What Is PIP Insurance in Florida: No-Fault Rules and 14-Day Limit

PIP insurance in Florida, short for Personal Injury Protection, is the mandatory no-fault coverage that pays up to $10,000 toward your own medical bills and lost wages after a car accident, regardless of who caused the crash. Every vehicle owner registered in the state has to carry it, and you draw from your own policy first before anyone else’s insurance comes into play. The coverage has sharp edges: a 14-day deadline to see a doctor, an 80/20 split on medical bills, and a $2,500 cap if your injury isn’t classified as an emergency medical condition.

How No-Fault Works in Florida

Florida Statute 627.733 requires everyone who owns or registers a motor vehicle in the state to maintain PIP continuously throughout the registration period.¹ After a crash, you file with your own insurer for your initial medical costs and wage losses, not the other driver’s. The point of the system is to get money to doctors quickly and cut down on lawsuits over smaller injuries.

One important boundary: motorcycles aren’t classified as “motor vehicles” under the No-Fault Law, so motorcycle owners carry no PIP obligation and have no PIP benefits to draw on after a crash. Riders rely on health insurance, MedPay, or a claim against an at-fault driver instead.

What PIP Pays For

The $10,000 policy limit covers three categories of loss, and they all come out of the same pot. Heavy medical bills can leave little left for wage replacement.

Medical expenses at 80 percent. PIP pays 80 percent of reasonable and medically necessary costs: hospital visits, surgery, rehabilitation, dental work, X-rays, prosthetics, and ambulance services. You owe the remaining 20 percent.²
Lost income at 60 percent. If injuries keep you from working, PIP reimburses 60 percent of your lost gross income and earning capacity, paid at least every two weeks. On a $3,000 monthly salary with two months off, that’s $3,600 of a $6,000 loss, assuming medical bills haven’t already consumed the policy.³
Death benefit of $5,000. If a covered person dies from accident-related injuries, PIP pays a separate $5,000 for funeral and final expenses, on top of the $10,000 in medical and disability benefits.²

The 80/20 split surprises most drivers. People hear “$10,000 of coverage” and assume it means $10,000 of free care. In practice, you owe 20 percent of every medical bill on top of any deductible you chose when buying the policy.

The 14-Day Rule and the Emergency Medical Condition Cap

Two rules can shrink or wipe out your PIP benefits.

First, you must receive initial medical services within 14 days of the accident. Wait longer and your insurer can deny the entire claim.² This is a hard cutoff. Drivers who feel fine at the scene and develop neck or back pain three weeks later often find out too late that they’ve lost coverage.

Second, the full $10,000 is only available if a licensed physician, dentist, physician assistant, or advanced practice registered nurse determines you have an “emergency medical condition.” If the provider says it isn’t one, your total PIP benefits are capped at $2,500.² A soft-tissue injury that generates $8,000 in treatment will only draw 80 percent of $2,500 under that cap. Where you go for initial treatment, and what that provider documents, controls which number applies.

Who Your Policy Covers

PIP benefits extend beyond the named insured. Under Florida law, coverage reaches:³

You, whether driving your own vehicle, riding in someone else’s, or struck as a pedestrian.
Relatives in your household by blood, marriage, or adoption, unless they own a Florida-registered vehicle and need their own policy.
Anyone driving your car with permission.
Passengers in your vehicle at the time of the crash.
Pedestrians and cyclists you hit, if they don’t have their own PIP policy or access to another vehicle owner’s coverage.

Coverage follows a priority order. A person’s own PIP always pays first. If they don’t have a policy, the policy on the vehicle they occupied applies. For pedestrians without a car of their own, the policy on the vehicle that struck them is the last layer.³

PIP also pays before your private health insurance, Medicare, or Medicaid. Those don’t kick in on accident-related care until PIP is exhausted, and some plans require proof of that before they’ll process a claim.

Deductibles and the Real Out-of-Pocket Math

You can lower your premium by electing a deductible. Insurers must offer options of $250, $500, and $1,000.⁴ The deductible applies to 100 percent of your expenses before PIP starts paying. The death benefit isn’t reduced by it.

Say you carry a $1,000 deductible and run up $5,000 in medical bills. You pay the first $1,000. PIP then covers 80 percent of the remaining $4,000, which is $3,200. You owe the other $800 as your co-pay. That’s $1,800 out of pocket on a $5,000 bill. A higher deductible means a lower monthly premium, but a bigger bite if you ever use the coverage.

