily function;
2. permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement;
3. significant and permanent scarring or disfigurement; or
4. death.

Whether an injury meets one of those categories is a medical question first and a legal one second. A doctor's opinion about permanence is usually the key piece of evidence, and the other side can ask the court to test whether you will be able to show it before trial.

You can still pursue the at-fault driver for expenses PIP did not pay, such as medical bills above the $10,000 limit or the 20% of medical costs and 40% of lost income that PIP leaves behind. The statute bars you from recovering the amounts PIP already paid or owed, so a claim against the other driver is about the gap.

Property damage and the other driver's coverage

Florida requires owners to keep at least $10,000 in property damage liability coverage (Fla. Stat. § 324.022), which is what pays for the other person's car if you cause a crash. The state's required coverages focus on PIP and property damage, and they do not require most drivers to carry bodily injury liability coverage. In practice, that means the at-fault driver may have little insurance for your injuries. Your own optional coverages, such as uninsured or underinsured motorist coverage, may matter a great deal. Check your policy's declarations page.

What to do in the first days

1. Report the crash. The statute requires the driver of a vehicle involved in a crash with injury, death, or apparent property damage of $2,000 or more to notify local police, the sheriff, or the Florida Highway Patrol right away (Fla. Stat. § 316.065).
2. Get examined within 14 days. Do it even if you feel only sore. Say you were in a crash and describe every symptom.
3. Give your insurer prompt written notice and keep a copy. Use your own words; do not guess about fault.
4. Keep records. Medical bills, explanation-of-benefits letters, pay stubs, photos, and the police report number.
5. Be careful with the other insurer. You are not required to give a recorded statement to the other driver's insurance company, and it is reasonable to speak with a lawyer first.

When to talk with a lawyer

PIP is simple on paper and complicated in practice. Consider an attorney if the insurer denies or cuts bills, if you suspect you are developing a permanent injury, if lost income is large, or if the other driver may be uninsured. Rodriguez & Williamson, PLLC offers free, confidential consultations in English or Spanish, and works on a contingency-fee basis for qualifying personal injury matters. See our car accident lawyer page for how we handle these cases, or the personal injury overview.

General information, not legal advice. Reading this page does not create an attorney-client relationship, and every case depends on its own facts. For qualifying personal injury matters the firm works on a contingency-fee basis, so attorney fees are not collected unless there is a recovery. Last updated: 2026-10-16.

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