What Is a No-Fault Car Accident Claim?

What Is a No-Fault Car Accident Claim?

Florida is a no-fault state, which means that if you get into an accident, your insurance policy pays for your damages, regardless of who is at fault. A driver must have personal injury protection insurance included in their policy to cover accidents. The state instituted no-fault laws years ago to make it easier for those in car accidents to access medical care.

However, medical expenses increased over the years, and the minimum of $10,000 is not nearly enough to cover costs. So, what happens when your insurance policy does not cover all of your damages?

Is No-Fault Coverage Mandatory?

Florida law requires that every registered vehicle have no-fault insurance, except for motorcycles. Additionally, if a non-resident is in Florida for more than 90 days of the previous 365 days, the non-resident must obtain no-fault coverage.

However, a vehicle owner can opt to provide “security” via a surety bond or by providing a certificate of self-insurance from the Florida Department of Highway Safety. People rarely use this form of “insurance,” as it is more difficult to use and more expensive than buying insurance.

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The Pros and Cons of No-Fault Motor Vehicle Insurance

No-fault insurance allows people to deal with their own insurance company after an accident. They don’t have to worry about proving fault, which means they do not have to prove their injuries.

Personal injury protection (PIP) covers medical expenses and lost wages, and the injured person receives compensation faster.

However, insurance laws limit personal injury protection via the amount and the type of damages you can recover.

You cannot file a personal injury lawsuit against the at-fault driver to recover damages such as quality of life and pain and suffering if your injuries are not permanent.

Another disadvantage of no-fault insurance is that premiums are often higher because no-fault insurance pays for more types of medical services than states with a tort system for insurance.

What is Personal Injury Protection Insurance?

As part of your no-fault policy, you must have personal injury protection (PIP). It covers you even when you are not driving or riding as a passenger in your vehicle.

It also covers you when:

  • You are a passenger in someone else’s vehicle.
  • You suffer injuries from someone else’s vehicle accident.

Personal injury protection insurance also covers any relatives that live in your home unless they have their own coverage. The insurance also covers anyone who drives your vehicle and uninsured passengers, even if they are not related to you.

Minimum Personal Injury Protection Insurance Requirements for Florida Drivers

The minimum amount of personal injury protection a driver can have is $10,000 per person per accident. No-fault also allows for $5,000 in death benefits. No-fault policies cover 80 percent of your medical treatments and 60 percent of lost wages or expenses to hire someone to help you, up to the $10,000 limit. PIP does not cover non-economic losses, such as pain and suffering.

How Does Living in a No-Fault State Affect You?

Your car accident claim becomes more complicated, especially if you have damages exceeding your insurance policy’s coverage or if you deserve compensation for pain and suffering and other non-economic damages.

The at-fault driver’s insurance will not cover anything your insurance covers. Thus, if you have to settle or sue the other driver (or his insurance company), your attorney must determine what your personal injury policy will pay, then sue for the remainder.

If you do have to sue or enter settlement negotiations to recover non-economic damages, you must prove you sustained permanent or significant injuries.

Recovering Additional Damages

Economic damages have a monetary value. In states without no-fault coverage, the court orders the at-fault driver to pay economic damages in an attempt to make you whole again. However, Florida is a no-fault state, so you get economic damages without having to prove fault.

But your insurance policy limits the amount you can recover. If you have a minimum of $10,000 and your medical expenses are hundreds of thousands, you will have to go after the at-fault driver to cover the difference. Insurance laws also limit economic damages to an extent.

Catastrophic injuries could mean that you have to find a way to pay:

  • Doctors’ appointments, surgeries, and follow-up appointments.
  • Therapy appointments, including physical therapy, occupational therapy, psychological therapy, and cognitive therapy.
  • Hand controls for your vehicle.
  • Prescriptions and prescribed over-the-counter medications.
  • Ambulatory aids, such as walkers, wheelchairs, and canes.
  • Medical equipment, including but not limited to oxygen machines and tanks.
  • Updates to your home, such as handrails, grab bars, widened doorways, and wheelchair ramps.
  • Rehabilitation or nursing home expenses.
  • Home health care expenses.
  • Lost wages.
  • Loss of earning capacity from the time of the accident through the time you would normally retire.
  • Funeral and burial costs, cremation expenses, probate attorneys’ fees, and certain probate costs if you lost a loved one in a car accident. The minimum amount no-fault pays for deaths is $5,000. Even if you take out a higher amount, it may not cover all death-related expenses.
  • Replacement or repair of destroyed or damaged personal property, including your vehicle and anything of value in it.

