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By Editorial Research Team · Florida injury guide ·

Florida PIP Insurance Claim After Car Accident: Steps, Deadlines and Limits

A Florida PIP insurance claim after car accident starts with your own insurer, because Personal Injury Protection (PIP) pays first no matter who caused the crash. PIP provides $10,000 in coverage, but it only pays medical benefits if you get initial treatment within 14 days of the crash (Fla. Stat. § 627.736). Report the claim to your insurer right away and see a doctor inside that window. If your injuries go beyond what PIP covers, you may have other options, including a claim against the at-fault driver. This guide walks Tallahassee drivers through each step.

Disclaimer: This guide is published by an independent information service and does not constitute formal legal advice. It is not affiliated with any law firm. For representation, consult a licensed Florida attorney.

How Does Florida’s No-Fault Law Work After a Car Accident?

Under Florida’s no-fault law, your own PIP coverage pays part of your medical bills and lost income after a crash, regardless of fault (Fla. Stat. § 627.736). The same rules apply on I-10, Capital Circle, Tennessee Street or any other Leon County road.

The system rests on two required coverages. Every owner of a registered vehicle with four or more wheels must carry $10,000 in PIP and $10,000 in Property Damage Liability (PDL). PIP protects you and certain family members. PDL pays for damage you cause to someone else’s property. Florida does not require ordinary drivers to carry bodily injury liability, which is a big reason so many crashes here involve underinsured drivers.

The trade-off is a limit on lawsuits. In exchange for prompt no-fault benefits, you generally can’t sue the other driver for pain and suffering unless your injury meets a statutory serious injury threshold, covered later in this article.

The no-fault system has been debated in the Legislature more than once, and proposals to change it come up regularly. The rules described here reflect the Florida Statutes cited throughout, including the 2023 tort reform (HB 837). Check the current statutes or ask a licensed Florida attorney before relying on any detail for your own claim.

Who Has to Carry PIP in Florida?

Registered owners of vehicles with four or more wheels, such as cars, pickups and SUVs, must carry PIP and PDL. Motorcycles are treated differently and don’t carry the same PIP requirement.

PIP can also reach beyond the policyholder. Resident relatives in your household are typically covered, and some passengers and pedestrians may be covered under a household policy or the policy of the vehicle they were riding in. Which policy applies depends on residency and on whether the injured person owns a vehicle, so read the policy or ask the insurer which one responds.

Does No-Fault Mean Nobody Is Blamed?

Fault still matters in Florida, just not for your first-line medical benefits. It controls:

What Is the Florida PIP 14-Day Rule?

The PIP 14-day rule in Florida means you must receive initial medical treatment within 14 days after the crash for PIP to pay medical benefits (Fla. Stat. § 627.736). Missing that window is the most common way people lose coverage they paid for.

Initial care must come from an eligible provider or be provided under that provider’s direction. Typical examples include:

In Tallahassee, that can mean the emergency department at Tallahassee Memorial HealthCare or Capital Regional Medical Center, an urgent care center, or a primary care office. Which provider you choose matters less than whether the visit happens in time and is documented.

There is a second layer. To reach the full $10,000, a qualified provider must determine that you had an emergency medical condition (EMC). If no emergency medical condition is determined, medical benefits are limited to $2,500 (Fla. Stat. § 627.736). Chiropractors can provide initial treatment, but they generally can’t make the EMC determination on their own, so a chiropractic-only path can leave you stuck at the lower cap.

What Counts as Initial Treatment Under the 14-Day Rule?

Initial treatment is the first qualifying exam or care for crash-related injuries from an eligible provider.

Generally qualifies:

Generally does not qualify on its own:

Keep the date of that first visit written down, along with the provider’s name and any paperwork you receive. If the insurer later disputes timing, that record settles the question.

What If I Didn’t Feel Hurt Until Days Later?

Delayed symptoms are common, especially whiplash, back strain and concussion, and the 14-day clock still runs from the day of the crash. If you feel stiff, foggy or sore a day or two later, don’t wait to see whether it goes away.

Gaps in care cause a second problem. If you see a doctor on day five, stop for six weeks, then return, the insurer may argue the later treatment isn’t related to the crash or isn’t medically necessary. Follow your provider’s treatment plan, and tell them plainly if symptoms persist.

Florida PIP $10,000 Coverage Explained

Florida PIP $10,000 coverage is a ceiling, not a guarantee of full payment: PIP pays 80% of reasonable medical expenses and 60% of lost gross income, up to the limit (Fla. Stat. § 627.736).

Two details trip people up:

  1. The $2,500 limit. If no emergency medical condition is determined, medical benefits are limited to $2,500 (Fla. Stat. § 627.736).
  2. The amount PIP recognizes. PIP pays reasonable charges under the policy’s terms, so the amount it recognizes can be lower than the amount a provider bills.

