Seek Immediate Medical Treatment After an Accident

PIP (personal injury protection) insurance benefits is required to be purchased by everyone who owns a vehicle in the state of Florida. The law requires that at a minimum, $10,000 of benefits be purchased in PIP coverage. PIP is a first-party medical coverage and will help cover your medical expenses, lost wages, and even can be used to reimburse you for things like lawn care, housekeeping and other things losses that result from an accident no matter who is at fault for the accident.

These benefits are not without limitation.  If you do not seek medical attention right away for your injuries, you risk getting disqualified for receiving these benefits.   After an accident, people who have no visible injuries tend to make a decision to forgo going to the emergency room. Even when soreness begins to set in, many people put off going to the doctor and assume the pain will get better on its own. Injury and soreness to the neck or back rarely resolves itself without some sort of therapeutic medical treatment.  The decision to forego immediate medical attention can have significant consequences.  Under current Florida law, you are only entitled to PIP medical benefits “if the individual receives initial services and care…within 14 days after the motor vehicle accident.” Fla. Stat. Ann. § 627.736(1)(a).

Another nuance to the Florida PIP statute is that in order to collect the full $10,000.00 benefit, a medical provider must determine that you have what’s called an “emergency medical condition” (EMC).  An EMC is described as a condition where the lack of immediate medical treatment may put the patient’s health in serious jeopardy.  According the statutes, only certain medical providers can declare an emergency medical condition.  Providers such as physicians, osteopathic physicians, dentists, physician’s assistants and advanced registered nurses can declare an EMC. Chiropractors are not listed and cannot declare an EMC. If you seek treatment within fourteen days of your car accident but do not obtain an EMC, your coverage may be limited to $2,500.00 pursuant to the dictates of the statue.

If you are in an accident and believe at any point in the future you may need to be treated for injuries, you must seek treatment within fourteen days of the accident and should seek treatment from a medical provider who can declare an EMC and qualify you for all of the benefits that you pay for with your insurance premium.  As a matter of best practice, it is a good idea to get checked out by a physician after any accident to rule out any type of life threatening medical conditions. 

If you have any questions about the complexities of the PIP statute, our lawyers will be happy to provide a free consultation and address any concerns you may have regarding these important benefits you have available to you.  

Florida Personal Injury Protection (PIP)

Everyone who owns a motor vehicle has it, but most people don’t know what PIP is or how it can help you after they have been in a car accident. PIP stands for Personal Injury Protection and is required to be carried by everyone who owns a vehicle in the state of Florida. The law requires that each person maintain a minimum $10,000 PIP coverage.  PIP is a first-party insurance coverage and will help cover your medical expenses, lost wages, and even can be used to reimburse for things like lawn care and housekeeping that are required as a result of your accident.

 Fla.Stat. 627.736 requires that the insurance company provide personal injury protection coverage to all insureds insured in the amount of $10,000. This coverage generally will pay up to 80% of all medically necessary treatment due to the accident. The treatment can include surgery, X-rays, dental procedures, rehabilitative treatment and more. PIP also covers 60% of loss wages that were suffered by the accident. This could include immediate time off due to the accident or time off at later dates for doctor appointments or surgery.

Many people do not know that PIP coverage can help pay for household services that you are no longer capable of doing because of the accident. For example, if you are responsible for your own lawn maintenance and are temporarily or permanently unable to continue this chore on your own, you can be partially reimbursed for the hiring of a lawn service.

Finally, PIP is allowed to pay $5,000 in death benefits if you or a loved one were to be in a fatal car accident or sustain injuries that lead to someone passing away. Obviously there is no amount of money that can comfort you when you have lost a loved one, but people need to understand this benefit is available to relieve some of the financial pressures after the death of a loved one.

         

PIP benefits may be available to more than just the named insured. PIP may extend to household relatives, a friend borrowing your car, passengers, or maybe even someone that was hit by a car walking down the street. Who qualifies for coverage can be difficult to determine sometimes on your own and we would suggest that you contact a personal injury lawyer to discuss questions of coverage.

PIP benefits are here to help you begin to restore your life to the way it was before an accident. You pay for this coverage so do not miss out on the benefits that you are entitled to receive.

Fabre (non-party) Defendants and Trial Procedure

Trial strategy is an important part of the preparation of any claim or claims to be tried before a jury.  Both Plaintiff’s attorneys and Defense attorneys must evaluate their case and determine the best possible way to present evidence to a jury so that it is understood and it creates the best chance of success for the client.  The developing of an effective trial strategy is one of the most important considerations in hiring a trial attorney. 

