The Ticktin Minute August 21, 2017 – PIP Off-Set

PIP Off-Set

As a “No Fault” state, Florida drivers are required to carry on their auto insurance policies, Personal Injury Protection (PIP) which covers the first ten thousand dollars ($10,000.00) of medical expenses at eighty percent (80%). Regardless of what a medical provider charges, the PIP carrier will reduce their bills according to the Florida PIP fee schedule which is based on the Medicare part B fee schedule. Most claimants will never see any money from these funds which are earmarked strictly for medical bills. If you are injured in an accident that was not your fault, you may be able to collect a settlement based on your damages from the defendant’s insurance company.

Whatever amount PIP pays towards your medical expenses, the defendant’s insurance company will be entitled to a credit or “off-set” against what was paid. Thus, in theory, if the value of your claim is $25,000.00 and your PIP pays a full $10,000.00, then the defendant would only have to compensate you for $15,000.00, as they are entitled to apply a $10,000.00 off-set. Is they had only paid out $5,000.00, the defendant would only have to compensate you $20,000.00. If your case proceeds to trial, a jury will not know whether your auto insurance would have paid your bills. After the jury’s verdict, if they find for the plaintiff and award money damages, the judge will adjuster the award by applying the PIP offset of the amount paid.

The situation gets more complicated when someone is in an accident and is not carrying PIP on their vehicle. Defense insurance companies argue that they should still be entitled to a $10,000.00 off-set based on the fact that the plaintiff should have been carrying PIP. The rationale is that the plaintiff should be the one punished, rather than the insurance company having to pay more money because the plaintiff failed to carry the necessary, required coverage. The state appellate courts in Florida differ on their view of this issue and it has not yet been heard by the Florida Supreme Court. For now, the issue of whether the off-set will be applied to an uninsured driver depends on where in the state the accident occurred.