What If My PIP Coverage Isn’t Enough to Cover My Medical Bills?
Understanding Florida PIP Coverage Limits
Florida requires only $10,000 in PIP coverage, but there’s a critical detail most drivers miss: PIP pays only 80% of medical expenses up to that limit. This means your actual medical coverage is $8,000, not $10,000. With Tampa emergency room visits costing $3,000-$5,000, surgical procedures ranging from $15,000-$50,000+, and physical therapy at $150-$300 per session, PIP coverage quickly depletes in serious accidents.
Additionally, PIP covers only 60% of lost wages, reducing the amount available for medical expenses. Under Florida Statutes § 627.736, you must seek treatment within 14 days of the accident to maintain PIP eligibility.
What Are Your Options When PIP Coverage Runs Out?
If another driver caused your accident, you could file a bodily injury claim against their liability insurance for all damages exceeding PIP coverage. This includes full medical expenses, complete lost wages, pain and suffering, and future medical costs that PIP does not cover.
To pursue this claim in Florida, your injuries must meet the “serious injury threshold” under Florida Statutes § 627.737: significant and permanent loss of an essential bodily function, permanent injury, significant scarring or disfigurement, or death. Most accidents serious enough to exhaust PIP coverage meet this threshold.
You’ll need to prove the other driver’s negligence caused your injuries through police reports, witness statements, medical records linking injuries to the accident, and documentation of all damages.
Use Your Uninsured/Underinsured Motorist Coverage
If the at-fault driver has no insurance or insufficient coverage, your UM/UIM coverage protects you. Florida law requires insurers to offer UM coverage equal to your bodily injury liability limits, though many Tampa drivers unknowingly reject this protection.
UM coverage pays when you’re hit by uninsured drivers (approximately 20% of Florida drivers operate illegally without insurance). UIM coverage activates when the at-fault driver’s limits are too low for your damages, which is common since Florida doesn’t require bodily injury liability coverage.
These claims proceed against your own insurance company, which may dispute your damages just like the at-fault driver’s insurer would.
Submit Remaining Bills to Your Health Insurance
Your health insurance should cover accident-related treatment after PIP is exhausted, subject to your policy’s deductibles and copayments. You may need to prove to your health insurer that PIP coverage has been exhausted.
Important: Your health insurance company has subrogation rights under Florida Statutes § 768.76, meaning they can recover what they paid from any settlement you obtain from the at-fault driver. These liens must be satisfied from your settlement, though experienced attorneys can often negotiate 30-60% reductions in subrogation amounts.
Negotiate With Medical Providers
Contact all medical providers immediately upon exhaustion of the PIP.
Many Tampa medical providers will:
Accept letters of protection, treating you on credit secured by your eventual settlement. Offer payment plans that spread costs over time. Reduce bills by 30-60% for lump sum payment from settlement proceeds. Continue treatment pending case resolution if you have attorney representation.
Don’t ignore medical bills; this can lead to collection efforts, credit damage, and termination of treatment.
What PIP Never Covers (Even When It Hasn’t Exhausted)
Understanding PIP’s limitations explains why you need additional compensation sources:
Pain and suffering are not compensated under PIP. Only 60% of lost wages are covered, leaving 40% of income loss uncompensated. Future medical expenses beyond immediate treatment aren’t addressed. Out-of-pocket expenses like family caregiving, transportation, and household help aren’t reimbursed. Property damage to your vehicle requires separate coverage.
When Should You Hire a Tampa Personal Injury Attorney?
Contact an attorney immediately if:
Your medical bills exceed your PIP coverage limits. You’ve suffered permanent injuries requiring ongoing treatment. The at-fault driver’s insurance company denies liability or offers an inadequate settlement. You’re dealing with UM/UIM claims against your own insurer. You’re unsure of the available compensation sources. Medical providers are threatening to collect or refuse continued treatment.
Attorneys handle bodily injury claims, UM/UIM disputes, health insurance subrogation, and medical lien negotiations while you focus on recovery. Most Tampa personal injury attorneys work on contingency (typically 33-40% of recovery), meaning you pay nothing unless they win your case.
Under Florida Statutes § 768.79, courts sometimes order losing defendants to pay your attorney fees separately from your damage award, meaning you can receive your full settlement without fee deductions.
Critical Deadlines You Must Know
Seek treatment within 14 days of your accident to maintain PIP eligibility under Florida Statutes § 627.736. File bodily injury lawsuits within four years under Florida Statutes § 95.11(3)(a). Respond to insurance company requests promptly to avoid claim denials. Contact attorneys before signing any settlement releases or recorded statements.
Typical Medical Costs That Exceed PIP in Tampa Accidents
Emergency room visits: $3,000-$5,000 before diagnostic tests. CT scans and MRIs: $1,500-$2,500 each. Surgical procedures: $15,000-$150,000 depending on complexity. Physical therapy: $150-$300 per session, 2-3 times weekly for 12-24 weeks. Orthopedic consultations: $500-$1,000 per visit. Hospital stays: $2,000-$5,000 per day.
A moderately serious Tampa car accident requiring emergency treatment, imaging, surgery, and rehabilitation easily generates $50,000-$100,000+ in medical expenses, far exceeding PIP’s $8,000 actual coverage.
How Much Additional Compensation Can You Recover?
Beyond PIP limits, bodily injury claims recover:
All medical expenses, past, present, and future (not just 80%). Full lost wages and reduced earning capacity (not just 60%). Pain and suffering are based on injury severity. Loss of quality of life and enjoyment of activities. Emotional distress from the accident. Property damage to your vehicle.
Typical bodily injury settlements in serious Tampa accidents range from $50,000 to $500,000+, depending on injury severity, permanent disability, and liability strength.
Why Legal Representation Matters After an Auto Accident
After a serious auto accident, recovering compensation often involves far more than filing a basic insurance claim. Florida accident cases can involve PIP benefits, bodily injury liability coverage, uninsured or underinsured motorist claims, comparative fault disputes, and aggressive insurance adjuster tactics designed to limit payouts.
When injuries are serious and medical bills begin to mount, insurance companies often look for ways to reduce claim value, dispute liability, or pressure injured victims into early settlements that do not reflect the true extent of their losses.
Williams Law Association, P.A. helps Florida accident victims pursue the compensation available under all applicable insurance policies and legal claims. Our team investigates the accident, gathers evidence, documents damages, negotiates with insurance carriers, and, when necessary, takes the case to litigation.
We proudly represent accident victims throughout Tampa, St. Petersburg, Clearwater, Brandon, Riverview, Wesley Chapel, and surrounding communities across Hillsborough, Pinellas, and Pasco counties. Since 1995, our firm has recovered more than $300 million for Florida clients.