Accident Injuries and Your Car Insurance

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1 Personal Injury Wrongful Death Slip & Fall Automobile Accidents Trucking Accidents Motorcycle Accidents Medical Malpractice Criminal Defense Accident Injuries and Your Car Insurance Critical Details You Need to Know FORT MYERS OFFICE 1533 Hendry Street, Suite 200 Fort Myers, FL Tel: PORT CHARLOTTE OFFICE 2525 Tamiami Trail, Unit F Port Charlotte, FL Tel:

2 Accident Injuries and Your Car Insurance Critical Details You Need to Know Insurance is one of those things in life that we too often take for granted. We know we have to have it but we really don t pay too much attention to it, except when it comes time to pay the monthly premium. Or when you ve been in a motor vehicle accident. In this report, we re going to review some very important topics to help you understand exactly what you re getting for your money when buying car insurance and perhaps more importantly, what you may not be getting. You ll learn about: Different Types of Auto Insurance Coverage IMPORTANT NEW PERSONAL INJURY PROTECTION (PIP) LAW CHANGES Insurance Company Won t Pay For Your Damages? What to Do Next 1

3 Different Types of Coverage - So Many Terms, So Much Confusion Do you even know what the minimum requirements are for purchasing car insurance in Florida? Do you really need collision insurance? Whose damage is covered under my policy mine, the other driver s or both? What if the other driver doesn t even have car insurance? And just what the heck does PIP coverage mean, anyway? Florida is one of 12 states that are regulated by no-fault insurance laws, and many people really don t understand exactly what that means. Under current Florida law, a driver involved in an accident is not required to prove that the wreck was somebody else s fault in order to qualify for Florida no-fault coverage benefits. As a nofault insurance state, Florida requires that all drivers carry Personal Injury Protection, commonly referred to as PIP coverage. JANUARY 1, IMPORTANT CHANGES TO PIP LAWS THAT CAN AFFECT YOU! Personal Injury Protection (PIP) This type of coverage is currently a source of great debate within Florida, because of revisions to the law that just happened in January of This type of coverage, a mandatory requirement in Florida, is meant to pay for 80% medical expenses for injuries caused by an accident, death benefits if a person dies in the crash, and 60% of lost wages from not being able to work. PIP coverage will cover you and/or any passengers* in your vehicle at the time of an accident, or if you are a passenger in someone else s vehicle. *Unless your passenger is covered by their own insurance policy. 2

4 Now, here is some critical news you need to know... The new PIP laws state that if you are injured in an accident, you now have only 14 days from the date of the accident to seek treatment. You will lose the ability to use your PIP coverage if you do not see a doctor within that time frame, even though you paid for the coverage. This makes it critical that you see a medical doctor, orthopedic specialist, an Advanced Registered Nurse Practitioner, (ARNP), or a chiropractic physician immediately. Injuries often don t manifest themselves fully until days after an accident. If you do not go to an emergency room or medical facility by ambulance after a crash, you should seek out a qualified practitioner like a walk-in care clinic to have your injuries evaluated thoroughly. Changes to Coverage and Treatment Options: Even though you are still required to pay premiums on $10,000 worth of benefits, THERE ARE NOW SITUATIONS IN WHICH YOU ARE ALLOWED ONLY $2,500 IN ACTUAL BENEFITS. The new law requires that you have been determined to have an emergency medical condition in order to have access to your full $10,000 of coverage. And it s no secret that most insurance companies will try to prove that you don t, and only allow you $2,500 in benefits. These types of situations are often litigated. We represent people who need someone to fight for their rights under the law. Additionally, there are now restrictions that limit exactly who can diagnose you as having an emergency medical condition. Most notably, in order for you to be eligible to receive your full $10,000 in PIP benefits, an emergency medical condition can only be diagnosed by an MD, a DO, an ARNP (Advanced Registered Nurse Practitioner), or PA (Physician s Assistant). The 2013 PIP Law does not allow a chiropractic physician to render such diagnosis to qualify you for the full $10,000 in PIP benefits. If massage therapy is recommended or if acupuncture is sought to treat your injuries, PIP will no longer pay for these treatments. 3

