If you’re ever in a South Florida bicycle accident with someone driving a car, one avenue through which you might obtain compensation is through your own personal injury protection (PIP) insurance that you purchase as part of your regular car insurance. As our Palm Beach personal injury lawyers can explain, PIP can be applied in bicycle accidents – even if you weren’t driving – so long as the incident occurred in traffic. Technically, bicyclists aren’t required to carry any insurance at all in Florida. However, it’s a good idea – particularly if you enjoy road cycling. And if you have a car, it’s easy, as PIP (which can be paid regardless of fault in the accident) is already required coverage for registered motor vehicles in the state. However, any PIP claims must be accurately and timely filed.
Underscoring this point was a case last year before Florida’s 5th District Court of Appeals.
In the matter of USAA Casualty Insurance Co. v. Mikrogiannakis, a bicyclist was struck by a car in Seminole County (Central Florida), and sought medical treatment for his injuries. During that initial visit, his registration form listed his contact information and the name of his personal injury lawyer – but not the name and address for a PIP insurer. That field had been left blank. Over the course of several months, he continued to receive medical treatment from that same provider.
Roughly 18 months after administering these treatments, the medical provider began submitting claims to USAA, the bicyclist’s PIP insurer. However, USAA denied the payments, citing failure to comply with F.S. 627.736(5)(c). The statute is extensive (which is why we recommend consulting with a personal injury lawyer if you aren’t sure of your rights), but that provision in particular refers to the requirement that any bills for emergency services or care must be submitted to the PIP carrier within 35 days (possibly for treatment rendered up to 75 days). The bills in this case weren’t submitted for a full 18 months.
But the plaintiff had argued – and the trial court agreed – that the first exception under the statute applied. That exception indicated that if the insured failed to furnish the provider with the correct name and address for their PIP insurer, the provider may be entitled to a grace period – but then they have 35 days from the date they obtain the correct information to furnish the insurer with the statement of charges. Even then, the insurer won’t be required to remit payment unless the provider can prove they reasonably relied on erroneous information form the insured in the form of a denial letter from the wrong insurer or evidence that they mailed a statement to the insurer within the 35-day window – but just didn’t have the right name and/or address.
When the insurer denied the PIP claim in this case for lack of timely filing, it meant the injured bicyclist was on the hook for those charges. He took the insurer to court, and initially, the trial court decided the matter in his favor.
However, the Fla. 5th DCA reversed. In its ruling, the court stated that the PIP statute’s 35-day time period is unambiguous (as any ambiguity would be decided in favor of the insured). Further, the 35-day time window is only applicable when a provider receives “erroneous information” – not when they receive no information at all. There was no disputing the invoices were submitted beyond that that 35-day mark. And the insured can’t seize on this exception when he failed to provide any PIP insurer information at all – despite having that coverage and knowing he had it.
Bottom line: If you’re injured in a bicycle accident (or any type of crash), it’s important to make sure you timely submit all the correct information to the proper parties to ensure covered accidents will in fact be covered. If you need help with this, our Palm Beach personal injury lawyers can provide assistance.
Contact the South Florida personal injury attorneys at Halberg & Fogg PLLC by calling toll-free at 1-877-425-2374. Serving West Palm Beach, Miami, Tampa, Orlando and Fort Myers/ Naples. There is no fee unless you win.
USAA Casualty Insurance Co. v. Mikrogiannakis, July 22, 2022, Florida’s 5th District Court of Appeal
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Do I Really Need a Palm Beach Injury Lawyer, Or Can I Manage Myself? Feb. 5, 2023, Palm Beach Personal Injury Lawyer Blog