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What is an ‘Emergency Medical Condition’ Under the New Florida PIP Law?

The new Florida Personal Injury Protection (PIP) law that went into effect in January of 2013 has been criticized for benefiting insurance companies at the expense of injured individuals. According to the new law, the amount of money paid out to an injured individual can be affected by whether or not the injury qualifies as an “Emergency Medical Condition”. Those who suffer from an “Emergency Medical Condition” may receive up to $10,000 in financial assistance to cover medical bills due to the injury. Injured individuals whose injuries do not qualify as “Emergency Medical Conditions” will only receive up to $2,500.

Emergency Medical Condition in Personal Injury Cases

What is an ’emergency medical condition’ under the new Florida PIP law? The new law sets forth three factors in determining whether or not a personal injury qualifies as an “Emergency Medical Condition.”  According to the new legislation, an injury only qualifies as an “Emergency Medical Condition” if it causes the patient one of the following:

  • serious jeopardy to patient health
  • serious impairment to bodily function
  • serious dysfunction to any bodily organ or part

In order for a personal injury patient to receive the full $10,000 from an insurance company under regulations associated with the “Emergency Medical Condition” distinction, a few other guidelines must be met. The only medical professionals qualified to diagnose an “Emergency Medical Condition” are medical doctors (MD), doctors of Osteopathic Medicine (DO), physicians’ assistants, advanced registered nurse practitioners, or dentists.

Personal Injury Defined as “Emergency Medical Condition”

So, just what is an ’emergency medical condition’ under the new Florida PIP law? Clearly, the specifications given on the definition of what constitutes an “Emergency Medical Condition” are vague and uncertain in the best of cases. The determination of whether a personal injury is an “Emergency Medical Condition” must be made by a medical professional, and so individuals suffering from an injury can only refer to a medical professional in determining whether or not they have an “Emergency Medical Condition”. The determination of what constitutes an “Emergency Medical Condition” is likely to cause much room for debate and scrutiny in personal injury cases that follow the new legislation.

These recent changes to Florida’s PIP law differ significantly from rulings that were in place in the past. Previously, there was no 14-day window during which motorists had to seek treatment for injuries.  Also, there was no need to prove that an injury qualified as an “Emergency Medical Condition” in the past. All injured individuals were eligible to receive up to $10,000 in compensation without meeting “Emergency Medical Condition” requirements. Now, motorists must take much more care to react quickly to automobile accident injuries.