· $2,500 maximum if no emergency medical condition was suffered
· $10,000 maximum if a victim suffered an emergency medical condition
This new distinction naturally led many people to wonder: what qualifies as an emergency medical condition under the new laws2 and how will I know if I am eligible for a higher payout?
Requirement for emergency medical conditions
The definition of emergency medical condition under Florida law is not completely clear. The injury must have acute and severe symptoms, which may include substantial pain or inability to move around. Additionally, an emergency medical condition can result in one of the following if you fail to seek immediate medical assistance:
· Serious deficiency or dysfunction of an important organ or body part
· Serious impairment to important bodily functions
· Other serious negative implications to a victim's health
Again, these requirements are not clear-cut. While serious and paralyzing spinal cord injury would almost always be considered an emergency medical condition, an equally disabling brain injury may not qualify if it does not present immediate and noticeable symptoms.
If you believe you have suffered an emergency medical condition for the purposes of PIP yet are being denied proper benefits by an insurance company, you have the right to bring a legal claim. It will then be up to a jury of your peers to determine whether your particular injuries were serious enough to be considered an emergency medical condition.
Furthermore, the PIP laws require that a certified medical professional must agree that your injury was serious enough to warrant immediate medical treatment. Such documentation must come from one of the following:
· Licensed medical doctor
· Advanced registered nurse practitioner
· Osteopathic physician
· Physician's assistant
· Dentist
Other types of medical treatments, including acupuncture, chiropractic, or massage therapy, are not acceptable forms of treatment to satisfy the emergency medical condition requirement.