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Most people don’t know what to expect when filing a PIP (personal injury protection) insurance claim in Florida until they have to; when an accident occurs. When an accident happens, insurance documents and payments can seem daunting, especially if you are dealing with the stress of an injury, an injured loved one, or even a death. But knowing what to expect and understanding the responsibilities of your insurer and your healthcare provider can help. 

What to Expect When Filing a PIP Insurance Claim in Florida

Right Away: Crash Report 

If you are not seriously injured, you should call a police officer to make a crash report. The officer will ask you, others involved, and witnesses what happened in order to make an accurate report. An accurate crash report will show who is at fault in an accident and what damages occurred. While Florida is a no-fault insurance state and you can expect to file a PIP insurance claim regardless of fault, it may make a difference in other areas of your insurance claim, or a personal injury claim against the at-fault driver. 

If you are seriously injured, you should seek medical attention right away. A crash report will still be filed, and you or a family member can contact the police afterwards to get a copy for your records. 

If you have the ability to help with a crash report, you should or, in some cases, must. In Florida, a crash report is legally required in the following cases, according to the DMV. It’s also a good idea to get one for the record even if it is not legally required. 

  • The damages from the accident appear to exceed $500.
  • Someone is injured or killed (motorist, pedestrian, or cyclist). 
  • Someone flees the scene (a hit-and-run). 
  • Someone is intoxicated 

Right Away: Get Medical Attention 

If you don’t get medical attention in the first 14 days after your accident, PIP insurance won’t cover you. The longer you wait to seek treatment, the harder it is to know what to expect when filing a PIP claim in Florida. 

All motorists in Florida are required to carry PIP insurance, and this insurance is required to cover the immediate costs of accident-related injuries, regardless of who is at fault. This means it is essential after an accident to get treated right away. Go to an emergency room, hospital, family doctor, or chiropractor as soon as you can. 

During Your Visit: Injury Assessment 

If you are not seriously injured when you visit the doctor, hospital, chiropractor or another healthcare provider, you may be asked to give details about your injury, the accident, health history, and your insurance. If you’re unable to answer questions or fill out forms when you seek treatment, you may be asked at a later date, or a family member may be asked for more details. 

When you seek treatment, your medical provider will ask you a series of questions to determine the best type of treatment, and the best way to file an insurance claim. They may also ask about the accident to determine how the injury may have occurred, and symptoms you may have later on. Remember that not all symptoms appear right away. Other symptoms, like symptoms of a concussion, can appear later once the adrenaline from the accident has passed. 

During Your Visit: Assignment of Benefits 

Your healthcare provider will ask about your car insurance information in order to file a PIP claim. At this stage, the doctor, hospital, or office may ask you to sign an “assignment of benefits form.” This will allow your healthcare provider to contact your PIP insurance provider for reimbursement. It also allows your insurer to pay the doctor, hospital, or chiropractor directly, so you don’t have to handle the payments yourself. If you don’t know what to expect when filing a PIP claim in Florida, this document can be confusing. Read it carefully and ask questions if you don’t understand. If you aren’t able to read or understand the document, ask a trusted family member for help. 

At The End of Your Visit: Follow-Up Appointments 

More than likely, you will require some follow-up appointments or extra care after your first visit following your accident. Towards the end of your visit, your healthcare provider will give you an outline for follow-up appointments or other services you may require, such as physical therapy. If you are seeking chiropractic care, this will probably include several visits for readjustments or realignments. 

Keep accurate records of all of these appointments. If a problem does come up with your insurer and your claim is denied, you’ll have the facts you need to support your case. 

After Visit: Physician’s Report And Claim

Once your healthcare provider has the information they need and permission to contact your insurer, they’ll make a claim for the amount the insurer will cover. In the case of PIP insurance, your healthcare provider will ask your insurance company to reimburse them for 80% of the covered expenses, including follow-up visits. They will fill out a Physician’s Report with details about your injuries and treatment. Your insurer or your healthcare provider or both will ask you to verify that the report is correct. Using this and other PIP insurance documents, your healthcare provider will file a claim with your insurer. 

In the Physician’s Report, the term “emergency medical condition” (EMC) can be important. The presence of an EMC determines whether you can receive up to $10,000 in benefits. If you do not have an EMC—which includes life-threatening and debilitating injuries—you will receive up to $2,500 in PIP insurance benefits. 

After Visit: Billing 

It is important to understand how billing works so you know what to expect when filing a PIP claim in Florida. Your PIP insurance will cover 80% of medical expenses incurred by the accident, but you are responsible for the other 20%. If you have a deductible on your PIP insurance, or you have Med Pay, these amounts may differ. Your medical provider will file a claim with your insurance and they will send you a bill for the expenses that are not covered. 

At Home: Compensation for Lost Wages 

Many people who do not know what to expect when filing a PIP insurance claim in Florida overlook this benefit of their insurance plan. Not all PIP insurance plans cover wages lost for the time you were out of work, but many do. To receive these benefits, you’ll need to request, fill out, and return a “Wage and Salary Verification” form. You will need your employer(s) to verify your income. 


When you know what to expect when filing a PIP insurance claim in Florida, the process does not seem so intimidating. Having a good understanding of what your PIP insurance covers before an accident can help you make a claim easily. Working with your healthcare provider and having a good understanding of expenses and treatment can also help. Once you understand the process, you can get the most out of your insurance.


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