What do I do if my PIP claim has been denied?

December 23, 2022
Kerri Deitsch

Written by:
Kerri Deitsch
Attorney at Law

Florida is a “no-fault state,” which means that every Florida driver is required to carry personal injury protection insurance (PIP) to cover personal damages no matter who is found to be at fault for the accident. However, what do you do if your PIP claim was denied by your insurer? While PIP insurance was meant to expedite the process of being able to get money for medical bills, lost wages, etc, sometimes the claim may be denied for a few major reasons. Read on to learn more about PIP insurance claims, why they may be denied, and what you should do if your PIP claim was denied. Car accidents are traumatic events, and having your claim denied can exacerbate your stress while you and your family are trying to recoup your finances and recover physically and mentally. This is why it’s critical to understand how PIP works and the timeframes you must meet in order to receive compensation from your insurance.

PIP Comes First In Insurance Claims

In the state of Florida, hospitals, doctors, and any other medical providers are required to first bill PIIP when there are any injuries in a vehicle accident. The Florida State Supreme Court has ruled that your deductible for PIP must be applied against all of the medical charges. Moreover, under Florida law, your medical care must be provided by credentialed medical providers to be covered by insurance or any other legal accident compensation.

Why Your PIP Claim May Be Denied

Even if you pay your insurance premiums regularly and on time, there are still cases where your insurance company may still deny your PIP claim. Remember that your insurance company, while meant to offer a measure of protection against accidents, is still a business and their number one priority is always the bottom line. If you don’t know and stick to all their stipulations and guidelines, your claim will be denied. The most common reason for PIP claims to be denied is the timeframe in which the claim was filed. PIP insurance has a 14-day rule, which dictates that you are required to seek medical attention within 14 days of the accident occurring. If you wait past this time limit, your PIP claim could be denied. This is why it’s essential to seek immediate medical attention even following minor accidents, as some injuries don’t become apparent for days.

You must also accurately document and provide proof of your expenses. For example, you can be reimbursed for the mileage you use getting to and from your medical appointments, but you need to be able to provide accurate information and receipts. Often, a PIP claim is denied due to inaccurate or insufficient information. Your payout may also be denied if your insurance company asserts that your payments were not made on time or that certain facts were misrepresented when you purchased the policy.

Contact Us Today

Following the guidelines for PIP coverage, including sticking to the mandated timelines, is key. If you think your claim has been unfairly denied, or if you are considering taking legal action to seek further compensation, you need an experienced car accident attorney on your side to help you navigate your case. Call Deitsch & Deisch Law to see if you can recover compensation today.