Understanding PIP Checks in Florida: Who Gets Paid and When?

Understanding PIP Checks in Florida: Who Gets Paid and When?

In most Florida car accident cases, PIP checks go directly to accident victims' doctors or medical providers, not to the victims personally. This usually happens because accident victims sign an Assignment of Benefits (AOB) form, allowing healthcare providers to bill the insurance company directly.

However, if you’re an accident victim and paid medical expenses out of pocket or did not sign an AOB, your insurance company may reimburse you directly. Florida’s Personal Injury Protection (PIP) coverage is designed to pay medical bills and lost wages quickly after an accident, regardless of who caused the crash.

Key Things to Know About Florida PIP Checks

If your PIP benefits are denied, delayed, or exhausted, you may have additional legal options. PIP checks are often the first source of payment after a car accident in Florida. Understanding how they work can ease some stress after a crash. For Florida drivers, knowing how PIP checks are issued and applied can make a big difference in their physical and financial recovery.

Below, we explain how personal injury protection (PIP) works, who receives payment, and what happens if your PIP benefits don’t fully cover your expenses:

• Florida drivers are required to carry at least $10,000 in PIP coverage.
• PIP insurance generally covers:
  • 80% of reasonable medical expenses
  • 60% of lost wages
  • $5,000 in death benefits
• Your medical provider usually receives payment directly from the insurance company.
• Insurance companies generally have 30 days from the date they receive medical bills to pay valid PIP claims.
• Any expenses not covered by PIP, including the remaining 20% of medical bills, may become your responsibility unless other insurance applies.
• If your PIP benefits are denied, delayed, or exhausted, you may have additional legal options.

What Is PIP and Why Does Florida Require It?

Personal injury protection, commonly known as PIP and “no-fault” auto insurance, is a type of no-fault auto insurance coverage. In Florida, every driver is required to carry at least $10,000 in PIP coverage as part of their auto insurance policy.

Florida’s PIP laws are found under Florida Statutes 627.736. In short, the no-fault rule provides that regardless of who caused the accident, your own PIP insurance covers your medical expenses and certain other costs up to the policy limit. Specifically, PIP typically covers:

• 80% of reasonable medical expenses
• 60% of lost wages
• $5,000 in death benefits

This system is designed to ensure that accident victims receive prompt medical care without the delays of proving fault in court.

Any remaining balance not covered by your PIP auto insurance, such as the 20% of reasonable medical expenses, must be paid by you.

Who Gets the PIP Check in Florida: Me or My Doctor?

One of the most common questions we hear is: When there’s a PIP payout, who actually gets the money?

In Florida, the answer often depends on how your medical providers handle billing and assignment of benefits. Typically, when you receive medical treatment after an accident, you’ll sign what’s called an assignment of benefits (AOB) form. This form allows your medical provider to bill your PIP insurance directly and receive payment straight from your insurance company.

So, in most cases, your doctor or healthcare provider receives the PIP check directly, not you. If you haven’t signed an AOB, your insurance company might reimburse you for out-of-pocket medical expenses after you submit your bills.

Under the statute, your auto insurance carrier has 30 days to pay PIP benefits to your medical provider after receiving the reasonable medical billing.

What Do I Do If My PIP Claim Is Denied?

Insurance companies don’t always make the claims process easy. If your Florida PIP check is delayed, underpaid, or denied, don’t panic, but act quickly.

Here are some steps to take:

• Request a written explanation from your insurance company about why the claim was denied.
• Review your policy carefully to understand what is and isn’t covered.
• Consult a personal injury attorney, especially if you believe the denial was unreasonable or you’re facing mounting medical bills.

With 35+ years of expertise in injury cases, our attorneys at Hancock Injury Attorneys can help you challenge the denial, negotiate with the insurance company, and ensure your rights are protected.

How Do I Coordinate My PIP with Health Insurance?

If your medical expenses exceed your PIP policy limit (often $10,000), you may wonder what happens next. This is where coordination of benefits comes into play.

In Florida, your PIP coverage is considered primary, meaning your PIP benefits pay out first before any available health insurance starts paying benefits. Once your PIP coverage is exhausted (a fancy way to say “used up”), your personal health insurance, if you have any (such as through an employer, Medicare, Medicaid, etc.), may cover your remaining medical costs. 

However, some health insurance policies require proof that your PIP benefits have been fully used before they start paying. Keep detailed records of all your bills, PIP payments, and communications with providers and insurers to make this process smoother.

It’s also worth noting that in cases where another driver is at fault, and your damages exceed what PIP and health insurance cover, you may have grounds to file a personal injury lawsuit to recover additional compensation against the at-fault driver’s bodily liability insurance.

Let Hancock Injury Attorneys Fight For You

Dealing with Florida PIP checks and understanding who gets paid, when, and how can feel overwhelming, especially in the aftermath of an accident. Knowing how PIP checks work puts you in a stronger position to advocate for yourself and get the care you need.

If you’re facing delays, denials, or confusion about your Florida PIP check, don’t navigate the process alone. We can answer questions about any remaining balance that you may owe to your medical providers.

The experienced personal injury attorneys at Hancock Injury Attorneys are here to protect your rights and help you get the compensation you deserve. Call us today at 813-915-1110. We’re ready to fight for you.

Video Transcript

My name is Kaimonne Douglas, and I'm a client of Hancock Injury Law Firm. Hancock Injury Law Firm did a fantastic job. From the accident to seeking medical help, they basically made me feel like they care about me and more than just the money.

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