Personal Injury FAQs

Personal Injury Comparative Fault

‘Comparable fault’ law entitles you to some medical coverage

Q: I had a car accident which was partly my fault, but the accident report only says that I was responsible. I was taken to the hospital by ambulance before the office could question me about the accident. I am now being treated by a chiropractor. Last week my insurance sent me to their doctor to be examined, and today I was told they won’t pay for any more of my medical bills. I really need more medical treatment, but I can’t afford to pay for it myself. Would it make a difference if I fight the police report?

A: I’m sorry to hear about your car accident. Trying to handle these problems on your own is probably causing even more stress. This is a good question with multiple issues that need to be explained:

• Florida laws follow the legal concept of “comparative fault,” meaning, if you were 40% at fault, and the other driver was 60% at fault, you’d be entitled to recover 60% of your total damages from the other driver. (Damages may include loss of earnings, past and future medical expenses as well as pain and suffering). Periodically we do see accident reports that are incorrect. It is unlikely the police officer’s report will be shown to a jury, or that he will be qualified to give his opinion as to who was at fault under Florida’s rules of evidence. Nonetheless, if you believe the police did not obtain the facts accurately, you should immediately hire a competent and reputable personal injury attorney to assist you in establishing the evidence to prove you’re not 100% at fault for this accident. An experienced attorney will attempt to find witnesses and get photographs, along with further accident investigation and analysis.
• Regardless of who is at fault in a car accident each person must submit his medical bills to his own insurance company. People commonly purchase $10,000 of PIP coverage. After the deductible has been met, your PIP coverage in Florida pays 80% of your medical bills and/or 60% of lost wages up to $10,000. In many cases, insurance companies look for ways to avoid paying out the entire $10,000 in benefits by limiting the medical treatment. As they did with you, they may require an “independent medical examination” (IME) to determine whether you are really injured and/or if further treatment is needed. Now that you have had the IME, your insurance company has apparently decided you are not in need of future care, regardless of what your own treating doctor recommends. Therefore, you must either fight the company to have your medical bills paid up to the limits of $10,000, or you will need to start paying your doctor out of your own pocket.

I urge you to speak to a personal injury attorney about these issues. Without assistance, you may lose the rights and benefits you need even if you are entitled to them.

Personal Injury PIP No-Fault Law

New PIP No-Fault Law will affect you

Q: I heard that the PIP Insurance rules have changed. How will this affect my family and me?

A: You are right. On January 1, 2013 a new PIP No-Fault was passed which significantly benefits insurance companies – at your expense. Florida is a “No-Fault” state where all drivers are required by law to carry Personal Injury Protection (PIP) Insurance. PIP is used to pay your medical expenses and lost wages when you are injured in an automobile accident regardless of who caused the accident.

• Here is how PIP worked prior to the change: If you purchased and paid for $10,000 of Personal Injury Protection, you would be entitled to $10,000 to cover lost wages and medical expenses incurred due to the automobile accident.
• Here is how the new PIP law affects you: Your insurance company can limit the payment of your lost wages and medical expenses to $2,500 if you fail to seek medical care within 14 days of an accident.

As a result of the change, the hard-earned dollars you paid in premiums will not provide you with money or medical care when your need is most critical, unless you see a qualified physician within 14 days of the accident. Not only must you seek medical care within this time frame but your medical provider must also diagnose your condition as an Emergency Medical Condition, directly caused by your accident.

• Here is why you should be concerned: The new law does not define what types of injuries qualify as an Emergency Medical Condition. Therefore, the insurance companies will be free to use this loophole to deny you the money you need and deserve. Our firm, Rosenthal, Levy, Simon & Sosa has been Fighting for the Injured since 1985. We have the strength and experience to get you all the benefits you are entitled to. These new PIP laws have only made us more determined to seek justice by protecting the public and fighting insurance companies.

If you are involved in an automobile accident, we urge you to call us without delay so that we can guide you through this legal minefield and help you prevent costly mistakes. Protecting your rights is what we do. We are dedicated to providing you the justice that you deserve.