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Florida injury claims, explained

Four rules decide the shape of most Florida injury claims long before anyone argues about value. Here they are, with the statute references, the traps, and an honest note about what needs verifying.

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Florida no-fault, section 627.736

The 14-day window that decides whether your own insurance pays

Florida pays your medical bills through your own Personal Injury Protection coverage, whoever caused the crash. That benefit switches off if you do not receive initial services and care within 14 days. Move the slider to the day you are on.

Day 0

Window open

You are inside the window with room to spare.

Florida's no-fault statute pays your own Personal Injury Protection benefits only if you receive initial services and care within 14 days of the crash. Nothing has been lost yet, and this is the cheapest possible moment to get examined.

  • See a physician, osteopathic physician, dentist, chiropractor or a hospital emergency department. Those are the provider types the statute recognises for initial care.
  • Say the crash caused the visit and describe every symptom, including the ones you think are minor. Undocumented complaints become disputed complaints.
  • Ask whether an Emergency Medical Condition determination is warranted. That single finding decides which PIP limit applies to you.

Who can make the EMC call

An Emergency Medical Condition determination may be made by a physician, an osteopathic physician, a dentist, a physician assistant or an advanced practice registered nurse. A chiropractor cannot make it, which is why a chiropractic-only course of care often ends with a reduced benefit.

What PIP actually pays

PIP is a percentage benefit, not a full indemnity: it reimburses a share of reasonable and necessary medical expenses and a smaller share of lost income, subject to the policy limit and any deductible you chose. The balance is a claim against the at-fault driver.

What PIP will not pay for

Massage therapy and acupuncture are excluded from PIP reimbursement by statute, however the treatment is billed or coded. Riders are excluded too: motorcycles are outside Florida's PIP requirement entirely, which is why a rider's medical bills start unfunded on day one.

Two limits, one determination

Florida's no-fault statute sets a full medical benefit limit and a lower sub-limit that applies when no Emergency Medical Condition is found. Both figures are set by statute and have been amended before, so confirm the current numbers against the statute rather than against any website, including this one.

Fla. Stat. § 627.736 (Florida Motor Vehicle No-Fault Law) sets the window, the benefit limits and the sub-limit. Those figures are amended from time to time, so confirm the current statutory text before relying on them. Nothing here is legal advice.

Fla. Stat. 768.81, amended 2023

One percentage point can end a whole case

Florida is a modified comparative negligence state. A jury assigns each party a share of the fault, and your award falls by your share. Cross fifty percent and you recover nothing at all. Drag the dial to see the effect.

The bar at fifty percent is the line the whole defence strategy aims for.

0%

Nothing is deducted for your conduct

The jury assigns you no share of the fault and your damages award is not reduced on this basis.

Your damages award is not reduced on this basis.

Fault is a number on the verdict form

Comparative fault is not an argument the adjuster makes and the jury ignores. It is a line the jury fills in: a percentage for each party whose negligence contributed to the injury, totalling one hundred.

Non-parties can be put on that form

Florida lets a defendant name a non-party it says shares the blame, so the jury can hand a share of the fault to someone who is not in the courtroom and cannot be collected from. Pleading and proof requirements apply, and they are strict.

Joint and several liability is gone

Each defendant pays its own apportioned share of non-economic damages. One deep-pocketed defendant no longer covers a share assigned to a defendant with no insurance, which changes who is worth suing.

Medical negligence is treated differently

The greater-than-fifty-percent bar was written for negligence actions generally, and medical negligence actions are carved out of it. Whether a given claim sits inside or outside that carve-out is a question to settle before filing, not after.

Fla. Stat. § 768.81, as amended by CS/HB 837 (effective 24 March 2023). The threshold, the carve-outs and the pleading rules for naming non-parties have all changed within recent sessions and can change again. Confirm the current statute and case law before relying on any of this. It is not legal advice.

Fla. Stat. 627.727 and the dangerous instrumentality doctrine

Florida does not require most drivers to carry injury coverage

PIP and property damage liability are the mandatory pair. Bodily injury liability is not. So the first job in every crash file is working out which policies exist at all. Answer four questions and we will list the layers worth chasing.

You were
The at-fault driver carried bodily injury coverage
You or a household relative carry UM coverage
The at-fault driver was working at the time

6 policy layers worth checking

  1. The at-fault driver's bodily injury liability policyFirst layer, when it existsFlorida does not require most private passenger vehicles to carry bodily injury liability coverage at all. PIP and property damage liability are the mandatory pair. So the first question in every crash file is not how much BI coverage there is, it is whether there is any.
  2. The vehicle owner's policy, even if the owner was not drivingDangerous instrumentality doctrineFlorida treats a motor vehicle as a dangerous instrumentality, so an owner who entrusts the vehicle to another driver is vicariously liable for that driver's negligence. A borrowed car therefore opens a second policy that has nothing to do with who was behind the wheel.
  3. Your own uninsured and underinsured motorist coverageThe layer people forget they boughtUM coverage follows the person, not the car. It responds when you are a driver, a passenger in someone else's vehicle, a pedestrian or a cyclist. It also responds when there is BI coverage but not enough of it, which is the far more common case.
  4. A resident relative's UM coverageHousehold policies, not just yoursA resident relative's UM coverage can reach you even though the policy is not in your name and the vehicle was not involved. That is why we ask for the declarations page of every policy in the household, not only yours.
  5. Stacked UM limits across multiple vehiclesStacked or non-stacked changes the ceilingStacked UM multiplies the per-vehicle limit by the number of covered vehicles on the policy. Non-stacked does not. Insurers may sell either, and a UM rejection is only effective if it was made on the approved statutory form, which is worth reading rather than assuming.
  6. Personal umbrella or excess liability policiesSits above the primary layerAn umbrella policy sits above the underlying auto limits and only responds once those are exhausted. Homeowners and umbrella carriers frequently deny that auto losses trigger them, so the declarations and the underlying-limits endorsement both matter.
  • Never accept a liability limits tender without written consent from your UM carrier first. Settling with the at-fault driver without that consent can wipe out the UM claim you were about to make.
  • A UM rejection signed years ago on a form that did not meet the statutory requirements may not be a valid rejection at all. We order the underwriting file rather than taking the carrier's summary for it.
  • Property damage liability coverage is not bodily injury coverage. A driver who tells you at the scene that they are insured may be insured only for your bumper.

