How are Personal Injury Protection Deductibles applied if I am involved in a car accident?

Florida Statute allows the named insurer to elect a PIP deductible that applies to the named insurer alone or the named insured and dependant relatives residing in the same household. F.S. 627.739(1). Therefore a claimant that isn’t a named insured or dependant relative in the household can have access to more benefits than the named insured. By Florida law, insurers can only offer deductible of $250, $500, and $1000. An exception to the PIP deductible is for death benefits payable under Florida Statute. Be mindful what your insurance policy states so you are aware if you are liable for out of pocket costs in the event of an accident. The PIP deductible does not have to come out of pocket from the insured and may be paid from other sources, including worker’s compensation. Fortune Insurance Co. v. McGhee, 571 So.2d 546 (Fla. 2d DCA 1990). In a case involving a $1000 deductible, an injured party would have to sustain $13,500 in medical expenses in order to claim the available $10,000 in PIP benefits. After the $1000 deductible is taken away, the insured is able to recover 80% of the balance, totaling $10,000.

When the insured is covered by more than one policy, the deductible doesn’t apply. State Farm Mutual Automobile Insurance Co. v. Zuckerman, 520 So.2d 895 (Fla. 4th DCA 1989). For example, if your child is injured as a passenger in a third party vehicle that has a $1000 PIP deductible, that deductible can’t be applied by your own insurance company for the payment of any medical benefits. In the Zuckerman case that decided this issue, a child was an injured passenger in a third party vehicle. The child was covered under two policies, the owner’s and his mother’s. The mother’s policy, which had a deductible paid out 80% of the claim after the deductible was applied. The owner’s policy didn’t have a deductible but the insurance carrier, State Farm, tried to apply the deductible language in its policy to subtract the benefits they had to pay. The Florida court ruled that State Farm could not do this.

Finally, if you have been involved in a Palm Beach County car accident, can the tortfeasor (person causing injury) be forced to pay the deductible under Florida Law? According to an amendment to the Florida Statute, the injured is now allowed to recover the deductible from a tortfeasor. F.S. 627.739(1).