Florida PIP Insurance: What Personal Injury Protection Pays, the 14-Day Rule, Lost Income and Death Benefits, and How PDL Fits
Riskado
Florida personal injury protection (PIP) pays injury benefits after a covered car crash, no matter who caused it. Every vehicle that must be registered in Florida needs it, with a $10,000 limit for medical and disability benefits and a separate $5,000 death benefit, under Fla. Stat. § 627.736 (opens in a new tab). The standard benefit pays 80% of reasonable, medically necessary medical expenses and 60% of lost gross income and earning capacity. Initial treatment must come within 14 days of the crash, and if a qualified provider finds no emergency medical condition, medical reimbursement is limited to $2,500. Property damage liability (PDL) is a separate required coverage: at least $10,000 for damage you cause to other people's property.
Key takeaways
- RequiredEvery vehicle that must be registered in Florida carries PIP, paying regardless of fault.
- Limits$10,000 for medical and disability benefits, plus a separate $5,000 death benefit.
- Percentages80% of reasonable, medically necessary medical expenses and 60% of lost gross income and earning capacity.
- DeadlinesInitial treatment within 14 days; $2,500 limit if a qualified provider finds no emergency medical condition.
- PDLA separate required coverage of at least $10,000 for damage to other people's property.
What Florida PIP pays
Under § 627.736 (opens in a new tab), a Florida PIP policy pays four kinds of benefits:
- Medical benefits: 80% of reasonable expenses for medically necessary medical, surgical, X-ray, dental and rehabilitative services, plus medically necessary ambulance, hospital and nursing services, when initial care comes within 14 days.
- Disability benefits: 60% of lost gross income and loss of earning capacity caused by the injury.
- Household services: reasonable expenses for ordinary and necessary services you'd have done yourself for your household without pay.
- Death benefit: $5,000 per person, on top of the medical and disability benefits.
Medical and disability benefits share the $10,000 limit. Disability benefits must be paid at least every two weeks. Because the statute sets the standard at 80% for medical bills, the remaining 20% and anything above the limit may fall to other coverage or to you. Ask your agent what percentage your policy pays, since your declarations page shows the PIP coverage you actually bought.
Is PIP required for your vehicle?
Yes, for an ordinary registered car. Florida's no-fault law requires security on every owner or registrant of a motor vehicle that must be registered in Florida, under Fla. Stat. § 627.733 (opens in a new tab). The Florida Department of Highway Safety and Motor Vehicles (FLHSMV) treats PIP as a prerequisite to registering a vehicle and matches insurer reports against its vehicle records, according to its insurance verification procedure (opens in a new tab).
A few vehicle types are handled differently. FLHSMV doesn't require proof of insurance at registration for self-propelled vehicles with fewer than four wheels, trailers, mobile homes, motorcycles or government-owned vehicles. Our article on Florida car insurance requirements covers every registration rule.
How much of a medical bill PIP pays
PIP pays 80% of reasonable expenses for medically necessary care, up to the limit. The statute also lets insurers limit reimbursement to 80% of a schedule of maximum charges tied to Medicare and other benchmarks, so the amount a provider bills isn't always the amount PIP uses.
Some care isn't covered at all. Medical benefits don't include massage therapy or acupuncture, regardless of who provides them, under § 627.736 (opens in a new tab). Care must be lawfully provided by qualifying providers or facilities.
Lost income and household services
PIP replaces 60% of the gross income and earning capacity you lose because the injury keeps you from working. It also pays reasonable expenses for household services you can no longer do yourself, such as the ordinary chores you'd have handled without pay.
Keep pay stubs, an employer's earnings statement and receipts for any help you hire. The insurer can ask for wage documentation before it pays.
The 14-day rule
To use PIP medical benefits, you must receive initial services and care within 14 days after the crash. The Florida Department of Financial Services (DFS) Spanish guide to applying for auto insurance (opens in a new tab) gives the same deadline.
If you're hurt, get checked within that window, even if the injury seems minor at first, and tell your insurer about the crash promptly. Missing the 14-day window can leave the medical benefit unavailable.
When the $2,500 limit applies
The $10,000 figure is the full limit, but the statute ties it to an emergency medical condition. Reimbursement for initial and follow-up care is available up to $10,000 when a qualified provider determines the injured person had an emergency medical condition, under § 627.736 (opens in a new tab). When a provider listed in the statute determines there was no emergency medical condition, reimbursement for that care is limited to $2,500.
The lower limit isn't automatic. It turns on the provider's determination, so ask your treating provider and your insurer which determination was made and how it affects the claim.
