Personal Injury Protection - PIP

Personal Injury Protection (PIP), also known as no-fault insurance, covers medical expenses and lost wages for you and your passengers if you're injured in an accident. PIP coverage protects you regardless of who's at fault.

It is primary against all other forms of medical and disability insurance coverages, EXCEPT worker compensation benefits (PIP is excess over WC).
Medical Payments coverage is issued on an excess basis to coordinate with PIP coverage (Medical Payments only pays amounts in excess of the 80% of reasonable expenses covered by PIP).

• PIP is primary to Medical Payments coverage
• PIP is excess to Workers’ Compensation

(Injury Amount – Deductible Amount) X PIP Benefit % (80% in most instances) = PIP Recovery

Keep in mind if you do the math and the dollar amount exceeds $10,000 then the max PIP recovery is $10,000.

When you calculate a PIP recovery the calculated PIP recovery amount can never be greater than $10,000.

PIP Deductibles: $0, $250, $500 or $1,000

Example 1:

Injury amount: $6,000
Deductible: $500
PIP Benefit: 80%
⇒    6,000 -500 = 5,000 X 80% = 4,000
⇒    PIP Recovery = $ 4,000

Example 2:

Injury amount: $20,000
Deductible: $1,000
PIP Benefit: 80%
⇒    20,000 -1000 = 19,000 X 80% = 15,200
⇒    PIP Recovery = $ 10,000 , because the maximum PIP payout is $10,000 no matter how great is the injury amount

No-fault PIP – 10,000 benefits:

• Medical benefits (Pays for 80% of the expenses, within 14 days of the accident and provided by a licensed medical care provider) plus $2500 for non-emergency
• Work loss benefits (Pays up to 60% of income loss)
• A household services benefit (Reimburse 100% of household services performed by others)
• Death Benefit ($5,000 additional to PIP $10,000)

Medical payments only pay amounts over the 80% covered by PIP.

PIP benefits 

A) For the named insured:

In Florida:

1. While occupying any motor vehicle

2. When struck by a motor vehicle while not occupying the vehicle

Outside of Florida:

1. While occupying an insured motor vehicle

2. While occupying the vehicle of a resident relative, if insured for PIP

B) For relatives who reside with the named insured:

In Florida:

1. While occupying any motor vehicle

2. When struck by a motor vehicle while not occupying the vehicle

Outside of Florida:

1. Only when occupying a named insured’s motor vehicle

C) PIP benefits to other persons:

In Florida:

1. Extends to other person while occupying a named insured’s motor vehicle

2. When struck by a motor vehicle while not occupying the vehicle extends to the uninsured person

The owner of a motor vehicle has to fund PIP for oneself and all residing family members provided they are not owners themselves.