Florida PIP Lawyer

Personal Injury Protection: the $10,000 every Florida crash claim starts with

Personal Injury Protection is the no-fault coverage Florida requires on every registered car and the first money paid after almost any crash. It pays regardless of fault, it is yours by contract, and insurers reduce, delay and deny it every day through rules most policyholders have never read. Kemp Law Group has handled PIP disputes for injured clients across Florida since 2008, both as the opening piece of a larger injury claim and as a stand-alone fight over benefits an insurer refuses to pay. This page explains how the coverage works, how it gets cut, and what the law lets you do about it, including what changed in 2023.

Call (727) 847-4878 or contact us online for a free review of your PIP denial or your crash claim. We answer 24/7.

What PIP pays, and the three rules that shrink it

Under section 627.736, PIP pays 80 percent of reasonable medical expenses and 60 percent of lost wages, plus replacement services, up to $10,000 per person, with a death benefit of up to $5,000 paid from whatever part of that limit remains. Medical charges are paid under a fee schedule tied to 200 percent of Medicare Part B, and most policies carry a deductible of up to $1,000 that comes off the top. Three provisions decide whether you see the full $10,000 or a fraction of it:

• The 14-day rule. You must receive initial services and care within 14 days of the crash, from a hospital, ambulance, physician, osteopath, dentist, chiropractor or supervised practitioner. Miss the window and PIP pays nothing for the injury, however serious.
• The emergency medical condition finding. The $10,000 medical benefit is available only if a physician, osteopath, dentist, physician assistant or advanced practice registered nurse determines you had an emergency medical condition. Without that finding, medical benefits stop at $2,500. A chiropractor cannot make the finding, which is why a patient who treats only with a chiropractor often sees benefits end at $2,500 without understanding why.
• Who is covered and in what order. PIP follows the person, not the car. Your policy covers you and the relatives living in your household, whether you were driving, riding as a passenger in someone else’s car, walking, or on a bicycle. Passengers who own no insured vehicle look to the policy on the car they were in. Motorcyclists have no PIP at all, which changes everything about a motorcycle claim.

How insurers cut PIP benefits

PIP carriers have a short list of tools, and they use the same ones in nearly every file.

• No emergency medical condition on record. If no qualified provider documented the finding, the carrier closes the file at $2,500 and calls it the statute, which it is. The fix is a proper examination and finding early, not an argument later.
• Paper reviews. A physician who never examined you reviews the bills and opines that treatment was not reasonable, related or necessary. Payment stops from that date forward.
• Independent medical examinations. Section 627.736(7) lets the insurer require an examination by a doctor of its choosing. An “unreasonable refusal” to attend ends benefits, and the examiner’s finding of no further need for treatment is used to cut them off.
• Examinations under oath. Attendance is a condition of coverage under 627.736(6)(g). Insurers schedule them to look for inconsistencies, prior injuries, and anything that supports a misrepresentation defense.
• Fee schedule reductions and delay. Bills paid at less than the schedule allows, or paid late. Benefits are overdue if not paid within 30 days after the insurer receives written notice of a covered loss, and overdue payments carry interest. An insurer with a reasonable belief that fraud was committed can take an additional 60 days to investigate, but it must say so in writing within the first 30.
• The 14-day rule, applied strictly. Urgent-care visits that didn’t generate the right record, or a first appointment on day 15.

Your remedies when a PIP insurer won’t pay

PIP is a contract claim, and the statute sets out the sequence. Before any lawsuit, the insurer must be served with a pre-suit demand letter under section 627.736(10) that identifies the claim, the provider and the exact charges at issue, with an itemized statement attached. The insurer then has 30 days to pay the overdue amount, plus a statutory penalty of 10 percent (capped at $250) and interest, and avoid suit. Many denials are reversed at this stage once the demand is drafted precisely enough to be enforceable. If the insurer still refuses, the claim is filed as a breach of contract, usually in county court, and a written insurance contract carries a five-year limitations period.

What changed in 2023. For decades, section 627.428 required an insurer that lost a PIP suit to pay the policyholder’s attorney’s fees, which made it economical to sue over a $600 underpayment. The 2023 tort reform repealed that statute for policies issued or renewed after March 24, 2023. What remains: fee awards in a declaratory action after a total coverage denial under section 86.121; fee exposure through proposals for settlement under section 768.79; the fraud provisions of 627.736 itself; and the old rule for policies that incepted before the repeal. The practical result is that a PIP suit now has to be worth bringing on its own numbers, and the pre-suit demand carries far more of the weight. We tell clients that plainly before a suit is filed, and we file the ones that make sense.

