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Unanswered Questions: Florida’s New Personal Injury Protection Insurance Coverage for Car Accidents and The Meaning of “Emergency Medical Condition”

As previously relayed in our blog, Florida’s personal injury protection insurance coverage for injuries resulting from car accidents has changed dramatically. Instead of an injured person having $10,000.00 in personal injury protection coverage for medical bills and lost wages resulting from injuries in car accident, the limit of coverage will now be only $2,500.00, unless the injured person has suffered an “emergency medical condition,” as determined by the person’s medical care providers.

Emergency medical condition is a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following: (a) Serious jeopardy to patient health; (b) Serious impairment to bodily functions; or (c) Serious dysfunction of any bodily organ or part.

What will qualify for these conditions is uncertain. What is certain is that there is going to be a flood of litigation to answer this question. Will injuries to a person’s muscles, ligaments or intervertebral discs with potentially worsening symptoms if additional treatment is not provided satisfy this requirement?

The provisions of the new personal injury protection statute are similar to existing federal legislation relating to situations where hospitals are required to provide emergency care to persons taken to the hospital even if that person has no health insurance. In cases interpreting that statute, the courts have made clear that only care for an acute condition will qualify. In other words, hospitals are not required to provide long lasting care for chronic conditions or chronic pain for uninsured persons.

While such an interpretation may make sense when forcing hospitals to see uninsured patients (a hospital should not be required to provided long-standing care for chronic but stable conditions), it does not make sense for persons suffering injuries in a car accident.

Meanwhile, the threshold requirements that a person must suffer a permanent injury in a car accident to recover damages for pain and suffering remain intact. Because of this, a person is denied their constitution right to access to the courts for a claim against another for car crash injuries that are not permanent. Because the former personal injury protection coverage provided a reasonable alternative to an injured person’s right to bring his or her action in court, the former statute was considered constitutional.

Since the time the original personal injury protection coverage amounts were set, medical care costs have risen substantially. As such, in order to remain a reasonable alternative to a person’s right to access to the courts, the personal injury protection limits should be increased and not decreased over time. You can expect a constitutional challenge to the new statute on these grounds very soon.

If you have questions about your rights resulting from car accident injuries occuring in the Jacksonville, Florida, area, please contact our Jacksonville injury law firm for a free consultation.