A common presumption about car accidents in no-fault states is that neither party is held liable. Either for injuries or property damage. This is inaccurate. What it actually refers to is the insurance policy that is mandatory for each vehicle to carry.
What is No-Fault State Car Insurance
No-fault state car insurance is known as the Personal Injury Protect (PIP) Policy, and it is designed to compensate victims of car accidents. What happens if you have an accident in a no-fault state? Car accident victims are provided quick compensation through their own insurance policy even if they were not at fault. The goal of this policy is to reduce personal injury lawsuits filed by victims of car accidents.
So, when you are making a no-fault insurance claim, you do not have to worry about your claim being denied. Because of a dispute over the cause of the accident. You do not have to prove that the accident was another’s fault, not yours.
What Kinds of Damages do PIP Policies Usually Cover?
PIP policies generally cover up to 80% of all emergency medical expenses within your policy’s limit. This is applicable for treat provided by a licensed doctor, dentist, or facility owned by the hospital. For injuries that are not very serious, policies usually provide compensation up to $2500.
Loss of Wages
PIP policies also make up for lost wages. When the injured victim was too weak to go to work. In Florida, PIP Policies will cover at least 60% of the victims’ wages. In fact, they base this percentage on the victim’s salary for at least 13 weeks immediately after the accident.
Death and Burial Expenses
PIP policies also cover death and burial expenses. And can provide up to $5000 as death benefits to all qualifying survivors.
The types of damages that are not covered by an individual’s PIP policy are usually pain and suffering claims and general damages.
If you are in a car accident in a no-fault state, you have to submit a PIP claim. Your insurance company has 30 days to accept or reject your PIP claim. If the insurers rejecting your claim, they have to provide a written explanation as to why. This gives you the opportunity to appeal your insurance company’s denial. A qualified attorney can help you with the steps.
There are some vehicles that no-fault coverage does not include. For example, in the case of motorcycles, the policy does not include motorcycles specially designed for off-roading purposes. Or certain types of commercial vehicles. But if you get injured riding a motorbike, bicycle, or even as a pedestrian, the no-fault coverage you have purchased for your car might be able to cover your injuries.
What Happens If the Car Accident Is Your Fault?
If the car accident was your fault and you have suffered an injury, you can file a claim under your own PIP insurance plan. If you drive impaired or if you caused the accident on purpose, your insurance policy can stop you from filing the claim. In Florida, to receive compensation through your PIP policy you need to seek medical attention within a period of fourteen days.
The other car’s occupant will also receive compensation through their PIP policy. But if their expenses exceed their policy’s limit, they can file a third-party claim for your insurance. If they have serious or permanent injuries, they can file a personal injury lawsuit.
Reasons Your Insurance Company Denied Your PIP Claim
Suppose you pay the premium of your insurance policy, but they reject your PIP claim. What reason could your insurers have to reject your claim?
They can reject your claim if you received minor injuries that did not require emergency medical attention. So, you did not qualify for compensation up to your policy’s limit.
A claim rejection can also happen if a pre-existing reason caused your injuries and were not caused by the accident. For example, if your car accident occurred while you were committing a felony. Or if you caused the accident on purpose. Or you were driving someone else’s car without permission.
Other reasons could be if your insurance plan has lapsed or if the damages you are seeking are not covered by your policy.
These are some of the reasons insurance policies deny no-fault car accident claims. Even when they have to pay, adjusters tend to look for reasons to avoid payment or to pay a lesser amount.
You do not necessarily need an attorney to file a no-fault claim with your insurance company. But it is always helpful to get an attorney’s guidance. They can also answer any questions you have regarding the insurance claim process. Moreover, if your insurance claim is rejected for some unknown reason, a car accident attorney can outline a legal course of action for you.