Florida PIP insurance explained in plain language

What PIP is, in general

PIP is first-party, no-fault coverage: benefits are generally claimed from your own policy (or another policy the statute points to) regardless of who caused the crash. "No-fault" describes how these benefits work; it does not decide legal responsibility for the crash.

The general benefit framework

The figures below are the general rules in section 627.736 (2026). Subject to the statute, policy terms, eligibility and individual facts. None of them is an automatic payment.

• 80%

  Medical benefit share

  Of reasonable, medically necessary covered medical expenses.

  Subject to the statute, policy terms, eligibility and individual facts.

• 14 days

  Initial care window

  Initial services and care within 14 days after the motor-vehicle accident.

  Subject to the statute, policy terms, eligibility and individual facts.

• $10,000

  Medical/disability framework

  Combined limit; medical reimbursement up to $10,000 where an eligible provider determines an emergency medical condition.

  Subject to the statute, policy terms, eligibility and individual facts.

• $2,500

  No-emergency medical limit

  Medical reimbursement limited to $2,500 where a listed provider determines no emergency medical condition.

  Subject to the statute, policy terms, eligibility and individual facts.

• 60%

  Disability / work loss

  Of qualifying lost gross income and loss of earning capacity.

  Subject to the statute, policy terms, eligibility and individual facts.

• $5,000

  Death benefit

  A separate death benefit amount.

  Subject to the statute, policy terms, eligibility and individual facts.

Coverage, eligibility, exclusions, deductibles, provider qualification, reasonableness, necessity and policy terms are all fact-specific. The narrower PIP 14-day rule page covers the timing provision on its own.

What an "emergency medical condition" determination means

The statute ties the $10,000 and $2,500 medical limits to whether a qualifying provider determines an emergency medical condition. That is a clinical determination made by a provider the statute lists. This page does not tell you whether you have one; your treating provider and insurer can explain how it was handled in your claim.

PIP versus other coverages

Florida DFS describes these as separate parts of an auto policy:

• PIP: 80% of necessary and reasonable medical expenses from a covered injury, regardless of liability, within limits.
• Bodily injury liability (BI): applies when the insured is legally liable for injury to others.
• Uninsured/underinsured motorist (UM): applies to your injury caused by a driver without enough insurance.
• Medical payments (MedPay): coverage for reasonable medical or funeral expenses from an auto accident, regardless of fault.
• Health insurance: a separate policy with its own terms.

How these interact depends on each policy and the facts. Your insurer can explain your policy.

When a bill is reduced or denied

• Save the itemized bill, explanation of benefits and any denial letter.
• Note the claim number and the insurer contact who handled it.
• Ask the insurer for a written explanation.
• Keep a dated log of calls, letters and submissions.
• Send requested documents by a method you can track.
• Use Florida DFS consumer assistance where appropriate.
• Seek individualized legal advice from a licensed Florida lawyer when you need it.

DFS suggests contacting your insurer first, keeping detailed records and gathering documentation. DFS can help explain a Florida-issued policy and review an insurer's response, but it cannot give legal advice, make medical judgments, determine fault, determine claim value, or compel payment absent a violation. See also what to note when an adjuster calls, keeping records together and finding medical care after a crash.

If you submit an intake request

The Florida car accident intake page asks short, general questions. We do not assess coverage, PIP eligibility or claim value. Keep policy and claim numbers out of the form.