PIP Insurance in Florida

What It Is and What It Actually Covers

Florida is one of a handful of states in the country that requires every driver to carry Personal Injury Protection insurance — better known as PIP. If you own and register a vehicle in Florida, you are legally required to carry at least $10,000 in PIP coverage before your car ever leaves the driveway. Yet most Florida drivers have only a vague idea of what PIP actually does, what it pays for, and — critically — what it doesn't cover when a serious accident happens.

Ian Duncan, a Florida personal injury attorney (Florida Bar #25920) who has handled car accident and insurance claims across Palm Beach County for over a decade, explains what injured drivers need to understand: "PIP is not a full safety net — it's a floor. It was designed to get initial medical bills paid quickly regardless of fault. But the $10,000 limit and the 80/60 payment rules mean most seriously injured drivers exhaust it within weeks, sometimes days, of a major accident. Understanding what comes next is where most victims need legal guidance."

This guide breaks down exactly how Florida PIP works, what the law requires, and what your options are when PIP isn't enough.

What Is PIP Insurance and Why Does Florida Require It?

PIP stands for Personal Injury Protection. It is a mandatory component of every Florida auto insurance policy, governed by Florida Statute § 627.736. Unlike traditional liability insurance — which covers injuries you cause to someone else — PIP covers injuries to you and your passengers, regardless of who caused the accident.

Florida is a "no-fault" insurance state. That designation is the reason PIP exists. In a no-fault system, each driver's own insurance pays for their initial medical expenses after a crash, without requiring anyone to prove the other driver was at fault. The goal is to reduce the volume of small injury lawsuits clogging Florida courts and to ensure accident victims receive prompt medical care regardless of who was responsible for the crash.

What Florida Statute § 627.736 Requires

Under § 627.736, every Florida vehicle owner must maintain a minimum of $10,000 in PIP coverage. The policy must also include a minimum of $10,000 in Property Damage Liability (PDL). These two coverages — PIP and PDL — are the minimum legally required auto insurance in Florida. Bodily injury liability coverage is not mandatory under Florida law (though it is highly advisable), which creates gaps that affect uninsured motorist claims.

PIP applies to the named insured and extends to:

• Relatives living in the same household
• Any passengers in the insured vehicle at the time of the crash (regardless of whether they have their own PIP policy)
• Named insureds and resident relatives injured as pedestrians or bicyclists struck by a motor vehicle
• Named insureds and resident relatives injured in crashes while occupying any motor vehicle (not just their own)

What PIP Insurance Actually Covers (and What It Doesn't)

Florida PIP is more limited than most policyholders assume. The coverage has a specific, defined scope — and what falls outside that scope is just as important as what's inside it.

What PIP Covers

What PIP Does NOT Cover

PIP coverage has significant exclusions. Understanding these gaps is essential — because they represent losses you may only recover through a liability claim against the at-fault driver:

• Pain and suffering: PIP pays nothing for physical pain, emotional distress, or non-economic losses. These damages are recoverable only through a third-party claim.
• The 20% of your medical bills PIP doesn't pay: PIP covers 80%, leaving 20% of medical costs your responsibility unless recovered through a liability claim.
• The 40% of lost wages PIP doesn't pay: You absorb 40% of lost income unless you pursue additional recovery.
• Property damage to your vehicle: PIP does not cover vehicle repair or replacement. That falls under collision coverage or the at-fault driver's PDL.
• Injuries sustained outside a motor vehicle accident: PIP is tied to automobile accidents — it does not apply to injuries from other causes.
• Medical expenses above $10,000: Once the PIP limit is exhausted, your health insurance becomes the next payer — unless you pursue a liability claim.

Florida's PIP Coverage Limits: The 80/60 Rule and the EMC Threshold

Florida's PIP statute contains two mechanics that significantly affect how much you actually receive — and both are widely misunderstood by accident victims.

