Let’s assume that you’re driving a friend’s car in Florida. Or you’re a passenger in a friend’s car. In either event, assume that another driver hits you.
The driver of the other car receives a ticket for a moving violation. Perhaps the other driver rear ended you.
Your neck or back hurts. Maybe you broke your leg or wrist.
Let’s assume that you don’t have health insurance. You don’t own a car.
Hopefully you know who pays your medical bills paid after a car accident.
You should be covered for personal injury protection (“PIP”) benefits if you make a claim through the car insurance of a relative residing in the same household.
Of course, you’ll also want to make a personal injury claim against the at fault driver. That claim would be for your lost wages, medical bills, bodily injury, pain and suffering, disability and physical impairment. You can also sue for disfigurement, mental anguish, inconvenience or loss of capacity for the past and future enjoyment of life.
You know that it’s important to get medical treatment shortly after your injured. Otherwise, the other driver’s insurance will claim that the accident didn’t cause your injury. I’ve heard GEICO and State Farm argue this countless times.
After all, you didn’t cause the accident. You are willing to make an injury claim against the negligent driver so long as you do not have to make a claim with your resident relative’s (e.g. your mom, dad, etc.) auto insurance.
Let’s say you lived with your dad in Florida at the time of the crash. Since you didn’t own a motor vehicle in Florida, your father’s auto insurance coverage pays you PIP benefits because you are a considered a “resident relative” under your father’s auto insurance policy.
(Note: If you owned a car in Florida but it wasn’t insured, you can’t make a PIP claim under your resident relative’s PIP insurance).
You may be unwilling to do so because your dad is complaining that his auto insurance rates will increase, or perhaps your dad simply doesn’t want to involve his auto insurance company.
If you do not make a PIP claim through your dad’s auto policy, then the host vehicle’s (car that you were in) PIP insurer will likely deny PIP benefits.
Why?
Because your dad’s auto insurer should be the proper insurer to extend PIP benefits.
What happens if you make a PIP claim is made through the host vehicle’s insurer?
The host vehicle’s insurer will likely notify your dad’s insurer about this crash and request that your dad’s auto insurer pay PIP benefits.
If you don’t want your dad’s auto insurance involved, then you may be left with a large amount of out-of-pocket medical bills.
I’ll explain why.
In Miami-Dade County, Florida, if at the time of the crash the at fault vehicle has auto insurance coverage, then owner of the car whose driver caused the crash will likely get up to a $10,000 credit for any medical bills paid or payable through PIP.
This is because Miami-Dade is part of the 3rd District Court of Appeals in Florida. To keep it simple, PIP pays 80% of medical expenses combined with lost wages, not to exceed $10,000.
How Bills Work if You Use a Resident Relative’s PIP
Medical bill is $5000.
$5000
x .80
PIP pays $4,000.
Your out of pocket bill is $1,000.
In your personal injury claim against the negligent driver, the negligent driver will get a credit for the $4,000 that PIP paid. Your out of pocket bills are $1,000.
Option #2 – You do NOT use your resident relative’s PIP (Bad Choice!)
Medical bill is $5000.
PIP isn’t available because you aren’t making a PIP claim.
Your out of pocket bills is $5,000.
Even though the other driver caused the crash, and you did nothing wrong, you are stuck with $5,000 in medical bills if you don’t use your resident relative’s PIP coverage.
Comparison between Option 1 and 2 (Using Relative’s PIP is Much Better)
If you use your resident relative’s PIP than you will owe $4,000 less to medical providers than if you didn’t use the PIP. As you can see, the choice is simple. Use your resident relative’s PIP.
Given the nature of your soft tissue injuries at the moment, without an objective injury (e.g. fractured bone, staples on your forehead, surgery, etc.) you may not be able to get non-emergency room medical care because medical providers want to get paid quickly and that usually comes in the form of PIP.
If you don’t have PIP benefits and the owner of the car that the negligent driver was operating gets a $10,000 credit against any of your medical bills, the settlement may not be large enough to pay your medical providers.
Let’s take a look at why your injury settlement may not cover your medical bills if you don’t use your resident relative’s PIP coverage and you only have soft tissue injuries.
Let’s assume that the other driver’s insurer, Progressive, offers you $1,000 shortly after the car crash to settle your personal injury claim. You went to the ER after the accident and your bill is $5,000 because they took some x-rays or a CT scan.
You unwilling to give the hospital your resident relative’s PIP info.
Medical bill is $5,000.
PIP isn’t available because you aren’t making a PIP claim.
Your out of pocket bills is $5,000.
Even though the other driver caused the crash, and you did nothing wrong, you are stuck with $5,000 in medical bills if you don’t use your resident relative’s PIP coverage. Assuming you accept Progressive’s $1,000 offer for your minimal treatment, you are stuck owing $4,000.
This is not good.
Progressive’s low offer for soft tissue injuries in Florida in this scenario is, in part, because in most, but not all, Florida auto accidents you need a permanent injury to get money for pain and suffering.
If your injuries significantly worsen, you may have a great case even if you don’t want to make a PIP claim. If you have a fractured bone, then your case may have settlement value even though you aren’t willing to make a PIP claim.
What Happens if You Live with More than One Resident Relative?
Notify all of your resident relatives’ car insurance companies. One of them may pay your medical bills. They’ll pay 80% of the medical bills up to $10,000.
The car insurance company that pays will then ask your other resident relative’s car insurers to pay them. Specifically, they’ll ask the other car insurer to pay its pro-rata share.
Thus, if there are two auto insurers, they’ll each pay up to $5,000 in PIP. If there are three car insurers, they’ll each pay up to $3,333. And so forth.
What happens if your relative doesn’t want to give you his car insurance information?
He won’t get away with it.
Here’s why:
The PIP insurer who pays your medical bills will find the other car insurers. Insurance companies have systems that track down the names of other resident’s insurers.
We are in the age of big data. Insurance companies can monitor everything.
Make the PIP Claim through Your Relative’s Car Insurance (Don’t Worry)
If you are a passenger or driver in a car that is struck by another vehicle, and you don’t own a car, you should make a written claim for PIP benefits. Do it through your resident relative’s car insurance policy immediately after the accident.
Send them a signed Statement-of-Vehicle-Non-Ownership. This may get your qualified for PIP coverage. If you don’t live with a resident relative who has auto insurance, then you should make a written PIP claim through the host vehicle’s auto insurer. You should also make an uninsured motorist insurance claim.
In Florida, there are so many auto insurers who can insure your relative if his or her current auto insurer increases their rates. Maybe your relative’s rates won’t even increase.
Getting your medical bills paid by PIP is more important than your relative paying a possible slight increase in their auto insurance premium.
Will Your Resident Relative’s PIP Pay Your Bills if You’re In a Lyft or Uber Accident?
It should. The exception would be if you are an Uber or Lyft driver. Learn more about Lyft and Uber accidents.
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Editor’s Note: This post was originally published in April 2014 and has been completely revamped and updated.