Florida is one of the few states that has a no-fault insurance law, but does not have mandatory bodily injury liability. To explain further: in order to be legal to drive/own a motor vehicle in Florida, you need only have insurance that covers yourself and the passengers in your car (no-fault or PIP insurance) and property damage liability, which will pay for damage to another vehicle or other property caused by your negligence. You do not need to have insurance that will pay for for injury to other people outside your car who you may injure in an accident! So, in addition to all of the people who are driving illegally on our roads (meaning that they do not have any insurance, or have allowed their insurance policies to lapse–yet they continue to drive), there are many people who are driving legally, with the insurance the law requires, but without the insurance that will assist you if they cause an accident and cause you bodily injury or physical harm.
Given this reality, the only way to protect yourself and your family and passengers in your vehicle is to purchase what is called Uninsured or Underinsured Motorist Coverage. This provides a fund of money that you can claim against in the event that you have been harmed by someone else in a motor vehicle accident and they either do not have bodily injury liability coverage to compensate you, or they do not have enough coverage to compensate you fully.
While Uninsured or Underinsured Motorist claims are made on your own insurance policy, it is an adversarial claim with your insurance company. In other words, just like a liability claim against someone insured by another company, your company is now in effect having to cover for the negligence of another party who was uninsured or underinsured. Therefore, their goal is to compensate your claim (if at all) as modestly as possible.
As in most insurance claims, there is a very simple adversarial relationship: The insurance company makes their profits by collecting premiums and minimizing what they pay out in claims. Meanwhile. your interest is in trying to be as fully compensated for your losses by the insurance company as possible. This does not put you and the insurance company on the same side! To get a fair recovery, you either need to know how to fairly evaluate your claim, or have legal representation.
Florida’s No-Fault Insurance Law
As a no-fault auto insurance state, drivers in Florida are required to carry auto insurance that pays personal injury protection, or PIP benefits. The PIP benefits pay up to 80% of medical expenses and 60% of lost wages.
Minimum PIP benefits in Florida are $10,000. When a crash occurs, each person involved in the crash has to turn to their own policy to pay the cost of their medical care and other losses. It does not matter who is at fault for the accident. This portion of auto insurance is a personal coverage, rather than a coverage that is attached to the vehicle.
This can be confusing. Here’s an example: If I am in your vehicle with you, and another driver runs a red light or a stop sign, or is speeding ,or is in some way negligent and causes an accident with us, and I have medical bills or lose time at work as a result of the accident, I have to claim my no-fault benefits on my own insurance policy (assuming I own a car). So that means that even though I am in your car, and even though someone else was at fault for the accident, I have to turn to my own insurance company for this particular benefit. In fact, even if I do not own a vehicle, if I live with a relative who owns a vehicle, I must claim the no-fault benefits on their policy. If I do not own a vehicle, and do not live with a relative who owns a vehicle, then I can claim my no-fault benefits on the policy of the vehicle I was in at the time of the accident. The only time I can claim no-fault benefits on the policy of the driver and owner of the vehicle that hit me is if I am injured as a pedestrian, and I do not own a vehicle or live with a relative who owns a vehicle!
We often explain to people that there are four separate claims that happen in an automobile accident. (1) Your property damage claim to get your car replaced or fixed (you often do not need a lawyer for this type of claim, because there is a finite value); (2) a no-fault claim for medical and wage benefits (as long as you can identify which company should pay it, you also should not need a lawyer for this); (3) a bodily injury claim against the at-fault parties (owner and driver of the at-fault vehicle); and finally (4) an Uninsured/Underinsured Motorist claim against your own insurance company (providing you carry this coverage).
Florida’s Injury Threshold / What Does Permanent Injury Mean?
In order to make a bodily injury claim against the at-fault parties in Florida, the injuries resulting from the auto accident have to be considered to be “permanent.” This is the injury threshold. Injuries are considered to be permanent if they result in significant and permanent scarring or disfigurement or significant and permanent loss of important bodily function. As we often explain to our clients, this does not mean that you have to be disabled as a result of an accident. Certainly more serious accidents that result in the need for surgeries, involving broken bones, loss of a limb, vision, paralysis, or death would automatically qualify under Florida law. More often, though, people end up with injuries to their spines or joints that result in permanent limitations or chronic pain. These, too, can qualify as permanent injuries. A simple way to look at it is: have you 100% returned to the state of health you were in before you were injured? If you have not, then arguably you have sustained a permanent injury.
Unless your injury has resulted in the need for some kind of immediate surgery, it is often difficult to tell shortly after an accident whether or not you have sustained or will sustain a permanent injury. It really depends on how you recover over the ensuing months, and sometimes years. It is therefore important to understand the full extent of your injuries before any potential case you may have can be fully resolved.
Soft Tissue Injuries
More often than not, the injuries people sustain in a typical minor to moderate car accident are what is commonly referred to as “soft tissue injuries.” This means that there are no broken bones and no objectively verified damage to your spine or one of the joints of your body (that can be identified in an x-ray or MRI), but nevertheless, you experience pain and limitations that you did not have before the accident. While these injuries can be quite debilitating, particularly for people who rely on their physical strength and mobility as part of their occupation, insurance companies tend to undervalue and discount the importance of these issues in people’s lives.