Florida PIP: the 14-day medical care rule

Treat the 14-day period as urgent.

Florida Statutes section 627.736 ties PIP medical reimbursement to receiving initial services and care within 14 days after the crash. Do not wait for symptoms to become severe or for the insurance investigation to finish. Seek care based on your health needs, and tell the provider when and how the collision occurred.

Use a provider recognized by the statute.

The statute identifies who may provide initial care, including certain licensed physicians, dentists, chiropractic physicians, advanced practice registered nurses, hospitals, and emergency transportation providers. Follow-up care has separate provider and referral rules. Confirm that the provider and services qualify rather than assuming every appointment will be reimbursed.

Understand the PIP benefit limits.

PIP generally pays 80% of reasonable, medically necessary covered medical expenses. Medical reimbursement may be available up to $10,000 when an authorized professional determines that the injured person had an emergency medical condition; otherwise, the statute limits medical reimbursement to $2,500. These are coverage limits, not promises that every charge will be paid.

Notify the insurer and save the records.

Section 627.736 permits the insurer to require notice as soon as practicable. Save the claim number, policy, medical records, bills, work notes, and insurer letters. Section 627.7401 generally requires a PIP insurer to deliver a notice describing insured rights within 21 days after receiving notice of an accident or injury claim, subject to a permitted extension. Review that notice and any benefit explanation promptly.

Common questions