Not every vehicle collision in the Sunshine State results in significant damage or severe injuries. Drivers and passengers can sometimes walk away with only a few minor cuts and bruises. Even vehicle damage can be minimal, but this isn’t always the case.
With an estimated 397,500 reported traffic crashes in 2022, Florida sees its share of vehicle accidents, and some result in serious injuries. So, what is the threshold for serious injuries in Florida, and how can it potentially impact your car accident claim?
What is Florida’s Serious Injury Threshold?
Since Florida is a no-fault insurance state, everyone involved in a car accident files a claim with their provider. This applies regardless of whether you’re the at-fault driver or not responsible for causing the accident.
Your PIP (personal injury protection) insurance covers your medical expenses. If your injuries are severe enough to force you to miss work, PIP may also cover some of your lost income. So far everything sounds pretty easy. Your insurance takes care of your damages.
Unfortunately, there’s a catch. PIP only covers up to 80% of your medical costs or the policy’s cap, whichever comes first. If your injuries are limited to a couple of cuts and maybe a sore spot on your shoulder from your seatbelt, PIP will probably cover the cost of your medical visit.
However, when your injuries are serious, being left with 20% of your medical costs can be a big deal. You may be looking at thousands of dollars in unpaid medical bills, and this is when Florida’s serious injury threshold can impact your insurance claim.
Types of Serious Injuries
When your PIP insurance doesn’t cover all of your medical expenses, you can usually file a claim against the at-fault driver. Your claim can only include damages not covered by your PIP policy. So, if PIP covers 80% of your medical costs, your claim can only be for the remaining 20%. You can only file one compensation claim for the same accident.
You may also need to meet Florida’s serious injury threshold. Florida defines a serious injury as either a:
- Injury resulting in significant and permanent scarring or disfigurement
- A permanent injury is diagnosed with a reasonable degree of medical certainty. For example, paralysis is a permanent injury that healthcare professionals can say with reasonable certainty requires lifelong care and treatment.
- A permanent and significant loss of an important bodily function
- However, if a fatality occurs in a traffic accident you may have a wrongful death lawsuit and not a personal injury case. Talk to an accident attorney before making an insurance claim if a fatality is present.
If your injuries meet any of the above-listed criteria, you probably meet the state’s threshold.
What Damages Can You Receive For Serious Threshold Injuries?
Okay, remember you can’t include any losses covered by PIP. Claiming the same losses twice may be considered a form of insurance fraud.
If it’s an honest mistake, your claim will be denied and you may need to start the legal process from the beginning. However, if the insurance company believes the attempted fraud is intentional, you may be facing serious charges that often result in fines and potential jail time.
With that being said, you should be able to recover your medical costs, which can include any costs relating to future treatment or long-term care. If your home or vehicle requires some modifications to accommodate something like a wheelchair, you should be able to include these expenses in your claim. Additional damages that are often included in serious injury threshold claims include:
- Lost future earnings: Permanent injuries often leave you unable to work and you should be able to recover a part of your future earnings. Something to consider is if you’re also planning on applying for disability benefits. Your disability benefits may be impacted by your personal injury claim. For example, your benefits may be reduced if your settlement includes compensation for lost future earnings. This is something you should discuss with your accident attorney before moving forward with the claim.
- Non-economic damages: PIP doesn’t cover non-economic damages like pain and suffering. You can list these damages in your serious injury threshold claim. Since non-economic damages are intangible, figuring out their value can be challenging. Your accident attorney can use either the multiplier or per diem method to calculate the value of your non-economic damages.
If you need help determining what your non-economic losses are, talk to your injury lawyer. Your non-economic losses may include more than pain and suffering. The type of injury and its severity typically play a large role in this part of the claim process.
Filing a Serious Injury Threshold Claim
If you’re dealing with serious injuries, you want to recover compensation. Your life is changing drastically and there’s not a lot you can do about it, except focus on making a recovery. You can also concentrate on filing a personal injury claim. So, how do you get started?
Contact the Insurance Company
You already filed a claim with your PIP provider, so this time you’re contacting the at-fault driver’s insurance provider. Don’t go into detail about the accident or your serious injuries—this isn’t the time. All you’re doing is letting the insurance company know you’re getting ready to file a claim.
The reason you don’t want to get into specifics is fairly simple. Anything you say to the insurance adjuster can be used to try and reduce the value of your claim.
Collect Your Medical Records
You’re going to need to provide plenty of proof to support your serious injury threshold claim, which means getting all of your medical records together, along with any bills and receipts.
You’re probably also going to need to provide expert medical testimony. Remember, you must meet the state’s criteria to prove you suffered a serious injury.
Partner with an Experienced Accident Attorney
Navigating the serious injury threshold can be a complex and challenging process. To help ensure you receive fair compensation, it’s a smart idea to partner with an experienced accident attorney.
They have a deep understanding of personal injury law and the specific legal requirements in the Sunshine State, allowing them to effectively advocate for your best interests. With their expertise, you’ll be better positioned to secure the compensation you deserve.