You could also have other injuries the accident did not directly cause. Wounds could become infected, or the accident could exacerbate previous injuries or conditions. You would not have the expenses or additional pain and suffering if not for the at-fault driver’s negligence. If your no-fault PIP insurance is not enough to cover everything, you might have to enter settlement negotiations or sue the at-fault driver or their insurance company.

If you deserve compensation for non-economic damages, you must sue or try to settle with the at-fault driver’s insurance. No-fault insurance does not cover non-economic damages. Similar to economic damages, in tort states, the court orders the at-fault driver to pay non-economic damages. Sometimes called general damages, non-economic damages do not have an objective monetary value.

Non-economic damages include:

  • Pain and suffering, including emotional distress.
  • Loss of quality of life if you have to make life-long changes, such as using ambulatory aids or taking prescriptions for the rest of your life.
  • Loss of use of a body part, such as an arm or foot.
  • Loss of use of a bodily function, such as your eyesight or bladder.
  • Loss of consortium if you can no longer have a physical relationship with your spouse.
  • Loss of companionship if you can no longer enjoy time with your family or participate in family activities and events.
  • Inconvenience if you have to hire someone for domestic activities, such as home repair and maintenance, lawn maintenance, house cleaning, and grocery shopping.
  • Excessive scarring or disfigurement.
  • Amputation of a limb or digit.

How to Recover a Fair and Reasonable Settlement?

Should you have to prove the other driver was at fault and that you deserve compensation for injuries and other damages, it could take time to gather evidence for your case. If your injuries allow, you can start documenting the incident at the accident scene.

After checking on other drivers and calling first responders and police:

  • Take photos of the accident scene from all angles. Be sure to take pictures of any damage to the road and nearby property, including mailboxes, utility poles, fences, traffic control signals, yards, and other property.
  • Ask the driver for their contact, insurance, and registration information. If possible, take clear photos of the documents.
  • Ask witnesses for their contact information. You can also ask witnesses what they saw.
  • Allow emergency medical technicians to check you over, even if you believe your injuries are minor. Sometimes serious injuries take hours or days to show up.
  • Give your statement to the police.

As soon as the police release you from the scene, seek medical attention to further document your case. Tell the doctors and nurses that you were in a motor vehicle accident and need a thorough check-up.

Finally, contact a car accident lawyer as soon as possible. If you have catastrophic injuries and cannot make the call yourself, your spouse can call. A lawyer will investigate the accident as part of representing you, as the police report is not always correct. The other driver could lie or may not remember the facts. The police only report what they can observe and what people told them.

Working With Insurance Companies

A common misconception is that your insurance company will look out for your interests. All insurance companies are in business to make a profit, and they do not care about your loyalty to them. They only care about their bottom line and will look for ways to avoid or reduce your settlement.

Thus, only give it your name, policy number, contact information, date and location of the accident, and your attorney’s contact information when you speak to the insurance company. If the representative encourages you to discuss the accident, continue referring them to your attorney.

Even though your insurer is obligated to pay the minimum, insurance companies might balk at paying out claims on higher amounts even when you have the extra coverage. They may use what you say to deny coverage or only offer a minimum, claiming certain expenses are not covered.

If you have to recover compensation from the at-fault driver’s insurance company, under no circumstances should you speak with them. They will likely use tactics to deny your claim or make you a lowball offer.

Insurance companies are less likely to try these tactics with an attorney because the attorney knows the complex laws of no-fault insurance. They also know that it is harder to convince an attorney of fault than it is a layperson.

Severe and Catastrophic Injuries

What’s the difference between catastrophic injuries and permanent injuries? A severe injury is one that most people recover from, even if it takes months. A catastrophic injury is life-changing, permanent, and often leads to death.

The Social Security Administration considers a permanent injury any injury that results in a disability expected to last longer than a year or cause death. While insurance companies have definitions of permanent injuries, the Social Security Administration’s definition is a good place to start.

Head, neck, and shoulder injuries can often be catastrophic. Traumatic brain injuries, back injuries, and spinal cord injuries are almost always catastrophic. One exception is a mild concussion. While medical professionals consider a mild concussion a catastrophic injury, most people recover from them within days or weeks.

However, mild concussions can affect a person later in life. You must tell your medical professionals and attorney if you have had a concussion before and how many. You could recover compensation for future injuries, such as chronic traumatic encephalopathy.

Severe injuries could also turn into permanent injuries. For example, doctors cannot always set a broken leg perfectly, and it could affect the rest of your life. In some cases, even if they set it properly, you could still have trouble. Your attorney will work with your doctors and other medical professionals to review your medical records and determine whether your injuries will become permanent disabilities.

If you suffered injuries in a car accident, contact a car accident lawyer for a free case evaluation as soon as possible. Even if you are still in the hospital, a lawyer can help you on your way to recovering the compensation you deserve.

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