5 ** PLEASE NOTE: THESE NEW PIP LAW CHANGES ARE CURRENTLY UNDER JUDICIAL REVIEW. As you may imagine, there was considerable opposition to the passage of the new PIP laws, with significant resistance from personal injury attorneys who represent people injured in accidents. As of July, 2013, there is an ongoing legal challenge within the court system over these radical new changes to Florida s automobile insurance legislation. WHAT TO DO IF YOU ARE DENIED COVERAGE ABOVE THE $2,500 LIMIT? After an accident, your auto insurance company may deny payment of any treatments for your injuries after paying $2,500 in benefits, even though you are still required to pay premiums for $10,000 in benefits. A qualified personal injury lawyer can file suit against your insurance company for their failure to pay beyond the $2,500 cap. Just because your PIP insurance refuses to pay beyond the $2,500 limit does NOT mean you can no longer seek treatment. If your treating physician feels further treatment is warranted, your attorney can advise you on how any additional bills will be paid. Your treating physician may agree to continue treating you with the understanding that your bills will be paid after you settle your claim. Your attorney can file a claim for recovery against the at-fault driver s insurance company. You have the right to legal representation if you feel your PIP benefits have been terminated prematurely you need an experienced lawyer one who is completely up-todate on the new laws - to go up against the insurance company s top lawyers and adjusters. 4

6 Other Types of Available Coverage Property Damage Liability Coverage In Florida, in addition to PIP coverage, this is the only other mandatory coverage you are required to carry by law. This coverage protects you if you are at fault in an accident that causes damage to someone else s property. Bodily Injury Liability Coverage This coverage protects you in the event you are responsible for an accident causing injury, and that injured person makes a claim against you for those injuries. Many people don t carry this type of coverage because it s not mandatory. Remember, it s legal to drive your car with only PIP and Property Damage Liability coverage. However, this is very risky - we strongly recommend you also carry Bodily Injury and Uininsured / Underinsured Motorist coverage. Collision Coverage This type of coverage will take care of repairs to your vehicle after an accident, no matter who was found to be at fault. Generally, you ll need to pay the amount of your deductible, which is the fixed amount you agreed to pay when you bought the policy. After that, the insurance company pays the remainder. The key to determining if you need collision coverage or not depends largely on the age of your car. If you own an older vehicle worth around $2,000 with a policy deductible of $1, and your car is considered totaled in a crash, collision insurance may not make financial sense. Basically, the more valuable your car, the more you need collision coverage. 5

7 Comprehensive Coverage This is often the most misunderstood type of auto policy coverage. Comprehensive coverage will pay for damage to your vehicle in the event it is not caused by an accident with another vehicle. Examples of this can include vandalism damage, theft, fire or an act of nature, like being in a flood or hailstorm. This portion of your policy will usually have a separate deductible, too. And again, opting to purchase this type of coverage usually depends on the valuation of your car. To pinpoint what your car may be worth, you can go to websites like NADA.com or kbb.com, type in the information about your car, and receive a pretty reasonable estimation. Uninsured & Under-insured Motorist Protection This coverage can be the single most important element of your automobile policy. Yet, UM and UIM, as they are called, can be very confusing to the consumer. By definition, UM or UIM coverage means pretty much what you may think coverage for your injury claim when the at-fault party has no insurance, has minimum coverage (carries no Bodily Injury coverage), or does not have enough Bodily Injury coverage to pay your claim in full. With UM or UIM coverage, there is no deductible to be met. You cannot purchase UM/UIM coverage without having purchased bodily injury coverage, and your coverage limit for UM/ UIM cannot exceed the coverage you have purchased for bodily injury coverage. 6

