A doctor talks to a patient

PIP vs Health Insurance: Which One Will Help During an Auto Accident?


After a car accident, you may be wondering what your next steps are — and what type of insurance you’ll be dealing with when you visit a doctor. Florida is a no-fault state, which means you’re required to carry Personal Injury Protection (PIP) insurance, and fault for the accident does not need to be established before you can pay for your medical care. However, you may also have regular health insurance, too. What’s the difference, and which one will you use if you have an auto accident?

PIP Insurance, Defined

Florida law requires that every vehicle (and vehicle owner) must carry $10,000 minimum PIP coverage on their auto insurance policy. This type of insurance is designed to protect drivers. It helps you avoid some of the pitfalls of traditional medical insurance coverage, such as a delayed health insurance policy payout. It also works without the need to establish fault through the court system, so you can see a doctor right away and provide the physician’s office with your PIP claim number for them to bill. PIP insurance typically covers approximately 80 percent of medical expenses and/or 60 percent of lost wages due to an injury.  However, when purchasing your auto insurance coverage, there is an option for work-loss exclusion so check with your insurance agent to see if you have opted for this coverage instead.

PIP vs Health Insurance

There are a few key differences between PIP and health insurance. For starters, regular health insurance does not cover lost wages. Also, many traditional health insurance plans have deductibles that must be paid before benefits kick in. PIP, on the other hand, may have no deductible, or may have a $500 deductible or a $1,000 deductible – these options vary. PIP will also cover any passengers that are in your vehicle if they don’t have their own policy (for example, a non-driver, someone who doesn’t have their own vehicle or a member of your household who qualifies for resident relative status).

Generally, you’ll make your initial claim for injury or lost wage benefits following an accident against your PIP policy, and then if/when those benefits are exhausted, your medical provider can bill your regular health insurance if your physician is a participating provider in your health insurance network.

Important Note About PIP Insurance

One crucial caveat with PIP insurance is that you must visit a medical provider within 14 days of your motor vehicle accident. This is important to note as sometimes a car accident leaves you feeling fine — or mostly fine — and you don’t think you have need of a doctor’s attention. However, some injuries from car accidents can take time to manifest themselves, which can leave you without the benefit of your PIP coverage.

This is why it’s important to see a doctor as soon as possible after your car accident, even if you only have mild symptoms. Additionally, if you get a prompt medical evaluation, injuries can be diagnosed earlier and treatment can begin that can ward off further injury down the road.

Personal Injury Protection First

If you’ve experienced a car accident, see a doctor as soon as possible, preferably one that is experienced with billing PIP insurance. Early evaluation will not only help you recover sooner (and possibly prevent your injury from getting worse) but it is essential to seek treatment before the 14-day window closes so your PIP benefits can cover your treatment.

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