All trial attorneys are trained in the rules of evidence and trial procedure.  Part of developing an effective trial strategy is the lawyer’s effective use of the rules of evidence and trial procedure.  However, sometimes a trial attorney tries to trap the opposing attorney in the minutia of trial procedure to such a degree that it could be considered “gaming the system.”

Rules governing the use of non-party defendants are particularly complex and sometimes ripe for gamesmanship that denies one side fair access to the judicial system.  A non-party defendant is a person or entity that a Defendant claims may be entirely or partially responsible for damages claimed by a Plaintiff in a civil case.   Fabre v. Marin, 623 So.2d 1182, 1185 (Fla.1993).  This principle is important because a Defendant may avoid financial responsibility for damages if a jury determines a non-party defendant is at fault for the damages claimed by the Plaintiff. 

Complications arise when a Plaintiff is damaged by multiple persons or entities.  The Plaintiff must sue or make claims against all persons or entities who may be responsible and during the course of settlement negotiations, some of the defendants may enter into settlement agreements with the Plaintiff and thus will be dismissed from the lawsuit.  Depending on the circumstances, a Defendant may ask the Court to allow the jury to consider the negligence of a settled Defendant in apportioning the fault of the non-settled Defendant. 

So what happens when a Plaintiff settles against potential Defendant’s and the remaining Defendant asks the Court to have the jury consider the negligence of the settled Defendant’s?  All manner of gamesmanship options can arise for the Defendant.  This is the scenario that the Second District Court of Appeal considered in a recent case.  Edwards v. Rosen, 41 Fla. Law Weekly D295 (Fla. 2nd DCA January 29, 2016).

In the Edwards case, the Plaintiff settled with multiple Defendants prior to trial.  At the start of trial, the remaining Defendant sought to add some of the settled Defendants as non-party Defendants.  The Court allowed the last minute addition and the Plaintiff was forced to adjust its trial strategy to address the arguments associated with the non-party Defendant’s.  However, at the end of the trial, the Defense attorney withdrew his non-party defendant request, which meant that the jury was no longer going to consider any non-party Defendant. 

The Plaintiff had expending much of his trial strategy addressing the Defense arguments that were no longer going to be considered by the jury, instead of addressing the negligence of the Defendant that remained in the case.  The Defense attorney used procedure to force the Plaintiff to argue against one theory, and then at the last minute was able to convince the trial judge to change the theory presented to the jury. 

The District Court of Appeal was not fond of the Defendant’s trial strategy of essentially baiting the Plaintiff’s attorney to argue one way, then requesting something different after the trial was concluded.  The Court ruled that the trial Court abused its discretion allowing the Defense attorney to game the procedure and system as he did.  As a result, the Plaintiff was granted a new trial where he could present his case without being prejudiced by the gamesmanship by a Defense attorney taking advantage of the Rules of Civil Procedure.   

Exclusions, Exclusions, Exclusions!!!!!!!!

Many folks purchase insurance policies and assume they are protected from all manner of legal consequences if their actions inadvertently cause injury to another person.  Many times, you would be right to assume this.  For example, if a person is not necessarily paying attention to the road while they are driving and accidentally rear ends another person, the at-fault party’s liability insurance would protect the at fault driver in the even that he or she was sued. 

However, many insurance policies contain exclusions.  An exclusion in an act that if occurs, will not be covered by the insurance policy.   If an event happens that could potentially fall within an exclusion of an insurance policy, then the insurance company will not pay out money on any claim and it will leave the insured exposed to personal liability for which he or she will be responsible for. 

Some common exclusions in insurance policies in Florida include, Acts of God, Intentional Acts, Criminal Acts exclusions, non-owned vehicle exclusion, workers compensation exclusion, and resident relative exclusion.

Insurance companies write policies and issue exclusions to protect their own financial interests.  However, if an insurance company tells you that and event is an excluded event, you need to have someone look at the claim more closely.  Some acts that cause financial damage or personal injury seem to be excluded under insurance policies but after a closer look, may actually be the exact type of incident that the insurance policy was meant to protect against.  The line between a covered act and an excluded act can often times be very thin. 

If you are involved in any incident where you may have a claim against an insurance company, please consult a lawyer prior to accepting the insurance company’s response that an event is an excluded event.  As a consumer and a person who has potentially been harmed by an event that was not your fault, it is important to make sure your rights are protected.  Don’t let an insurance company tell you that your accident, injury, or damage is not covered by an insurance policy.