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Dear Miami Car Accident Attorney:

I got rear-ended a couple of weeks ago by a lady in a big Audi as I was trying to park at Chipotle. I got out of the car- there wasn’t much damage to my car-and I felt a little shaken up– but not hurt.

While I was eating my burrito I started to feel a little pain in my left knee. I used to play football in high school (tight end if you are wondering) so I have a very high threshold for pain. I decided to just shake it off. That night my knee started swelling up. My mom suggested I go to urgent care- but with the hurricane, my demanding job and Halloween, who has the time?

It still hurts and now I’ve developed a limp. My friends tell me it is because I am favoring the other knee when I walk. It hurts to stand for long periods of time- and I am taking more and more Advils. I am also feeling a little depressed lately- I think it might be from the pain.

Is it too late for me to do anything about this? I need your help.

Thank you,

Sore Knees in Sweetwater

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Dear Sore Knees:

Thank you for your email. I am sorry to hear about your accident and knee pain. The most important thing we can recommend you do is to see a doctor, regardless of whether or not you have a case. You may have torn a ligament or tendon in your knee, and the longer you walk, run, sit, squat or rollerblade on it the worse you can make it. In fact, we have seen many cases where a delay in diagnosis and treatment made a benign injury into a surgical case. And you sound like a young and active man.

We would recommend that you go to an orthopedic surgeon or a sports medicine doctor immediately. The problem is that your PIP or personal injury protection insurance will probably not pay for it because while you did not provide specific dates- it has been over 14 days since your accident.

PIP’s 14 Day Rule and the Emergency Medical Condition

Without getting too technical, Florida’s Personal Injury Protection (PIP) statute which governs who, when and how medical bills are paid by auto insurance after an accident was gutted in 2013; and now includes a new requirement known as the 14-day Rule and the Emergency Medical Condition Rule.
PIP as you probably know is the mandatory minimum insurance that every motor vehicle owner in Florida is required to have. ((

627.736 Required personal injury protection benefits; exclusions; priority; claims.(1) REQUIRED BENEFITS.—An insurance policy complying with the security requirements of s.627.733 must provide personal injury protection to the named insured, relatives residing in the same household, persons operating the insured motor vehicle, passengers in the motor vehicle, and other persons struck by the motor vehicle and suffering bodily injury while not an occupant of a self-propelled vehicle, subject to subsection (2) and paragraph (4)(e), to a limit of $10,000 in medical and disability benefits and $5,000 in death benefits resulting from bodily injury, sickness, disease, or death arising out of the ownership, maintenance, or use of a motor vehicle.

)) I am assuming you had a valid PIP policy at the time of your crash with the lady at Chipotle.

PIP will pay or should pay your medical bills regardless of who causes a car accident. That is why in Florida it is often referred to as No-Fault Insurance. But it only pays up to 80% medical expenses paid, up to $10,000. It also covers other things like lost wages and death benefits.

Now, the statute states anyone claiming medical expense reimbursement must seek medical treatment from either a hospital facility, emergency transport, medical doctor, doctor of osteopathy, chiropractic or a dentist within 14 days from the date of the accident or they lose all of their PIP coverage. So for you, Sore Knees, your PIP will most likely not pay your medical bills- because of your delay in treatment– due to your knee symptoms not bothering you enough in the first two week period. Of course, if you have health insurance, it should cover it without any problem.

This new law was purportedly passed to reduce the incidents of PIP insurance fraud- As a PIP accident lawyer in Miami–I suspect it was really done to protect the profits of insurance companies who will save millions by not paying for the medical treatment of legitimately injured people which began after the first 14 days.

PIP Emergency Medical Condition (EMC)

Assuming you had seen a doctor within 14 days, the PIP statute only allows claimants to obtain the full $10,000 if it is documented that the treatment was for an emergency medical condition. (EMC) are defined as those that have “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:

• Serious jeopardy to patient health,

• Serious impairment to bodily functions,

• Serious dysfunction of any bodily organ or part.

Who knows what that means?/ But unless a doctor expressly states that a patient has an EMC the injured person will be entitled to receive just $2500 in PIP benefits for their medical treatment rather than the full $10,000. The statute is so unclear it has opened a floodgate of litigation on just the issue of who, when and how is a doctor required to diagnose and document an EMC.

It should be noted that regardless of whether your PIP pays, the lady in the Audi is still responsible for your injuries and you still can make a claim against her up until four years from the date of the incident.

You should consult with an experienced car accident lawyer in Miami as soon as possible. Our office is pleased to offer you and anyone who is hurt in a car accident, motorcycle accident, bus accident, truck accident, bicycle accident or pedestrian accident a free initial consultation at your home, office or hospital 24/7. Simply contact us by telephone locally: 305-441-0440, toll-free 1-866-597-4529 or by email at [email protected].

We are ready to help you and thank you again for reaching out to us!

Spencer Aronfeld
Board Certified Civil Trial Lawyer