AUTOMOBILE ACCIDENT QUESTIONS & COVERAGES
Over the past several weeks I have had the opportunity to meet with several clients all of whom have had their lives changed by automobile accidents. Unfortunately, in some of these cases, my clients have lost loved ones, or sustained significant injuries in these automobile accidents. Several, if not most, were unaware of who would pay for the property damage to their vehicles, whether their insurance company is required to repair their car (when the insurance company considers the car a “total loss”), and who is responsible to pay for the medical bills.
Unfortunately, in some cases, we discovered that there was nothing my office could do to help these victims because of the lack of insurance coverage available to them to pay their damages, or the damages from the loss of a loved one. Remember, simply because another driver may crash into your car, you should not always expect the other driver to be properly insured, and in the most tragic of cases, insured at all, so that you will be able to recover for your damages. Remember, in Florida the only insurance required by state law to operate an automobile is PIP and Property Damage Liability coverage. Bodily Injury coverage is not required, although I personally believe it should be required. Therefore, I would encourage anyone reading this blog to consider purchasing UM coverage for those situations in which you may find yourself injured by an uninsured driver.
As a result of these interactions, I thought it would be helpful to those of you viewing my blog to read a primer on the insurance converge which may be available to you and those which are mandatory in Florida.
Insurance Coverages:
Bodily Injury Coverage (BI): This coverage which the at-fault driver may have that will cover your injuries and will compensate you for your injuries. However BI coverage is not mandatory in Florida and there are many drivers who do not carry BI coverage. If you were hit by a motorist who did not carry BI coverage and that driver has no assets to pay for your damages, then your claim may not be worth pursuing, or you may need to pursue a UM claim (see below). If the driver does have BI coverage the insurance carrier will only pay amount to the limits of the policy (i.e., a $10,000/$20,000 will only pay up to $10,000.00 to anyone person injured in an accident and a maximum of $20,000 for all persons injuries from an accident).
Personal Injury Protection (PIP): This coverage is the insurance through your own automobile insurance company which pays for your or your family’s medical care and treatment or lost wages or income whether or not you cause the accident or some else is at fault, up to the limits of the policy. This is sometimes referred to as “NO Fault” insurance. These polices are mandatory in Florida and are usually limited to $10,000.00 and then only pay 80% of the medical bills, or 60% of the lost wages or income as a result of the accident. You are responsible for paying the other 20% of medical bills, or submitting them to your health insurance carrier. Once you have exhausted, or used up all of your coverage, you are responsible for paying your own medical expenses.
Regardless of whether you have health or hospitalization insurance, Florida Law requires drivers who are employed in Florida, have children in school in Florida, resides in Florida, or have operated a vehicle in Florida for more than 90 days during the preceding 365 days, to carry PIP coverage in a minimum amount of $10,000.00.
Medical Payments (MedPay): This is supplemental coverage offered by your insurance company which will pay for your or your family’s medical bills not covered by PIP coverage. It will pay the 20% not covered by PIP up to the limits of the policy. Following the exhaustion of this coverage, you are responsible for paying your own medical expenses.
Uninsured/Underinsured Motorist Protection (UM): This is the coverage provide by your insurance company which will cover you and your family for your medical bills, lost wages, and other economic and non-economic damages not covered by PIP, MedPay, or in the situation where the driver who ran into you either does not carry BI coverage, or does not have sufficient BI coverage to pay or compensate you for your losses and injuries.
Property Damages Liability Coverage (PD): This is insurance which is required by the State of Florida and provides coverage to repair the damage to a vehicle which you damaged in an accident. This is the only other coverage which is required by Florida Law. The mandatory minimum coverage is $10,000.00.
Comprehensive Coverage (COMP): This is coverage afforded to you by your insurance company which covers losses from incidents other than an accident such as damage from hail, fire, theft, vandalism, etc. Many of these types of policies have a deductible which must first be paid by you before the insurance company pays any money.
Collision Coverage (COLL): Collision insurance coverage pays for damage caused to your vehicle in an automobile accident and the other driver who is at fault does not have Property Damage Liability Coverage or does not have enough coverage to pay for all the damage to your car. Most standard collision automobile insurance policies will pay for any repairs up to the fair market value of your car. It is important to remember that this value can be significantly lower than the cost of replacing your vehicle (or your loan balance.) If your car is financed or leased, you will need to consider purchasing gap insurance to reimburse you for the difference between what you owe and what the car is worth.
Gap Insurance (GAP): Because most comprehensive and collision policies only cover the fair market value of a car (usually only 80% of what you paid for your car), you should consider gap insurance depending how much you owe on your car. If you are involved in an auto accident and your car is totaled in the accident many times my clients are left with the unfair reality that they still owe money on their car, even though it is a total loss, and end up having to pay off the loan on the car they cannot drive. A gap insurance policy insures you for the difference between what you owe on your car and what an insurance company claims is the fair market value of the car.