What PIP Will Not Pay

Florida law allows insurers to exclude benefits in a few specific situations. The two statutory exclusions are injuries you cause to yourself intentionally and injuries sustained while committing a felony.³ If someone is charged with a felony tied to the accident, the insurer can hold PIP payments until the criminal case resolves. Dropped charges or an acquittal restart the 30-day payment clock.

Benefits can also be denied if you’re hurt while riding in another vehicle you own but didn’t insure under this PIP policy, or if someone was driving your car without permission.³ Own two cars and insure only one? If you get hurt driving the uninsured one, your other PIP policy won’t help you.

DUI isn’t on the list of standalone exclusions, which surprises people. A DUI charged as a felony (a third offense or one causing serious bodily injury) can trigger the felony exclusion and let the insurer hold benefits during the criminal case, but a basic DUI isn’t an automatic bar to coverage.

When You Can Still Sue the At-Fault Driver

No-fault doesn’t close the courthouse door entirely. You can step outside the system and sue for pain, suffering, mental anguish, and inconvenience if your injuries meet one of these thresholds:⁵

Significant and permanent loss of an important bodily function.
Permanent injury (other than scarring or disfigurement), established within a reasonable degree of medical probability.
Significant and permanent scarring or disfigurement.
Death.

A broken arm that heals cleanly usually doesn’t clear the bar. A herniated disc requiring surgery and leaving chronic pain generally does, but you’ll need medical evidence of permanence. Adjusters fight the “significant and permanent” language hard, so documentation from your treating physician carries more weight here than in states without a tort threshold.

Economic damages beyond PIP are a different story. If your medical bills exceed $10,000 or your lost income runs past what PIP covered, you can sue for the overage without meeting the threshold. The restriction only applies to non-economic damages.

Filing a Claim

Notify your insurer as soon as you can after the accident. The 14-day medical clock is already running, so get in to see a doctor without delay. Your insurer will want medical records, hospital bills, diagnostic results, and proof of lost income if you’re seeking wage benefits, along with a completed benefits application describing the crash and injuries. Incomplete paperwork is the easiest reason for an insurer to drag its feet.

Once the insurer has written notice of a covered loss and the amount, PIP benefits are overdue if not paid within 30 days.² Partial payments or denials have to come with an itemized explanation of each reduced or declined amount and a contact person for follow-up. Overdue amounts accrue interest.

If the Insurer Underpays or Denies

Florida law requires a formal demand letter before you can sue your insurer over PIP. The letter must be titled “demand letter under s. 627.736” and include the insured’s name, claim or policy number, the medical provider’s name, and an itemized list of the disputed amounts with dates and treatment types. Send it by certified or registered mail.³

The insurer then has 30 days to pay the overdue claim with interest and a penalty of 10 percent of the overdue amount, capped at $250. Pay in that window, and you can’t sue on that claim.³ Miss it, and you can file suit.

If you win in court, Florida law allows the court to award you reasonable attorney fees against the insurer.⁶ That exposure often moves insurers to settle legitimate claims at the demand letter stage. Keep every bill, payment record, and piece of correspondence. PIP disputes turn on documentation.

What Happens If Your Coverage Lapses

Your insurance company reports any cancellation or lapse to the Florida Department of Highway Safety and Motor Vehicles. Without a replacement policy on file, the state suspends your driver license and vehicle registrations for up to three years or until you meet reinstatement requirements.

Reinstatement requires a new PIP policy and a fee: $150 for the first reinstatement, $250 for the second, and $500 for each additional one within three years of the first.⁷ You then have to maintain proof of coverage for two years. Three clean years resets the fee to $150.

Beyond the fees, driving uninsured strips a key legal protection. Under Florida Statute 627.733, an owner who doesn’t maintain the required coverage at the time of an accident loses tort immunity and becomes personally liable for PIP-level benefits.¹ An injured person can come after you directly for amounts the insurance would otherwise have covered. The policy costs less than that exposure.

1
Florida Senate. Florida Statutes 627.733 – Required Security
2
Florida Senate. Florida Statutes 627.736 – Required Personal Injury Protection Benefits; Exclusions; Priority; Claims
3
Online Sunshine. Florida Statutes 627.736 – Required Personal Injury Protection Benefits; Exclusions; Priority; Claims
4
Online Sunshine. Florida Statutes 627.739 – Personal Injury Protection; Optional Limitations; Deductibles
5
Florida Senate. Florida Statutes 627.737 – Tort Exemption; Limitation on Right to Damages
6
Florida Senate. Florida Statutes 627.428 – Attorney Fees
7
Florida Senate. Florida Statutes 324.0221 – Financial Responsibility; Proof Required Upon Certain Convictions, Revocations, and Suspensions