A simple example (numbers are illustrative, and your policy’s deductible and terms will control): say you have a $500 PIP deductible and the crash leaves you with $8,000 in recognized medical charges and $2,000 in lost gross income.

ItemCalculationPIP pays
Medical($8,000 − $500 deductible) × 80%$6,000
Lost income$2,000 × 60%$1,200
Total$7,200

You’d be left with the deductible and the 20% medical share, which a health plan or MedPay coverage may help with. And you’d have only $2,800 of your PIP limit remaining.

What Does PIP Pay For and Not Pay For?

Typically coveredTypically not covered
Emergency room careVehicle repair or replacement
Doctor visits and follow-upsPain and suffering
X-rays, MRIs and other diagnosticsThe 20% medical share and the deductible
Physical therapy and rehabTreatment found not medically necessary
Surgery and hospital staysMassage therapy and acupuncture
60% of lost incomeMedical costs beyond the $10,000 limit
Some replacement services, per policy terms

Collision coverage or the at-fault driver’s PDL handles the car, not PIP.

How Long Does PIP Take to Pay?

Florida’s PIP statute puts time limits on insurers to pay or deny a covered bill once they receive notice of the loss and the amount (Fla. Stat. § 627.736). Ask your insurer which deadline applies to your claim and keep a record of when each bill was submitted.

In practice, delays happen. Insurers request records, order an independent medical exam, or question whether treatment was necessary. If your claim stalls, the statute provides remedies for overdue benefits, and a lawyer can explain how they apply to your situation.

How to File a Florida PIP Insurance Claim After a Car Accident, Step by Step

File with your own insurance company, not the other driver’s, and do it quickly. Here is the sequence most Tallahassee drivers should follow.

  1. Get medical care right away. Go to the ER, an urgent care, or a doctor within 14 days, sooner if you can. Tell the provider you were in a car crash and describe every symptom.
  2. Report the crash. Call law enforcement from the scene. In Tallahassee, that may be the Tallahassee Police Department, the Leon County Sheriff’s Office or the Florida Highway Patrol, depending on where you are. Ask the responding officer how to get the crash report number and a copy of the report.
  3. Notify your insurer. Call the claims line or use the app as soon as possible. Give the date, location and basic facts, and stick to what you know.
  4. Complete the PIP application. Your insurer will send a form asking about your injuries, other coverage and employment. Answer carefully and return it promptly.
  5. Make sure providers bill PIP. Give each provider your claim number and policy information so bills go to the right place.
  6. Submit income proof if you missed work. Pay stubs, an employer letter or tax records are common.
  7. Keep records. Save medical bills, explanations of benefits, receipts, mileage to appointments, photos, and every email or letter from the insurer.
  8. Track your benefit balance. Ask for periodic PIP payment logs so you know how much of the $10,000 is left.

What Information Will My Insurer Ask For?

Expect requests for:

Accuracy counts. Small inconsistencies, like the date of your first symptoms, can become reasons to question a claim. You generally have a duty to cooperate with your own insurer, but take a moment before a recorded statement. Review your facts, don’t guess, and say you don’t know when that is the truth. You usually have no obligation to give a recorded statement to the other driver’s insurer.

What If My PIP Claim Is Denied or Delayed?

Start by asking for the reason in writing. Common reasons include:

From there, ask your provider to correct billing errors, submit missing records, and request a re-review. Some denials can be challenged through the insurer’s internal process, the Florida Department of Financial Services consumer helpline, or formal legal steps. If a denial leaves you with unpaid treatment, it is reasonable to talk to a lawyer before any deadlines pass. A PIP lawsuit would generally be filed in Leon County court if the crash and your residence are in the area.

What to Do When PIP Benefits Are Not Enough in Florida

When PIP benefits are not enough in Florida, you have several other sources to check, because serious crashes can exhaust $10,000 in days. An ambulance ride, ER visit, CT scan and a single night in the hospital can use most of it.

Pull out your declarations page now and see what you actually bought. Many people don’t know whether they carry MedPay or UM/UIM until they need it.

Can I Sue the At-Fault Driver After Using PIP?

You can, if your injury meets Florida’s threshold. Under the no-fault statutes, you can pursue non-economic damages like pain and suffering if you suffer:

Even without meeting the threshold, you may still recover economic losses that PIP didn’t cover, such as medical bills beyond PIP and lost wages. If you meet the threshold, damages can also include future medical care, reduced earning capacity, and non-economic losses. Whether you meet the threshold usually depends on medical opinion, so documentation matters.

Fault is weighed too. Since HB 837 took effect in 2023, Florida applies modified comparative negligence: a claimant found more than 50% at fault for their own harm cannot recover damages, and a claimant at 50% or less has damages reduced in proportion to their share of fault (Fla. Stat. § 768.81). This rule does not apply to medical negligence actions.

What Is Uninsured/Underinsured Motorist Coverage and Why Does It Matter?