Auto Accident FAQ’s
Who will pay my medical bills?
Residents, persons with children in school in Florida, persons who work in Florida and anyone who operates a vehicle in Florida for more than 90 days in the preceding 365 days are required to carry Personal Injury Protection (PIP) insurance. This insurance will pay 80% of your medical bills up to the limits of the policy. You will be responsible for the other 20% unless you have a MedPay supplemental policy. The remaining 20% can be submitted to your health insurance carrier or hospitalization insurance carrier. If you do not have health or hospitalization insurance, you will be responsible to pay these medical bills as they are in your name. This is true regardless of who is at fault in the accident. The at-fault driver’s liability insurance carrier will be responsible for reimbursing the damages you have suffered as a result of being injured in an accident, which would be the medical expenses you have incurred from hospitals, doctors, chiropractors, physical therapists, costs of prescriptions or medical devices prescribed by the physicians treating you for your injuries.
How Do I Make a Personal Injury Claim if I am Injured in an Auto Accident?
A claim for personal injuries sustained in a car accident is based on a claim that the at-fault driver was careless or negligent in operating his/her automobile. You will have to establish that the at-fault driver was either careless or negligent (failed to use reasonable care) in operating the automobile. The issues to be determined are:
Who was at fault or caused the accident – Liability; and
Has someone sustained an injury – Damages; and
Were the injuries caused by the accident – Causation.
What is meant by Florida being a “No Fault” state?
Although Florida is considered a “No Fault” state, there is no state which is a true “No Fault” state. Florida uses a combination of No Fault, as well as the liability system. This means that you are required to carry insurance to protect yourself in the event you are injured in an automobile accident. This is referred to s your Personal Injury protection (PIP) insurance. PIP will pay up to the limits of the policy (generally 80% of the medical bills up to $10,000.00). Beyond the $10,000.00 mark, the at-fault driver can then be held responsible to pay for or reimburse you for the other 20% of the medical bills. See Who Will Pay My Medical Bills?
What is a permanent injury?
Under Florida Law, in order to recover for your damages, including non-economic damages, often referred to as pain and suffering damages, an injured person must have sustained a “permanent injury.” According to the Florida Statutes, drivers may “recover damages in tort for pain, suffering, mental anguish, and inconvenience because of bodily injury, sickness, or disease arising out of the ownership, maintenance, operation, or use of such motor vehicle only in the event that the injury or disease consists in whole or in part of:
(a) Significant and permanent loss of an important bodily function.
(b) Permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement.
(c) Significant and permanent scarring or disfigurement.
(d) Death.
According to the Florida Courts, in order to prove a “permanent injury” a driver must establish the presence of a permanent injury within a reasonable degree of medical probability. This means that the driver must present expert testimony from a physician, chiropractor, or other qualified expert that the injured person suffered an injury from the accident. A driver’s “mere recitation of …subjective complaints of pain is insufficient” to establish a permanent injury. However, the Florida Supreme Court has ruled that “subjective evidence of pain (from an injured party) may properly be used to meet requirement of no-fault statute that plaintiff prove existence and permanency of injury, provided that expert medical testimony is presented to establish the existence and permanence of pain within reasonable degree of medical probability.
What is meant by the Threshold Requirement?
In order to file suit and recover for your damages, including non-economic damages, an injured driver must have sustained one of the four factors required by the Florida Statutes. Without meeting or establishing one of these requirements your case may be dismissed by the Courts. See What is a Permanent Injury?
I Ride A Motorcycle. Do I Need PIP Coverage?
Florida's No-Fault, or "PIP Law" does not apply to motorcycles; however, the Financial Responsibility Law applies to ALL motor vehicles in Florida, including motorcycles. Thus the voluntary purchase of motor vehicle liability insurance by an owner, operator or owner/ operator is highly recommended. If you operate a motorcycle and cause an accident you can be held liable for the injuries you have caused in the accident. If you do not carry insurance and cause an accident you can be required to obtain “full coverage” including liability, PIP, etc. and file an SR-22 form before you are able to register or operate a motorcycle or any other motor vehicle in the State of Florida.
If you would like further information regarding automobile accidents or any other issue related to an injury whether as the result of an automobile accident, trucking accident, motorcycle accident, pedestrian accident, death of a loved one from an accident, or any other injury matter, please feel free to call Mark P. Cressman at the Cressman Law Firm. The offices of the Cressman Law Firm is located at 13330 West Colonial Drive, Suite 140, Winter Garden, Florida 34787. Mark P. Cressman may also be reached for questions or comments at 407-877-7317; email at mark@cressmanlaw.com; or at the firm website www.cressmanlaw.com.