Personal Injury Protection (PIP) Claim Filing And Billing Requirements In Florida
Personal Injury Protection benefits are to allow you to get access to medical coverage as soon as possible, without having to fight says our Cooper City personal injury attorney at Law Offices of Bradley S. Hartman, P.A.
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November 3, 2018

Florida is one of few states with no-fault auto insurance laws. In Florida, all motorists registered in the state are required to purchase a minimum of $10,000 in car insurance coverage, also known as Personal Injury Protection (or “PIP”) benefits.

PIP benefits are available to Florida registered motorists regardless of their fault in a car accident. It does not matter if you are fully at fault, partially responsible, or did not contribute to the accident at all, PIP allows you to obtain medical coverage without having to waste your time on negotiations with the other party, their lawyers, and insurance companies involved.

What is Personal Injury Protection and how does it work in Florida?

“The purpose of Personal Injury Protection benefits is to allow you to get access to medical coverage as soon as possible, without having to fight over who was liable in the accident,” says our Cooper City personal injury attorney at Law Offices of Bradley S. Hartman, P.A.

The only downside to the PIP coverage is that it offers only a relatively small amount of coverage (in the event of a severe injury, $10,000 will most likely not help you reimburse even half of the medical expenses).

However, in no way does it mean that obtaining medical coverage through your PIP policy will be a trouble-free process presenting no difficulties whatsoever. In fact, there are quite a few detailed and strict requirements you need to follow in order to obtain PIP coverage.

“Florida’s PIP statute is comprised of a number of requirements that you must follow when making a claim to your insurance company,” says our experienced personal injury attorney in Cooper City.

Requirements for filing PIP coverage claim

Under Florida’s no-fault law, all medical bills and charges for treatment and services provided to the patient to facilitate his or her recovery must be submitted to the insurance provider within 35 days of the date the treatment or service was rendered.

Insurance companies have a right to deny your PIP benefits request if you submit your medical bills outside the 35-day window. In addition to the time limitations, insurance companies also demand their policyholders to use the Centers for Medicare and Medicaid (CMS) 1500 form or a UB 92 form, which has to be properly and accurately completed by the insured.

Failure to submit a request within 35 days and/or failure to properly fill out the required form may lead to denial of your claim.

When will you get paid on your PIP coverage request?

To make the process of requesting medical coverage through Personal Injury Protection even more complicated, Florida laws also require providers and insured to follow the Physicians’ Current Procedural Terminology (CPT) or Healthcare Correct Procedural Coding System (HCPCS) for the year in which the treatment or services were rendered. Also, insurance providers and their policyholders must follow the CMS 1500 form instructions.

But do not be naïve to think that the insurance provider will accept your request and/or provide coverage the same day you make the request. Under Florida law, insurers have 30 days from the date the request was received to provide coverage. Failure to pay within these 30 days means that the insurance provider’s bill is overdue.

Get a free consultation from a personal injury lawyer

Since even the tiniest mistake can lead to denial of your PIP claim, it is highly advised that you consult with a Cooper City personal injury attorney in order to ensure that you are following all filing requirements.

A lawyer can also help you minimize the risk of insurance companies unfairly denying your PIP coverage when you submitted a properly completed claim in a timely manner. Do not forget to keep track of all the bills you submit to the provider.

Schedule a free consultation with our lawyers at Law Offices of Bradley S. Hartman, P.A. by calling at 954-438-1000 .

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