Make sure an officer is called to the scene
Florida law does not require an officer to be called to the scene of an auto accident without injuries. In a simple fender bender with no one hurt, each driver is simply required to stop and provide his or her name, address, registration number, and if requested, show the other driver his or her license. The risks of not calling an officer to the scene are fairly obvious, at least if the other driver is at fault. You may be provided with false information and if you do not have a police report you may be at a disadvantage in trying to negotiate your claim and establish the other driver’s liability. If you think the other driver is at fault, we therefore recommend that you call an officer to the scene of any accident in which you expect to make a property damage claim against the other driver or have the slightest suspicion that you or one of your passengers may be injured. If you do not call an officer to the scene, make sure that you get the aforementioned information from the other driver, as well as the name of his or her insurance provider, and ask to be shown a driver’s license to confirm the driver’s identity. If there are any witnesses, try to get their names and phones numbers.
Seek medical treatment as necessary
This is where some of the recent amendments to Florida’s No-Fault Law become particularly important. Under the new law, in order to be qualified for PIP benefits you must seek initial care within14 days of the accident. This provision is effective for medical services rendered on or after January 1, 2013. If you do not seek initial care within 14 days of the accident, you forfeit any subsequent claim to PIP benefits. This provision was intended to protect against fraudulent claims, but it will also have the effect of cheating some injured persons out of the benefit of their PIP coverage simply because they fail to seek treatment quickly enough. This is not all that unusual, as many accident victims avoid going to the hospital or a doctor because they think their post-accident aches and pains will go away or because they do not want to incur the expense. One of the ironies of the new law is that persons who are least likely to complain about and exaggerate their injuries may be the ones who are penalized. In any event, if you have any injury that requires medical attention from a doctor, it is imperative that you not delay in going to your doctor or the hospital for treatment. The initial treatment must be by a licensed EMT or a hospital’s staff or be provided, supervised, ordered or prescribed by a medical doctor, osteopathic physician or a chiropractor. Initially going to a podiatrist, naturopathic physician, acupuncturist or a massage facility is not sufficient.
The new law also provides some additional restrictions on PIP coverage. For example, the PIP medical benefits, which currently have a maximum value of $10,000 combined with any lost wage benefits, will be reduced to $2,500 if any of the insured’s medical providers determines that the insured did not have an “emergency medical condition.” Services provided by acupuncturists and massage therapists will not be compensated by PIP under the new law. Where PIP does not provide medical coverage, your own health insurance will become the primary payer for health care. Because of the foregoing rules, it is important that you make sure that your initial health care provider certifies whether you have an “emergency medical condition” at the time that you are initially seen.
Under current law, $5,000 of the maximum $10,000 in PIP benefits must be reserved for the initial treatment by doctors (M.D.’s or D.O.’s) or dentists who provide emergency services care or hospital inpatient. This requirement applies for only to the first 30 days after the insured has reported the accident to the PIP insurer and covers medical bills for which claims are submitted to the insurer within this time period. Thereafter, any of the remaining PIP funds may be allocated to either medical care or lost wages.
Report the accident to your insurer immediately
Your insurance policy probably requires you to notify your insurer as soon as possible after the accident. It is important that you follow the instructions in the policy, both to preserve your insurance benefits under the policy and to start the ball rolling on processing property damage claims (your own and, if you were at fault, the other driver’s). It is also important to notify your insurer as soon as possible after the accident to start the 30-day period running in which $5,000 of PIP benefits must remain allocated to initial medical care.
Take photographs of the vehicle damage and your own injuries
Even though photographs of the vehicle damage may later be available from the insurance company, it is a good idea to take your own photographs. Make sure that you include all of the areas of exterior damage and any areas of interior damage. You will also want to preserve photographic evidence of your injuries following the accident. Bruises fade, and photographs taken near the time of the accident are often valuable evidence of the force of the collision. If the vehicle has been totaled and you anticipate that you may have a personal injury claim, you should consult with an attorney before allowing the vehicle to be destroyed.
Consider making a property damage claim for your repaired vehicle’s diminished value
After you have reported the accident to your own insurer, you can expect to be contacted by a property damage adjuster who will be responsible for either paying for the repairs to your vehicle or declaring it a total loss and paying you the replacement value (if you are not entitled to more because of gap coverage). If the other driver was clearly at fault, you will likely be dealing with the property damages adjuster for his or her insurance company. If you were at fault, or if liability is contested, you will be dealing with your own adjuster. In any event, if the vehicle has not been totaled and is being repaired, you should consider whether you want to make an additional claim for the diminished value of the vehicle as a result of the accident. A vehicle that has been in an accident is never as marketable or valuable as a similar vehicle that has not. The difference in value is potentially compensable under the property insurance policy. This sort of claim is usually only made with newer or expensive vehicles.
Do not talk with BI or UIM adjusters without an attorney’s advice
As stated above, if you are not at fault for the accident you can expect to hear from the other driver’s property insurance adjuster about resolving your property damage claim. While you can and must talk with the property damage adjuster in order to resolve your claim, if you are contacted by the at fault driver’s BI adjusteror by your own UIM adjuster about resolving any claim for bodily injuries, you should talk with any attorney before making any statement.
Contact an attorney if your PIP insurer requests a medical examination
If requested by the insurer, a person claiming PIP benefits is required to submit to a mental or physical examination by a physician paid for and chosen by the insurer. Such an examination can be requested whenever the mental or physical condition of an injured person is material to any claim that has been or may be made for past or future personal injury protection insurance benefits. An “unreasonable” refusal to submit to or failure to appear for such an examination constitutes grounds for termination of benefits. Under the new PIP law, an insured’s refusal to submit to or failure to appear at two examinations raises a rebuttable presumption that the insured’s refusal or failure was unreasonable. If your insurer requests that you appear for such an examination, it is a sign that the insurer is contemplating the possible termination of future treatment on the grounds that it is unnecessary, either because you have already recovered or because the treatment is unrelated to any injury that you may have suffered in the accident. If you receive such a request, you should contact an attorney immediately so that you can discuss your legal options.