The 80/60 Rule

PIP does not reimburse 100% of covered losses. Under § 627.736, PIP pays:

• 80% of all reasonable and necessary medical and surgical expenses
• 60% of gross lost wages and earning capacity
• Up to $20/day for replacement services (domestic tasks you can no longer perform)

This means that even within the $10,000 benefit cap, you are never made fully whole by PIP alone. A $5,000 medical bill results in a $4,000 PIP payment — you are responsible for the remaining $1,000 unless it is recovered through a separate claim. The 40% wage gap can be devastating for anyone who misses weeks or months of work.

The Emergency Medical Condition (EMC) Threshold

This is the most consequential — and least publicized — aspect of Florida's PIP law. Under the 2012 amendments to § 627.736, your maximum accessible PIP benefit depends on whether your treating physician certifies that you suffered an Emergency Medical Condition (EMC):

• EMC certified: You have access to the full $10,000 PIP benefit.
• Non-EMC (or no EMC determination): Your accessible benefit is capped at $2,500, regardless of what your policy limit states.

An EMC is defined as a medical condition "manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in serious jeopardy to patient health, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part."

In practical terms: if you see a chiropractor or primary care physician as your first provider and they do not document an EMC, your PIP benefit may be limited to $2,500 — even if your injuries are ultimately serious. This is why the treating provider's documentation and coding decisions matter enormously in Florida PIP claims.

How to File a PIP Claim After a Florida Car Accident

Filing a PIP claim is different from filing a liability claim against the at-fault driver. PIP is a first-party claim — meaning you file it with your own insurance company, not the other driver's. Here is the process step by step.

When PIP Coverage Isn't Enough: Your Right to Sue in Florida

Florida's no-fault system limits the right to sue — but it does not eliminate it. If your injuries meet Florida's "serious injury" threshold, you retain the full right to pursue a personal injury claim against the at-fault driver for damages that PIP does not cover, including pain and suffering, the uncovered portions of your medical bills, future medical expenses, and the full value of your lost wages.

Florida's Serious Injury Threshold

Under Florida Statute § 627.737, you can step outside the no-fault system and sue the at-fault driver if your injuries meet at least one of the following criteria:

• 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
• Death

These thresholds are intentionally broad — Florida courts have interpreted them expansively. A herniated disc with permanent nerve impairment, a torn rotator cuff requiring surgery, chronic back pain from a spinal injury, permanent vision changes, or significant facial scarring can all meet the threshold. The word "permanent" does not require you to be totally disabled — it requires medical documentation that the condition is ongoing and will not fully resolve.

What About Uninsured or Underinsured Drivers?

Florida has one of the highest rates of uninsured drivers in the United States. Approximately 20% of Florida drivers carry no auto insurance — and many more carry only the minimum $10,000 PDL policy with no bodily injury liability coverage. If the at-fault driver is uninsured or underinsured, your recovery path depends heavily on whether you purchased Uninsured Motorist (UM) coverage on your own policy.

UM coverage — which is not required in Florida but must be specifically rejected in writing if not purchased — can provide the same level of compensation you would have received from the at-fault driver's bodily injury policy. Given Florida's uninsured driver rate, carrying UM coverage is one of the most important financial decisions a Florida driver can make.

How DIG Law Helps Florida PIP Victims Get Full Compensation

Most accident victims in Florida settle for whatever PIP pays — never realizing they have additional recoverable damages. The attorneys at Duncan Injury Group have helped clients across Palm Beach County, Jupiter, Boca Raton, Delray Beach, and the surrounding areas recover compensation that far exceeds their PIP limits by pursuing the at-fault driver, the at-fault driver's insurer, and — where applicable — uninsured motorist coverage.

Our approach to Florida PIP and auto accident cases:

• We immediately evaluate whether your injuries meet the serious injury threshold for a liability claim — most do
• We identify all available insurance coverage, including the at-fault driver's BI policy, UM coverage, and umbrella policies
• We challenge PIP benefit denials and IME-based cutoffs when insurers wrongfully reduce or terminate coverage
• We document the full scope of your losses — including future medical care, permanent impairment, and non-economic damages — to maximize your total recovery
• We handle all negotiations and litigation, so you focus on recovery

DIG Law has recovered $250M+ for injured clients across Florida. There are no fees unless we win.