In Florida, the maximum PIP (Personal Injury Protection) coverage is $10,000 per person. It pays 80% of medical expenses and 60% of lost wages after a car accident, regardless of fault. If costs exceed that amount, lawsuits or other insurance policies may cover the difference.
Why PIP Coverage in Florida Confuses So Many Drivers
Paramedics take you to the ER. Between the ambulance ride, scans, and follow-up visits, your medical bills hit $12,000, and climbing. You expect your insurance to cover it all. But your adjuster says, “You’ve hit your PIP cap.” Wait, what?
Welcome to the maze of Florida’s no-fault insurance system.
Florida is a no-fault state, meaning your own auto insurance pays for medical expenses and lost income, even if someone else caused the accident. This is made possible through PIP insurance, which is mandatory for all Florida drivers.
But here’s the kicker: Florida’s maximum PIP coverage hasn’t been updated in decades. While costs rise, your PIP stays locked at $10,000. That’s created a dangerous gap between what drivers expect and what their insurance actually delivers.
In this article, we’ll break down:
- How much coverage PIP actually provides
- What happens when your bills exceed the limit
- Whether you can buy more PIP (spoiler: you can’t)
- How PIP affects your personal injury settlement
- What legal and insurance options you have when $10,000 isn’t enough
- Common questions Florida drivers are asking
- And the real-world worries you won’t find in most insurance guides
What Is PIP Insurance in Florida?
Florida requires all registered vehicle owners to carry Personal Injury Protection (PIP) as part of their auto insurance policy. This is because Florida is one of the few states that follows a no-fault system, which means your own insurance pays for your medical bills and lost wages after a crash, even if someone else caused it. That’s the job of PIP.
We explain how PIP and PDL insurance work, and why they matter in this article: What Is PIP And PDL Insurance in Florida?
What PIP Covers
PIP insurance kicks in immediately after a motor vehicle accident and typically covers:
- 80% of medical expenses related to accident injuries
- 60% of lost income if you’re unable to work
- $5,000 in death benefits, separate from the medical cap
- Reimbursement for household help or transport, if medically necessary and you can no longer manage daily tasks
It’s worth noting that PIP does not pay for damage to your vehicle or the other party’s vehicle. It also won’t cover pain and suffering, emotional distress, or anything considered non-economic. That’s where other types of coverage, like bodily injury liability or personal injury lawsuits, come in.
The 14-Day Rule (And Why Timing Can Cost You Everything)
Florida’s 14-day rule often catches people off guard. To access your PIP benefits, you must seek medical treatment within 14 days of the accident. Miss that window, and your claim could be denied, even if your injuries are legitimate.
To get the full picture, read: Florida 14-Day Accident Law | What You Need To Know
People frequently ask, “What if my injuries didn’t show up until day 15?” That’s not uncommon. Soft-tissue damage or internal issues might take days to appear. Fortunately, there is a workaround: an Emergency Medical Condition (EMC) determination.
While the initial visit must occur within the 14-day window, the EMC diagnosis can be completed later, by a physician, dentist, advanced registered nurse practitioner, or someone qualified under Florida law. If your condition qualifies, you may unlock the full $10,000 in coverage.
Florida’s PIP Payment Limits, Maximum and Minimum
What’s the Most You Can Get from PIP in Florida?
The maximum payout under Florida’s PIP laws is $10,000 per person, per accident, but there’s a catch.
You only get that full amount if your injuries are diagnosed as an Emergency Medical Condition. Without that designation, your claim maxes out at just $2,500. That’s not enough to cover even one night in the ER for most people.
Here’s how the benefits break down:
- 80% of your medical costs (e.g., ambulance, surgery, imaging)
- 60% of lost wages
- $5,000 in funeral expenses, which is paid out in addition to the $10k limit
The medical and wage reimbursement shares the $10k pool, so if you have a long hospital stay and miss work, it dries up fast.
Can You Buy More Than $10,000 in PIP?
The short answer is no.
Florida caps PIP at $10,000, and you cannot increase it through add-ons or higher premiums. It’s a fixed limit, written into law, and hasn’t been adjusted for inflation or rising medical costs.
People sometimes assume they can upgrade their coverage like in New Jersey or Michigan, where expanded no-fault policies exist. But Florida doesn’t offer that flexibility. Once your PIP runs out, you’re left with a gap, unless you’ve planned ahead with MedPay, bodily injury liability, or uninsured motorist coverage.
And that’s where a lot of Floridians get stuck. They hit the cap and realize they need to sue the other driver, or lean on health insurance, to cover the rest.
Where the Rest of the Money Comes From (When $10k Isn’t Enough)
PIP First, Then What?
Here’s the reality: $10,000 doesn’t go far when you’re dealing with real injuries. Emergency room visits, MRIs, surgery, rehab, time off work, it adds up quickly. So what happens when your personal injury protection (PIP) limit is reached?
Florida law provides several paths forward once PIP is maxed out:
- File a claim against the at-fault driver’s liability insurance. This is where bodily injury liability (BIL) and property damage liability come into play. If the other driver caused the crash, their insurance should cover what PIP didn’t.
- Pursue a personal injury lawsuit. If your injuries are classified as “serious,” Florida law allows you to step outside the no-fault system and sue for pain and suffering, long-term medical expenses, and loss of quality of life.
- Use MedPay or your health insurance. If you purchased medical payments insurance (MedPay), it can help cover remaining bills. If not, you may need to turn to your health insurance, if you have it. Keep in mind that health insurers may later seek reimbursement if you receive a legal settlement.