Hover or tap a row to highlight it.
| Benefit or rule | What the statute provides |
|---|---|
| Medical benefit | 80% of reasonable, medically necessary covered expenses |
| Disability benefit | 60% of lost gross income and loss of earning capacity |
| Medical and disability limit | $10,000 |
| Limit without an emergency medical condition | $2,500 |
| Death benefit | $5,000 per person, in addition to the $10,000 |
| Initial treatment deadline | Within 14 days after the crash |
Who Florida PIP covers
PIP isn't only for the policyholder. Under § 627.736 (opens in a new tab), it covers:
- The named insured.
- Relatives living in the same household, unless excluded under the statute.
- People operating the insured vehicle.
- Passengers in the vehicle.
- Other people struck by the vehicle who are hurt while not riding in a self-propelled vehicle.
That last group includes pedestrians and bicyclists struck by the vehicle, subject to the statute's conditions. Which policy pays first can depend on whether the injured person has PIP of their own, so ask the insurer which policy is primary for each injured person.
Can you waive PIP or change it?
You can't drop PIP from a car that must be registered in Florida, but you can change how it pays. Under Fla. Stat. § 627.739 (opens in a new tab), insurers must offer deductibles of $250, $500 and $1,000, and they must offer an option to exclude lost income and earning capacity benefits. The deductible or exclusion can apply to the named insured alone or to the named insured and dependent relatives in the household.
A deductible applies to all PIP benefits except the death benefit, according to the DFS Automobile Insurance Toolkit (opens in a new tab). Excluding lost income lowers the premium, which the toolkit notes some retirees or people without wages consider. Ask how each choice would change both the premium and what you'd collect after a crash.
What PIP doesn't cover
An insurer may exclude PIP benefits in these situations, under § 627.736 (opens in a new tab):
- The named insured or a household relative hurt while occupying another vehicle they own that isn't insured under the policy.
- Someone driving the insured vehicle without the insured's express or implied consent.
- An injured person who caused the injury intentionally.
- An injured person hurt while committing a felony.
PIP also doesn't pay for massage therapy or acupuncture, and it never pays for damage to someone else's property. That is the job of PDL.
How PDL fits next to PIP
PDL is property damage liability. It pays for damage to or destruction of another person's property caused by your vehicle, subject to the policy limit and exclusions. Every owner or operator of a vehicle that must be registered in Florida must be able to pay at least $10,000 for property damage in any one crash, under Fla. Stat. § 324.022 (opens in a new tab), usually through a PDL policy.
Hover or tap a row to highlight it.
| Personal injury protection (PIP) | Property damage liability (PDL) | |
|---|---|---|
| What it pays | Your covered medical, disability and death benefits | Damage you cause to someone else's property |
| Fault | Pays regardless of fault | Pays when you're legally responsible |
| Florida minimum | $10,000, plus a $5,000 death benefit | $10,000 per crash |
| Statute | § 627.736 (opens in a new tab) | § 324.022 (opens in a new tab) |
PDL doesn't pay for your own car. Collision coverage does that when you buy it. Think of the two required coverages this way: PIP is for injuries, PDL is for other people's property.
How PIP works with other insurance
PIP benefits are primary under Florida's no-fault law, with a few coordination rules, under § 627.736 (opens in a new tab):
- Workers' compensation benefits you receive are credited against PIP benefits.
- Medicaid coordination rules apply when Medicaid pays or becomes liable for related care.
- Medical payments coverage on your auto policy is secondary to PIP, according to the OIR's PIP notification form (opens in a new tab). It may or may not pick up the 20% PIP doesn't pay and the deductible, depending on your policy.
- Bodily injury liability is a separate claim against the at-fault driver's policy for injury or death they caused. It isn't the same as your own PIP benefits.
If you're deciding whether to add medical payments or uninsured motorist coverage on top of PIP, our article on whether PIP is worth it covers those choices in general terms.
How to file a Florida PIP claim
A PIP claim follows a set of statutory deadlines, under § 627.736 (opens in a new tab):
A Florida PIP claim, step by step
- Right after the crashNotify your insurer as soon as you can; the policy may require written notice.
- Within 14 daysReceive initial medical services and care.
- As care continuesYour provider submits bills and records; you send wage proof if the insurer asks.
- Within 30 days of written noticeBenefits are overdue if the insurer hasn't paid after it receives written notice of the covered loss and amount, with statutory exceptions.
- If a billing error is flaggedYou have 15 days after the insurer's explanation to submit a revised claim.
- If fraud is suspectedThe insurer must notify you within 30 days, may take 60 more days to investigate, and must pay with interest or deny no later than 90 days after the claim.
Keep the crash report number, medical records, itemized bills, wage documents, receipts for household help and every letter from the insurer. If the insurer reduces or denies part of a claim, it must explain what it cut. If you still disagree, contact the DFS Division of Consumer Services at 1-877-MY-FL-CFO (1-877-693-5236), according to its contact page (opens in a new tab), and ask about the automobile mediation program. Our article on how to file a car insurance claim covers the general process.