Fla. Stat. § 627.727 (uninsured and underinsured motorist coverage), together with Florida's financial responsibility requirements and transportation network company statute. Mandatory coverage types, UM rejection formalities and rideshare period limits are all set by statute and are amended from time to time. Confirm the current text. This is not legal advice or a coverage opinion.

What happens between the cheque and your bank account

Six things happen to a recovery before you are paid

Most firms show you a number. The number is not the point. What decides what you keep is the order below, and how hard somebody argues at step five. Scroll: each stage pins as the next one arrives.

  1. The recovery lands in the trust account

    Nothing is disbursed on the day the cheque arrives.

    Every dollar recovered on your behalf is deposited into the firm's trust account and stays there until it clears and until every competing claim against it has been identified and resolved. A lawyer who disburses around a known lien is exposed, and so is the client.

    • Funds are held in a Florida Bar trust account, separate from firm operating funds.
    • We do not disburse against uncollected funds, so a large cheque adds days, not weeks.
    • You receive a written itemisation before anything moves.
  2. Advanced case costs come off the top

    The money the firm already spent to build the case.

    Costs are not the fee. They are the out-of-pocket expenses advanced while the case was running, and under our fee agreement you owe them only out of a recovery. If there is no recovery, we absorb them.

    • Filing fees, service of process, court reporters and deposition transcripts.
    • Medical records and imaging, accident reconstruction, and treating-physician testimony.
    • Mediation fees, expert retainers and trial exhibit preparation.
  3. The contingency fee is calculated and disclosed

    A regulated sliding scale, not a number we choose.

    Contingency fees in Florida personal injury matters are governed by the Rules Regulating The Florida Bar. The permitted percentage steps down as the recovery grows and steps up at defined litigation milestones, and exceeding the scale requires court approval, not merely your signature.

    • The scale is set by rule; ask any firm to show you where their number sits on it.
    • A written closing statement signed by you and by the lawyer is required.
    • Confirm the current rule text before relying on any percentage quoted anywhere.
  4. Health care claims and statutory liens are resolved

    This is the step that quietly decides what you keep.

    Several different entities may have a legal claim on your recovery, each created by a different body of law and each negotiated differently. Treating them as one pile is how clients end up with far less than they expected, or with a repayment demand months after the file closed.

    • Letters of protection given to treating providers who deferred payment.
    • Hospital lien ordinances, where the county has adopted one.
    • Health insurer subrogation and reimbursement, including self-funded ERISA plans, which are the hardest to reduce.
    • Medicare conditional payments under the Medicare Secondary Payer Act, with mandatory insurer reporting by the carrier.
    • Medicaid's statutory claim, limited to the portion of the recovery that represents past medical expenses.
    • A workers' compensation carrier's equitable distribution claim where comp paid for the same injury.
    • The collateral source setoff, which is a separate question from any of the above and is resolved by the court.
  5. Every one of those claims gets negotiated down

    The number a lienholder first asserts is an opening position.

    Providers, plans and government payers routinely assert more than they are entitled to: unrelated treatment folded into the claim, charges that were already written off, and interest that was never owed. We audit line by line and argue reductions under the doctrines that apply to that particular claimant.

    • Unrelated and pre-existing treatment is carved out of the claim.
    • Common-fund and made-whole arguments are raised where the plan language allows them.
    • Medicare and Medicaid resolutions follow their own procedures and timelines; we start them early rather than at the end.
  6. The net reaches you, with the arithmetic shown

    One page, every line, signed before disbursement.

    The closing statement lists the gross recovery, each cost, the fee, every lien and its negotiated resolution, and the net to you. You sign it before the funds move, and you keep a copy. If a line does not make sense, it does not get signed.

    • No disbursement happens before you have read and signed the statement.
    • Any future-medical or set-aside obligation is explained in writing at the same time.
    • We keep the lien releases on file so a payer cannot come back years later.

Fee percentages, lien reduction doctrines and Medicare and Medicaid recovery procedures all change. Confirm the current Rules Regulating The Florida Bar and the current federal and state recovery rules before relying on any of this.

We publish no settlement figures, verdict figures or recovery ranges anywhere on this site, including in this explainer. A number from someone else's case tells you nothing reliable about yours.

What none of this can tell you

Your case is not a rule. It is a file.

Everything above is general information about Florida law, not legal advice, and reading it does not make us your lawyers. Which rule bites in your case depends on the police report, the policies, the medical records and the calendar, and we cannot know any of that from a web page. That is what the free review is for.

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Say what happened. We will tell you if you have a case.

(305) 555-0158

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