PIP and the rest of your injury claim

For most clients, PIP is the first $10,000 of a much larger recovery, and the two have to be managed together.

• PIP does not reduce what the at-fault driver owes beyond the benefits PIP paid or should have paid, which section 627.736(3) sets off from the tort recovery. The 20 percent of medical bills PIP never covers, everything above $10,000, lost wages beyond 60 percent, and pain and suffering once the permanent-injury threshold is met are all claims against the at-fault driver’s bodily injury coverage and your own uninsured motorist coverage.
• Your PIP carrier has no lien on your recovery. Unlike health insurers and Medicare, a Florida PIP insurer generally cannot take back what it paid from your settlement with the at-fault driver section 627.736(3) says so in terms, and the carrier’s only reimbursement rights run against commercial vehicles under section 627.7405 and against owners who carried no insurance at all under section 627.733(4), never against your settlement. PIP money is yours to keep.
• The PIP record is the threshold record. The emergency medical condition finding, the treating physicians’ notes and the continuity of care that keep PIP flowing are the same evidence that proves a permanent injury later. A sloppy first 30 days costs twice.
• Exhaustion and the health insurer. When PIP exhausts, bills move to health insurance, to medical payments coverage if you bought it, or to treatment under a letter of protection, each with its own repayment rules at settlement. We sequence them to leave the most in your pocket.

For medical providers with denied or reduced PIP bills

Clinics, imaging centers, orthopedic and chiropractic practices treating crash patients under assignments of benefits face the same tools: fee schedule cuts, paper-review denials, demands for records, and silence past 30 days. Kemp Law Group reviews provider PIP disputes, prepares the 627.736(10) demand for each disputed bill, and litigates the claims that justify it. We are candid about the 2023 fee repeal: for policies issued or renewed after March 24, 2023, the insurer no longer pays your lawyer when you win, so the fee arrangement is set with you up front, in writing, and the first review is free. If your practice is accumulating denied bills, send us the explanation of benefits and the demand history, and we will tell you which ones are worth pursuing.

Where we handle PIP claims

Kemp Law Group represents injured people and providers throughout Florida and in Georgia, from our office at 11567 Trinity Boulevard in Trinity. See our pages for Pinellas, Pasco and Hernando counties, for South Florida, Central Florida, Southwest Florida and North Florida, and for Georgia, where there is no PIP and a crash claim follows Georgia’s at-fault rules.

Frequently asked questions about Florida PIP

Do I really have to see a doctor within 14 days?

Yes. Section 627.736 makes initial treatment within 14 days a condition of PIP medical benefits, with no exception for feeling fine at first. If you are reading this inside the window, go today, to a hospital, urgent care, physician or chiropractor, and tell them it was a crash.

Why did my PIP stop at $2,500?

Because no physician, osteopath, dentist, physician assistant or nurse practitioner documented an emergency medical condition. Without that finding, the statute limits medical benefits to $2,500. A chiropractor cannot make the finding; a referral to a physician who can is often the fix, if the medical facts support it.

Does using my PIP raise my insurance rates?

Florida law prohibits an insurer from surcharging you for an accident in which you were not substantially at fault, and PIP is paid without regard to fault. Using the coverage you paid for is not a reason to expect a rate increase.

Do I have to attend the insurer’s medical exam and examination under oath?

Both are conditions of the policy, and an unreasonable refusal ends benefits. Attend, with preparation. We prepare clients for both and attend the examination under oath, because what is said there is used in the PIP file and in the injury claim that follows.

I was a passenger and don’t own a car. Where does my PIP come from?

From a policy in your household if a relative you live with has one; otherwise from the policy on the car you were riding in. If neither exists, there is no PIP, and the claim proceeds against the at-fault driver’s coverage with your medical bills paid through health insurance or a letter of protection in the meantime.

Can I still sue the other driver for the medical bills PIP didn’t pay?

Yes. The 20 percent PIP leaves unpaid, everything above the $10,000 limit, and your other losses are recoverable from the at-fault driver, subject to Florida’s comparative negligence rule. Pain and suffering requires meeting the permanent-injury threshold in section 627.737.

Is it still worth suing over a PIP denial after the 2023 changes?

Sometimes. The pre-suit demand letter resolves many disputes, and a suit is still right where the amount is meaningful, where the insurer made a total coverage denial (which opens a path to fees under section 86.121), or where the policy predates the repeal. We review the numbers with you before anything is filed.

If your PIP has been denied, cut off or paid late, or you’ve been hurt in a Florida crash and want the whole claim handled correctly from day one, call (727) 847-4878 or request a free case review online. We answer 24 hours a day, and injury clients pay nothing unless we win.