Can a PIP claim raise your premium?
It can, depending on the insurer's rating plan. No Florida rule says every PIP claim raises a premium. Once an insurer confirms surcharges or accidents, it may apply an additional premium as of the effective date, according to the DFS auto FAQ (opens in a new tab). A private passenger auto policy's outline of coverage must describe the credit or surcharge plan being applied, under Fla. Stat. § 627.4143 (opens in a new tab). Ask your insurer how its plan treats a PIP claim in your situation.
What the "51% rule" has to do with PIP
Florida's modified comparative fault rule affects lawsuits, not PIP. Under Fla. Stat. § 768.81 (opens in a new tab), a claimant's damages in a negligence action are reduced by their share of fault, and a party found greater than 50% at fault for their own harm can't recover damages. Chapter 2023-15, Laws of Florida (opens in a new tab) made the change. It took effect on March 24, 2023, applies to causes of action filed after that date unless the act provides otherwise, and doesn't impair rights under an insurance contract in effect on or before that date.
None of that changes your PIP percentages, the 14-day rule or the $10,000 limit. PIP pays regardless of fault; the 50% bar matters only if you bring a separate injury lawsuit.
Spanish resources, license checks and complaints
DFS publishes its Automobile Insurance Toolkit, Filing an Auto Claim guide and Automobile Mediation Program brochure in English and Spanish on its consumer guides page (opens in a new tab). More Spanish materials, including insurance FAQs and consumer tips, are listed on its all documents page (opens in a new tab). FLHSMV's insurance verification documents are in English, so use the FLHSMV (opens in a new tab) materials or contact the agency for help in another language.
Check an agent or agency in the Florida insurance license lookup (opens in a new tab), where you can search by name, license number or National Producer Number, according to DFS (opens in a new tab). Riskado's directory lists Florida insurance agencies by city and by category if you want to talk through PIP options with one.
Questions to ask an agent
- What PIP limit is on my declarations page?
- Does my policy pay 80% of medical expenses and 60% of lost income, or did I choose modified benefits?
- Did I elect a PIP deductible, and does it apply to my household?
- Did I exclude lost income or earning capacity?
- How does the emergency medical condition determination affect my available limit?
- Which policy pays if a passenger, pedestrian or bicyclist is hurt?
- What PDL limit is on the policy, and what does it exclude?
- How does the policy coordinate with health insurance, workers' compensation, Medicaid, medical payments and uninsured motorist coverage?
- What notice does the policy require after a crash?
- How does the insurer's surcharge plan treat a PIP claim?
Check what you know about Florida PIP
Frequently asked questions
Can you opt out of PIP in Florida?
Not on a vehicle that must be registered in Florida. You can choose a $250, $500 or $1,000 deductible or exclude lost income benefits under § 627.739 (opens in a new tab), but PIP stays on the policy.
What percentage of lost income does Florida PIP pay?
PIP pays 60% of lost gross income and loss of earning capacity, within the $10,000 limit it shares with medical benefits. Disability payments must be made at least every two weeks.
What happens if I don't have PIP?
Without the required PIP and PDL in force, FLHSMV can suspend your registration and driver license after notice. Our article on driving without insurance in Florida covers the penalties and reinstatement fees.
Does PIP pay funeral costs?
PIP includes a $5,000 death benefit per person, separate from the $10,000 for medical and disability benefits. The DFS Spanish guide describes it as up to $5,000 for funeral expenses.
How long does an insurer have to pay a PIP claim?
Benefits are generally overdue if not paid within 30 days after the insurer receives written notice of the covered loss and its amount. A fraud investigation can extend that, but the insurer must pay or deny within 90 days.
The two steps that protect a PIP claim
Get initial care within 14 days of the crash, and tell your insurer right away. Then keep every bill, wage record and insurer letter together, and check your declarations page for the PIP percentage, deductible and any lost income exclusion so you know what to expect before the first payment arrives.
Key terms
Tap a term to see what it means.
Personal injury protection (PIP). Florida's required no-fault coverage that pays covered medical, disability, household services and death benefits regardless of fault.
Emergency medical condition. A provider's determination that controls whether PIP medical reimbursement can reach $10,000 or is limited to $2,500.
14-day rule. The requirement to receive initial services and care within 14 days after the crash to use PIP medical benefits.
Disability benefit. PIP's payment of 60% of lost gross income and loss of earning capacity.
Property damage liability (PDL). Coverage for damage your vehicle causes to someone else's property, at least $10,000 in Florida.
Lost income exclusion. An option under section 627.739 that removes PIP's lost income benefits in exchange for a lower premium.
Medical payments coverage. Optional auto coverage that is secondary to PIP in Florida.
Modified comparative fault. The 2023 rule that bars a party more than 50% at fault for their own harm from recovering damages in a negligence lawsuit.
