What Is An Emergency Medical Condition?
If a Floridian is injured in a car accident, Personal Injury Protection (PIP) coverage could be key to connecting with recovery funds for medical expenses and lost wages. Should this be the case for you, understand that Florida’s PIP law has limitations, and one of the biggest factors that can affect your benefits is whether your injury is classified as an Emergency Medical Condition (EMC).
Navigating Florida’s PIP system can be complicated, especially when an EMC requirement is called into question. If you were injured in a car accident, it’s essential to get the right medical evaluation and legal guidance to maximize your benefits. Have a conversation with a Miami personal injury lawyer about how EMC determinations are made.
What Qualifies as an Emergency Medical Condition?
As a no-fault state, Florida requires that drivers carry their own PIP insurance to cover medical expenses and lost wages. But PIP only covers up to $10,000 in benefits, and that’s only if your injury is classified as an EMC. Should an injury not meet the criteria for an emergency condition, your PIP benefits are capped at $2,500. This distinction can make a significant difference in how much financial relief you receive after an accident.
Under Florida law, an Emergency Medical Condition is defined as an injury with acute symptoms that require immediate medical attention. This means the injury is a serious jeopardy to your health, has an impairment of a bodily function, or is a dysfunction of an organ or body part.
Examples of injuries that may qualify as an EMC include:
- Traumatic brain injuries
- Fractured bones
- Major burns
- Internal organ damage
- Spinal injuries
On the other hand, less severe injuries, such as minor sprains, soft tissue damage, or mild whiplash, may not be classified as an EMC, limiting the PIP payout.
Who Determines Whether an Injury Is an EMC?
Not every healthcare professional can determine whether an injury is an Emergency Medical Condition. Under Florida law, an EMC determination must be made by a medical doctor (M.D.), a doctor of osteopathic medicine (D.O.), a dentist (if the injury involves dental trauma), or an advanced registered nurse practitioner (ARNP) working under a doctor’s supervision.
Importantly, chiropractors cannot diagnose an EMC. Even if you are receiving chiropractic treatment for your injuries, you will still need an M.D. or D.O. to confirm that your condition meets the emergency criteria.
When an injury is not deemed an Emergency Medical Condition PIP benefits are limited, even if your medical bills exceed that amount. Then, you may have to rely on your own health insurance to cover additional medical costs or pursue a personal injury lawsuit if another driver was at fault. A Miami personal injury lawyer can help you challenge insurance denials, explore other compensation options, and fight for the financial relief you deserve.
How has a medical assessment impacted your claim? Protect your interests, connect with the seasoned injury attorneys at Spencer Morgan Law. Call 305-423-3800 to book a confidential consultation.