Payment of Medical Expenses Resulting from a Motor Vehicle Accident

When someone is injured in an accident as a result of someone else’s negligence it is a traumatic event which can have a dramatic effect on the person’s entire life.  One has to contend with the injuries, the stress of losing time from work, the damage to ones vehicle, the medical care, the unknown effect these injuries will have on the individuals life and future, and if that wasn’t enough, the worry over the amount of medical expenses and how they will be paid.  An accident can be a truly life altering event.

Florida is a No-fault state, which means your own motor vehicle insurance policy covers your medical expenses in the event of a motor vehicle accident, regardless of fault.  Florida law provides that every owner or registrant of a motor vehicle purchase insurance which is to include Personal Injury Protection coverage or PIP.  Basic PIP coverage essentially pays for 80% of reasonable expenses for medically necessary care, 60% of lost wages, and $5,000 death benefit or the remainder of unused PIP benefits, whichever is less.  If you are a passenger and do not own a vehicle, then you would be covered under either a policy owned by a relative who lives with you or the vehicle owner/drivers policy.

Oftentimes PIP is inadequate to cover all of your medical expenses and then there the 20% balance for which one is personally responsible.  Many insurance policies offer supplemental products to cover these expenses.  Extended PIP or additional PIP increases the percentage PIP pays to 100%, however, it does not increase the aggregate limit.  Med Pay (Medical Payments Coverage) is designed to cover the 20% not paid by PIP as well as any amounts over the $10,000, up to the limit obtained.  This does increase the aggregate limits by the amounts obtained, e.g. $1,000, $2,000, etc. Be aware that most policies require that the insurer be reimbursed for any Med Pay payments made in the event there is a recovery for the injuries sustained.

Even with the supplemental coverage’s mentioned above; many times the medical expenses will exceed the monies available from the insurance.  Depending on the amount of medical expenses and the ability of the individual to pay, one may qualify for emergency Medicaid.  Most hospitals provide assistance in applying for this benefit or one can apply through the local Medicaid office.  Medicaid has a statutory right to be reimbursed for any benefits paid if there is a recovery for the injuries sustained.

Finally, the person at fault for the accident is responsible for the injuries caused as a result of their negligence.  As such, they must pay for all out of pocket expenses, which include medical bills, anything not paid by PIP or other insurance, any liens, and lost wages, among other damages.  In addition, in Florida if the threshold is met: significant and permanent loss of an important bodily function, permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement, significant and permanent scarring or disfigurement, or death; one can recover for pain, suffering, mental anguish, and inconvenience.

Though a motor vehicle accident is a traumatic and life changing event, it does not necessarily have to be a financial catastrophe.  There are a multitude of options available to help minimize the financial impact of an accident, which allows the individual to focus on their therapy and their health.

Franklin Domenech, Esq., is an experienced personal injury attorney with Bogin, Munns, & Munns, P.A., a full service law firm with offices in Orlando, Clermont, Kissimmee, Deltona, Daytona Beach, Ocala, Melbourne, Gainesville, and Leesburg, Florida.  Mr. Domenech works out of the Kissimmee office of the firm and welcomes questions and comments regarding the above and can be reached at fdomenech@boginmunns.com.

NO LEGAL ADVICE: This blog entry is not intended as legal advice nor should you consider it as such. It is intended only as general information.  You should not act upon this information without retaining professional legal counsel. Please keep in mind that merely subscribing to or reading this blog or otherwise contacting Bogin Munns & Munns, P.A. in the manner that you have will not establish an attorney-client relationship with our firm. Bogin Munns & Munns, P.A. cannot represent you until the firm knows there would not be a conflict of interest, and the firm determines that it is otherwise able to accept the engagement. The engagement would also be confirmed by a written agreement.

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