Florida PIP Coverage Calculator

How this calculator works

Florida is a no-fault auto-insurance state. Every vehicle registered in Florida is required to carry at least $10,000 of Personal Injury Protection (PIP) coverage under F.S. § 627.736. PIP pays the insured's own medical, wage loss, and replacement-services exposure (plus a separate $5,000 death benefit) regardless of fault. The legislative trade is that a Florida driver may only step outside PIP and sue the at-fault party for non-economic damages — pain and suffering — when the injury crosses the F.S. § 627.737 permanent-injury threshold. PIP itself does not require the threshold; the threshold gates the tort suit, not the no-fault recovery.

This calculator applies the full PIP benefit ladder to a specific accident. Enter the medical bills, wage loss, and replacement-services cost; mark whether an Emergency Medical Condition (EMC) determination has been made by a licensed provider; confirm whether treatment began within the 14-day window; choose any elected deductible; and the calculator returns the total PIP paid, the per-benefit breakdown, the patient's out-of-pocket coinsurance share, the remaining PIP limit, an exhaustion flag, and the F.S. § 627.737 tort-threshold note. The formula is a pure function over the inputs — every number on the result card maps directly to a statutory provision, and the FAQ below cites the controlling subsection for each branch.

Florida's no-fault system — 1971 to 2026

Florida adopted no-fault auto insurance in 1971 as part of a national wave of state-level reforms aimed at reducing tort-litigation costs by routing routine accident claims through first-party PIP coverage. The structural promise was lower premiums and faster medical-bill payment in exchange for a tort-recovery limitation on minor injuries. The trade has held for fifty-five years across multiple legislative revisions, the most recent of which was 2012 HB 119 (which added the 14-day treatment rule and the non-EMC $2,500 sub-limit) and the 2024 HB 5051 (which attempted to repeal no-fault entirely and was defeated in the legislature). As of 2026, PIP remains required on every Florida-registered private-passenger vehicle.

The 2024 repeal attempt is worth noting because it nearly succeeded. HB 5051 would have replaced the $10,000 PIP requirement with a mandatory $25,000 / $50,000 Bodily Injury Liability minimum, eliminated the 14-day rule, and ended the permanent-injury tort threshold under F.S. § 627.737. The bill passed the House but stalled in the Senate over rate-impact concerns. The repeal debate will return in subsequent sessions; for now, PIP and the threshold-tort framework are the law of the land.

What PIP covers and what it does not

PIP covers four categories of loss on a Florida-registered private-passenger auto accident:

• Medical: 80% of reasonable medical charges from licensed providers, up to the applicable medical cap (EMC: $10,000; non-EMC: $2,500). The remaining 20% is patient coinsurance — out-of-pocket exposure that PIP does not pay.
• Wage loss: 60% of actual lost wages, up to the remaining PIP limit after medical has been applied. The 60% rate is statutory and is not adjusted for income tax.
• Replacement services: 80% of reasonable household-services costs (childcare, housekeeping, lawn care) the insured cannot perform because of the injury, up to the remaining PIP limit after wage loss.
• Death benefit: $5,000 under F.S. § 627.736(1)(c). Separate from and additive to the $10,000 medical / wage-loss / services limit; paid even if the medical limit has been fully exhausted before death.

PIP does not cover:

• Vehicle property damage. PIP is exclusively bodily-injury and lost-wage coverage. Property damage to the insured's own vehicle is paid by collision (first-party) or by the at-fault driver's Property Damage Liability (third-party); the at-fault driver's Bodily Injury Liability pays the insured's bodily-injury exposure above the F.S. § 627.737 threshold.
• Pain and suffering. PIP pays economic loss only. Non-economic damages — pain and suffering, loss of consortium, loss of enjoyment of life — require a tort suit that crosses the F.S. § 627.737 threshold.
• Motorcycles. F.S. § 627.736(1) excludes motorcycles from the PIP regime. Motorcycle accidents are governed by ordinary tort recovery; the threshold-tort framework does NOT gate motorcycle suits.
• The 20% coinsurance share. Patient out-of-pocket coinsurance can typically be recovered from MedPay (an optional auto endorsement), health insurance (subject to its own deductible and copay structure and a likely subrogation lien), or — if the injury crosses the threshold — a third-party tort suit as part of the medical-specials recovery.