At Applebaum Accident Group, we’ve seen this scenario play out hundreds of times. A client runs through their PIP, and suddenly they’re stuck, unsure what to do next. That’s where our network becomes valuable. We connect accident victims with the right legal team, aggressive when it counts, but also ready to navigate settlement, insurance policy limits, and long-term recovery options.
PIP vs. Personal Injury Settlements, How They Work Together
A personal injury settlement isn’t just about covering what your PIP insurance missed, it’s about making you whole again. That means covering:
- Pain and suffering
- Future medical expenses
- Lost earning capacity
- Out-of-pocket expenses PIP didn’t reimburse
Let’s say your total accident-related costs hit $40,000. PIP pays $10,000. That leaves $30,000 in uncovered losses, which can potentially be recovered through a legal settlement or trial verdict.
This is also why having uninsured motorist coverage (UMBI) matters so much in Florida. If the other driver has no insurance or too little, UMBI steps in. It’s not required by law, but we strongly recommend it. In fact, many people don’t realize they’ve waived it when signing up for auto insurance, something we help our clients review closely.
“Is $10k Really Enough After a Car Accident?”
If you’ve ever been to a Florida emergency room, you already know the answer: no.
One ER visit, advanced imaging, and a few weeks of physical therapy can easily hit $15,000 to $30,000. That’s before factoring in missed paychecks, child care, or long-term rehabilitation. And yet, PIP caps out at $10,000, if you qualify.
Drivers often ask, “Isn’t $10k supposed to cover everything?” The short answer: not even close. And the frustration is real. We’ve heard it countless times from clients: “I paid for insurance. Why am I getting bills?”
“What If I Didn’t Get Medical Help in Time?”
Let’s talk about the 14-day rule again, because it trips people up.
Many accident victims don’t feel serious symptoms until days or weeks later. It might be soft tissue injuries, a concussion, or worsening back pain. But if you didn’t see a medical provider within two weeks of the crash, your PIP claim could be denied.
However, there’s one last window of opportunity: if you did see someone, a chiropractor, urgent care, even a general practitioner, within 14 days, you may still be able to qualify for the full PIP limit with an Emergency Medical Condition (EMC) evaluation. That evaluation doesn’t have to happen on day one.
“Is There Any Way Around the PIP Limit?”
Unfortunately, no.
Florida law hard-caps PIP at $10,000, and you can’t raise that limit with endorsements or riders. There’s no version of “premium PIP” like in other states.
So how do you protect yourself?
- Buy higher bodily injury liability (BIL) limits on your own policy
- Add uninsured/underinsured motorist coverage (UMBI)
- Consider an umbrella policy for catastrophic scenarios
These aren’t just bells and whistles, they’re often the only buffer between financial security and bankruptcy after a serious crash. That’s why we help our clients evaluate insurance coverage as part of the attorney referral process. Knowing what you have, and what you need, can make all the difference when it counts.
What To Do After a Crash (If You’re Counting on PIP)
When you’ve just been in a car accident, everything feels urgent. But what you do next, especially in the first two weeks, can directly impact your insurance benefits and long-term financial outcome. Here’s how to protect yourself if you’re relying on personal injury protection (PIP) to cover your costs.
Immediate Action Steps That Preserve Your Rights
- Seek medical attention within 14 days: Whether it’s the ER, urgent care, or your chiropractor, get evaluated. Waiting too long can make you ineligible for PIP, even if your injuries are serious.
- Ask for an Emergency Medical Condition (EMC) evaluation: If your symptoms are beyond mild soreness, request an EMC determination. This opens the door to the full $10,000 PIP limit. If you’re unsure how to get one, TeleEMC provides a simple way to connect with licensed professionals who can make that call.
- Document everything: Save your medical records, insurance correspondence, and out-of-pocket expenses. Insurance companies often question the necessity of treatment. Good records help eliminate doubt.
- Contact a professional if costs exceed $10,000: Once your medical bills or lost wages start piling up, your situation moves beyond what PIP alone can handle. At Applebaum Accident Group, we match injured drivers with experienced attorneys and medical providers who can guide them through the process, without the guesswork.
Can I stack PIP with health insurance?
Yes, but the order matters. PIP pays first, and your health insurance may cover what’s left over. Be aware, though: your health insurer may seek reimbursement from a legal settlement later.
What’s the difference between PIP and MedPay?
Both cover medical bills, but PIP also includes lost wages and funeral benefits. MedPay typically has fewer restrictions and can help cover co-pays or deductibles. It’s a helpful add-on but doesn’t replace PIP.
Don’t Let $10,000 Be the End of Your Recovery
Florida’s PIP system was created to make things simpler. But in reality, it often leaves accident victims overwhelmed, under-compensated, and unsure of their next step.
If your medical expenses, lost income, or long-term care costs are more than $10,000 (and they usually are), you need to know what other options are available. Whether that means pursuing a lawsuit, using uninsured motorist insurance, or negotiating a settlement, the right guidance makes all the difference.
At Applebaum Accident Group, we don’t just explain the rules, we connect you to professionals who can help you navigate them, maximize your compensation, and move forward with confidence. You don’t have to face the insurance companies or the system alone.
Reach out today, and we’ll connect you with the right attorney and medical provider, fast, local, and trusted.
Take the First Step Toward Justice
If you’ve been injured in a car accident, don’t wait to seek legal help. Call Applebaum Accident Group today, and we’ll connect you with the right attorney to fight for your rights.
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