8 Understanding Your Car Insurance Declarations Page Bodily Injury Liability Coverage This coverage protects you in the event you are responsible for an accident causing injury, and that injured person makes a claim against you for those injuries. Property Damage Liability Coverage In Florida, in addition to PIP coverage, this is the only other mandatory coverage you are required to carry by law. Personal Injury Protection (PIP) This type of coverage, a mandatory requirement in Florida, is meant to pay for 80% medical expenses for injuries caused by an accident, death benefits if a person dies in the crash, and 60% of lost wages from not being able to work. Uninsured & Under-insured Motorist Protection This coverage can be the single most important element of your automobile policy. Collision Coverage The key to determining if you need collision coverage or not depends largely on the age of your car. Comprehensive Coverage Comprehensive coverage will pay for damage to your vehicle in the event it is not caused by an accident with another vehicle. Your Car Insurance Company Policy Number: Effective Date: NAME OF INSURED: Mr. John Doe 1234 Any Street SUMMARY OF COVERAGE FOR Your Town, USA VEHICLE # 1: 2011 Mercedes Benz 500 S COVERAGE LIMITS DEDUCTIBLE PREMIUM Automobile Liability Insurance Bodily Injury $250,000 each person Not Applicable $ $500,000 each occurrence Property Damage $100,000 each occurrence Not Applicable $57.00 Personal Injury Protection - PIP $0 $62.00 Death Benefit $5,000 each person Aggregate Medical Expenses (Emergency or Non-Emergency Medical Condition), Income Loss and Loss of Service $10,000 each person Medical Expenses - Emergency Medical Condition $10,000 each person Medical Expenses - Non- Emergency Medical Condition $2,500 each person Emergency and Non-Medical Emergency Medical Expenses are subject to the $10,000 per person aggregate limit. Income Loss does not apply to insured or any dependent resident relative Uninsured Motorists Insurance $250,000 each person Not Applicable $90.00 For Bodily Injury $500,000 each accident Uninsured Motorists Insurance limits of insured vehicles may not be stacked Automobile Medical Payments $5,000 each person Not Applicable $17.00 Auto Collision Insurance Actual Cash Value $500 $75.00 Auto Comprehensive Insurance Actual Cash Value $250 $23.00 Towing and Labor Costs Coverage $100 each disablement Not Applicable $7.00 Rental Reimbursement Coverage $30/day max; 30-day max. Not Applicable $23.00 TOTAL PREMIUM FOR 2011 MERCEDES BENZ 500 S $ Policy shown is an example only. Rates and coverages are for representative purposes only. So many people never take the time to actually read their insurance policy declarations page closely to fully understand their coverages. This is painfully obvious immediately after an accident - just when you need your insurance the most. We urge you to ask your insurance agent specific questions if your policy declarations page confuses you. We can t stress enough the importance of carrying adequate coverage levels in order to protect your financial interests should you suffer a serious injury in a car crash. 7

9 As personal injury attorneys, we negotiate with insurance companies every day, fighting to get fair and legal compensation for clients injured in many types of accidents. We have attorneys and support staff with decades of experience, and who have previously worked as senior insurance claims analysts and adjusters. They know exactly how the system works, and what to do to make sure you don t settle for less than you are entitled to under the law. And, I ll share a little insight I ve learned over the many years I ve been helping people like you insurance companies are not as friendly after you file a claim as they were when they were selling you your policy. Let s be clear. Insurance companies are businesses, and like any business, the bottom line is making a profit for their shareholders. Insurance adjusters and claims analysts get ahead in their careers by paying out the absolute minimum amount possible when negotiating a settlement if they pay you anything at all. With all the effort that goes into trying to get you to sign on the dotted line, it still amazes me that in many cases, you ll have trouble getting a living person on the phone when you re calling about being injured in an accident. (L-R) Attorneys Ray Racila, Mike Noone and Scot Goldberg Suffering a serious injury or being involved in any type of accident can be a traumatic experience. Your attorney should be prepared to work tirelessly to ensure that all of your needs are met, and that you are 100% satisfied with the final outcome of your case. I m attorney Scot Goldberg, and my Partners and I are available to speak to you any time, day or night, at no cost to you. Call us at and let us help. The information contained in this publication is for informational purposes only and is not, nor is it intended to be, a source of solicitation or legal advice. Use of this information does not create an attorney/client relationship. Individuals should not rely on the information contained in this publication when making decisions regarding legal matters, and should consult with a qualified attorney for legal advice. The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience. We look forward to talking with you and reviewing related documents in order to come to a full understanding of what happened, how it occurred, and all those who may have been at fault. 8

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