Does Your Injury Qualify as an Emergency Medical Condition Under the Florida PIP Laws?

Florida Senate Bill 1860 was supposed to reduce insurance fraud and insurance rates, but the new personal injury protection (PIP) regulations may serve only to reduce the amount of coverage that an injury victim can expect for a Boca Raton car accident injury.

Under Florida’s new PIP law, there are two levels of personal injury protection coverage for car accident injuries. A person who is diagnosed with an emergency medical condition may receive up to $10,000 in medical benefits. If a Florida accident injury is not classified as an emergency medical condition, a Florida accident victim is limited to $2,500 in coverage.

The term “emergency medical condition” comes from the U.S. Emergency Medical and Active Labor Act, a federal law that requires hospitals to treat uninsured patients with emergencies. An injury can be considered an emergency medical condition if the absence of medical care will result in any of three conditions:

1. A serious jeopardy to the patient’s health
2. A serious impairment of body functions
3. A serious dysfunction of any organ or body part

The injury must be classified as an emergency medical condition by a physician (MD or DO), dentist, physician assistant, or advanced registered nurse practitioner.

How will you know if you have an emergency medical condition? Is a painful, stiff neck from whiplash considered enough of an emergency to deserve treatment? Is being unable to walk comfortably a “serious” impairment of body function? Does severe pain jeopardize to a patient’s health. The truth is that nobody knows yet.

The average emergency room visit costs about $1,400. If you go to the emergency room and are not diagnosed with an emergency medical condition, you could end up with very little coverage for your injuries. This goes against the purpose of PIP law that was first enacted in 1972 for the sole purpose of ensuring that every Florida driver would be able to pay accident-related medical bills.

There are other ways to pay for your medical bills. If you were injured in a Florida car accident, a Boca Raton injury lawyer can help locate all the resources available to pay for your medical care. To learn more, contact David Glatthorn at 866-413-5525.