UM/UIM coverage pays you when the at-fault driver has no insurance or not enough. This matters in Florida because the minimum required coverage doesn’t include bodily injury liability. A driver who hits you may carry only the required $10,000 PDL and have nothing to pay for your injuries.

UM/UIM is usually offered when you buy a policy, and you can reject it in writing or choose lower limits. If you’re hurt by an uninsured driver and you carry UM, your own insurer steps into the other driver’s shoes. Those claims can still be contested, so keep records and meet policy deadlines.

What Is the Statute of Limitations for a Florida Car Accident Claim?

Negligence claims that arise on or after March 24, 2023 must generally be filed within two years (Fla. Stat. § 95.11). Before the 2023 change (HB 837), the limit was four years, so the date of the crash determines which period applies.

Other claim types have their own rules, and wrongful death and claims against government entities can follow different timelines. Some policy provisions also carry shorter notice requirements, so don’t treat two years as a safe default for every situation. A licensed Florida attorney can confirm the deadline that applies to your case.

Do I Need a Lawyer for a PIP Claim in Florida?

A simple PIP claim with minor injuries, prompt treatment and no dispute can often be handled without a lawyer, but a denial, a billing dispute, a serious injury or another driver’s insurer can change that.

Many car accident lawyers may offer a free initial consultation and may handle injury cases on a contingency basis, which means no attorney’s fee unless there is a recovery. Practices vary by firm, so confirm both points before you sign anything. Fee arrangements for PIP disputes can differ from those in injury lawsuits, so ask directly how fees would work in your situation.

Questions worth asking a Tallahassee car accident lawyer:

None of these automatically means you need a lawyer, but each is a reason to at least get a professional opinion:

How Much Does a Car Accident Lawyer Cost in Florida?

Many injury lawyers charge a contingency fee, meaning a percentage of the recovery rather than hourly billing. Under Rule 4-1.5 of the Rules Regulating The Florida Bar, a contingency fee agreement must be in writing and signed by both the client and the lawyer, and the client must receive a Statement of Client’s Rights.

For personal injury cases, the rule sets presumptively reasonable maximums: 33⅓% of any recovery up to $1 million if the case resolves before an answer is filed (or the time to answer expires), and 40% of any recovery up to $1 million after that point through trial. Lower percentages apply to amounts above $1 million (Rule 4-1.5 of the Rules Regulating The Florida Bar). These are general limits, not a quote, and an individual agreement may be lower. Ask for the fee agreement in writing and have the lawyer explain how costs such as filing fees, experts and records are handled and when they are deducted.

Common Mistakes That Hurt Florida PIP Claims

This article is general educational information, not legal, insurance or financial advice, and reading it doesn’t create an attorney-client relationship. It was written by the Editorial Research Team of Florida injury guide, an independent information service that is not affiliated with any law firm, insurer or provider, and it has not been reviewed by a licensed attorney. The legal points come from the Florida Statutes (§§ 627.736, 95.11 and 768.81, as amended by the 2023 tort reform, HB 837) and Rule 4-1.5 of the Rules Regulating The Florida Bar. You can read the primary sources on the Florida Legislature’s statutes site and at The Florida Bar.

Florida laws, including no-fault rules, comparative negligence and filing deadlines, can change, and your situation may differ. Consult a licensed Florida attorney or your insurer about your specific claim. Time limits apply, so don’t wait.

Frequently Asked Questions

How long do I have to see a doctor after a car accident in Florida for PIP?

You have 14 days from the crash. Initial treatment must come from an eligible provider within that window for PIP to pay medical benefits (Fla. Stat. § 627.736).

How much does PIP pay in Florida?

Up to $10,000, covering 80% of reasonable medical expenses and 60% of lost gross income. If no emergency medical condition is determined, medical benefits are limited to $2,500 (Fla. Stat. § 627.736).

Does Florida PIP cover passengers?

Often it does. A passenger may be covered under the vehicle owner’s policy or under their own household policy, depending on residency and which vehicles they own. Check the specific policies.

Does PIP pay if the accident was my fault?

It does. PIP is no-fault coverage and pays regardless of who caused the crash, subject to its terms and limits.

What happens when PIP runs out in Florida?

You can turn to health insurance, MedPay or UM/UIM coverage, or pursue the at-fault driver if your injury meets the serious injury threshold.

Does PIP cover lost wages in Florida?

It does. PIP pays 60% of lost gross income within the $10,000 limit, with proof of the loss (Fla. Stat. § 627.736).

Do I need a lawyer for a PIP claim in Florida?

Minor, undisputed claims are often handled without one. A lawyer becomes more useful for denials, serious injuries, or when PIP benefits aren’t enough.

Will my rates go up if I file a PIP claim?

That depends on your insurer and who was at fault. A PIP claim alone doesn’t automatically raise rates, but an at-fault crash can affect premiums. Ask your insurer directly.

Can I choose my own doctor for PIP in Florida?

Generally you can, among eligible provider types. The provider must bill PIP properly and the treatment must be medically necessary and related to the crash.