Florida Car Insurance Laws

Florida car insurance laws have provisions regarding mandatory limits, and they dictate what type of coverage is made part of a policy.  With respect to medical bills incurred as the result of the accident, Florida car insurance policies are required to contain Personal Injury Protection or PIP coverage.  This is often referred to as no-fault insurance and is common in many states. In Florida, owners of a registered vehicle are required to carry PIP coverage.  The State of Florida may suspend a policyholder's driver license and vehicle registration if the policyholder fails to maintain PIP coverage.

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No-fault PIP benefits are designed to pay the medical benefits of those injured in a car, regardless of who was at fault for the accident.  This means that if you are driving your car, and someone else causes your accident, Florida car insurance law dictates that your own policy always pays for your medical bills.  In Florida, this also includes pedestrians that are struck by a covered vehicle.  This legislation is designed to eliminate delays caused by liability disputes common in car accidents.  Without no-fault laws, a person’s medical care may be placed in jeopardy while the insurance companies fight over which driver was liable for the accident, which could take a significant amount of time.

Along with details about which insurance company will cover which people, the legislation also has strict rules for insurers to abide by, specifically with respect to the time it takes to get a payment issued for medical bills.  If PIP payments are not made within 30 days, a Florida car insurance company is subject to penalties and interest.  If a covered person files a lawsuit against the insurance company for PIP benefits, the insurer is also then responsible to pay for the insured’s lawyer.

Insurance companies have a defense to this 30-day requirement however.  If they can prove that they had “reasonable proof” that would demonstrate that they were not responsible for payment, then the payment cannot be considered overdue.  The question begs, “What is reasonable?”  Currently the law says that if the insurer asserts that the treatment was unrelated to the auto accident, was not medically necessary or was “unreasonable”, or was in excess of what was permitted by law, they do not have to pay and will not be subject to fines for over due payments.

This has been recently confirmed in a recent court decision United Auto. Insurance Co. v. Millennium Diagnostic Imaging Ctr., Inc. (Fla. 3d DCA Case No. 3D08-772, Opinion Filed May 6, 2009).  In that case, the court affirmed that an insurer can challenge treatments at any time, and that they can rely on a report to challenge the treatment if the report was not obtained until after the 30-day time-period had elapsed.

By stating that Florida car insurance company can challenge a treatment at “any time”, the court has made it possible for an insurance company to delay payment for as long as it would take to obtain a report that would refute the need for treatment. 

No-fault PIP coverage is an important aspect of Florida auto insurance and remains one of the most effective means of ensuring that medical bills are paid promptly when people are injured in an auto accident.  Ensuring compliance with PIP insurance laws is undertaken by the Florida Department of Financial Services.

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