EMC vs non-EMC — the 2012 HB 119 split

The 2012 HB 119 reforms introduced the EMC / non-EMC bifurcation that drives the medical-limit math on every Florida PIP claim. An Emergency Medical Condition determination by a licensed physician, dentist, physician assistant, or ARNP under F.S. § 627.732(16) unlocks the full $10,000 PIP medical limit. Without an EMC determination, medical is capped at the $2,500 sub-limit codified at F.S. § 627.736(1)(a)1.

The EMC requirement narrows the provider categories who can make the determination. Chiropractors alone cannot determine EMC, though they can treat the patient up to the applicable cap once another qualifying provider has documented the determination. The determination can be made retroactively after the fact — a claim that was initially capped at $2,500 can be re-opened to the full $10,000 limit if an EMC determination is later obtained and documented. Many Florida PIP attorneys treat the EMC question as the single most important post-accident step for any non-trivial injury; the difference between $2,500 and $10,000 of medical coverage is often the difference between a recovery that pays for itself and one that leaves the insured with thousands of dollars of unpaid bills.

The 14-day rule

F.S. § 627.736(1)(a) requires the insured to begin treatment with a licensed provider within 14 calendar days of the accident. Allowed providers include licensed physicians, hospitals, dentists, ARNPs, physical therapists, and chiropractors (subject to scope-of-practice limits). Failure to begin treatment within the 14-day window forfeits PIP entirely — no medical, no wage loss, no replacement services. The $5,000 death benefit under (1)(c) is unaffected by the 14-day rule.

The 14-day rule is a hard statutory deadline with no good-cause exception. It survived constitutional challenge in Florida appellate cases after 2012 HB 119 added it; carriers enforce it strictly and Florida courts have not carved out exceptions for hospitalization, out-of-state residence, or delayed-onset symptoms. Practical recommendation: any auto-accident occupant should see a licensed provider within the first week to preserve the PIP benefit, even when injuries seem minor at the scene. Soft-tissue and traumatic-brain injuries frequently present with delayed onset; the 14-day clock runs from the accident, not from the symptom.

Worked example 1 — $25K medical, EMC, 14-day compliant

A Florida-registered driver is rear-ended on I-95. EMC determined by an ER physician at admission. Treatment begun the same day, well within the 14-day window. Medical bills total $25,000. Wage loss of $5,000. No deductible elected, no prior PIP draw. Apply PIP:

• Medical: 80% of $25,000 = $20,000 of theoretical PIP payable, but capped at the $10,000 EMC limit. PIP medical pays $10,000.
• Wage loss: Limit exhausted by medical; no remaining PIP for wage loss.
• Replacement services: Limit exhausted; no PIP payable.
• Total PIP paid: $10,000 — the full statutory limit.
• Patient out-of-pocket coinsurance + balance: $25,000 − $10,000 = $15,000 of unpaid medical exposure.
• PIP exhausted: Yes.

The $15,000 of unpaid medical exposure runs against the insured's MedPay (if carried), health insurance (subject to its deductible and copay), and — because the injuries are likely to cross the F.S. § 627.737 permanent-injury threshold given the medical-bill magnitude — a third-party tort suit against the at-fault driver as part of the medical-specials recovery. The $5,000 wage loss is recoverable through the same tort suit as economic damages. This is the canonical "PIP exhausted — go tort" pattern that any Florida personal-injury attorney sees daily.

Worked example 2 — $5K medical, no EMC

Same accident, but no EMC determination has been made. Treatment was begun within the 14-day window, but the treating provider — a chiropractor — cannot make the EMC determination alone. Medical bills total $5,000. No wage loss, no deductible, no prior PIP.

• Medical cap: Non-EMC $2,500 sub-limit applies.
• Medical: 80% of $5,000 = $4,000 of theoretical PIP payable, but capped at the $2,500 non-EMC limit. PIP medical pays $2,500.
• Wage loss / services: $0.
• Total PIP paid: $2,500.
• Patient out-of-pocket coinsurance + balance: $5,000 − $2,500 = $2,500 of unpaid medical exposure.

The recommendation is to obtain an EMC determination from a licensed physician, dentist, physician assistant, or ARNP as quickly as possible. EMC can be determined retroactively; once documented, the claim re-opens to the full $10,000 limit, lifting PIP medical from $2,500 to $4,000 (80% of $5,000) and reducing patient out-of-pocket from $2,500 to $1,000. The cost of an EMC office visit is typically a small fraction of the $1,500 marginal recovery.

Worked example 3 — missed 14-day window

Same accident, but the insured did not seek treatment until day 18 — symptoms were minor at the scene and worsened over the following week. Medical bills total $8,000.

• 14-day rule: Forfeiture under F.S. § 627.736(1)(a).
• Medical / wage loss / services: $0.
• Total PIP paid: $0.
• Patient out-of-pocket exposure: $8,000 of medical, in full.

PIP is gone. The insured's remaining options are MedPay (if carried), health insurance, and a third-party tort suit against the at-fault driver — but the suit is not gated by the F.S. § 627.737 threshold for medical-specials recovery (the threshold gates non-economic damages, not economic), so the medical bills are recoverable from BI if the at-fault driver carries it. This is the worst-case PIP outcome and the reason every Florida-licensed agent's intake script includes "see a doctor within the first week even if you feel fine."

The permanent-injury tort threshold

F.S. § 627.737(2) requires that an injury meet one of four severity tests before a Florida driver can sue the at-fault party for non-economic damages (pain and suffering): (1) significant and permanent loss of an important bodily function; (2) permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement; (3) significant and permanent scarring or disfigurement; or (4) death. The threshold is the structural trade for the no-fault system — most accident victims recover through PIP and never sue, but seriously-injured victims retain the right to sue for pain and suffering when the injury rises above the threshold.

Documentation of the threshold typically comes from the treating physician's permanency report and, in litigated cases, an independent medical examination. Florida appellate courts have generally read the threshold as a low bar — "significant and permanent" is closer to "more than transient" than to "catastrophic" — but defendants routinely contest threshold satisfaction at summary judgment in PIP-tort cases. Any Florida PIP claim that approaches the $10,000 limit or involves any structural / orthopedic / neurologic injury is a candidate for tort-threshold analysis with a Florida-licensed personal-injury attorney.

Death benefit and deductible

The $5,000 death benefit under F.S. § 627.736(1)(c) is separate from and additive to the $10,000 medical / wage-loss / services limit, and is paid even if the medical limit has been fully exhausted before death. The 14-day rule does NOT apply to the death benefit; death from accident-related injuries triggers the benefit regardless of treatment timing. The benefit is payable to the executor or administrator of the decedent's estate.

The optional PIP deductible under F.S. § 627.739 allows $0 (default), $250, $500, or $1,000 elections at a corresponding premium reduction. The premium savings from a $1,000 deductible typically run 10-20% of the unstacked PIP premium — modest in absolute terms ($20-$40 per year on a $200 annual PIP premium). Higher-net-worth households that can comfortably absorb the deductible often take it; lower-cash-flow households should typically not. The deductible applies to the medical benefit first — the carrier subtracts the deductible from billed charges before computing the 80% coinsurance payment — so the effective first-dollar exposure is the deductible plus the 20% coinsurance on the bills above the deductible.

Common errors

Three errors recur in Florida PIP claims:

• Assuming PIP covers everything. It doesn't — it pays 80% medical and 60% wage loss, both capped at $10,000 combined (less the EMC sub-limit if no determination is made). Significant accidents routinely exhaust PIP within a single ER visit. Plan for the gap: MedPay, health insurance, and (for serious injuries) a tort suit against the at-fault driver.
• Missing the EMC determination. Treatment by a chiropractor alone — even competent, well-documented treatment — leaves the claim capped at $2,500 unless a physician, dentist, PA, or ARNP separately documents EMC. The determination can be obtained retroactively, but each day without it leaves the claim at the lower cap.
• Missing the 14-day window. Delayed-onset symptoms are common in soft-tissue and traumatic-brain injuries; the 14-day clock runs from the accident, not the symptom. Any auto-accident occupant should see a licensed provider within the first week. The 14-day rule is the single most preventable cause of PIP forfeiture.

How this page is maintained

F.S. § 627.736 (PIP), F.S. § 627.737 (tort threshold), and F.S. § 627.739 (deductibles) have been substantially stable through the 2024 legislative session, including the unsuccessful 2024 HB 5051 repeal attempt. The 2012 HB 119 reforms (14-day rule, EMC bifurcation, non-EMC $2,500 sub-limit) remain controlling. If the legislature substantively changes any of these statutes or a Florida appellate court materially modifies the PIP framework, this page is updated and re-stamped within the quarter.

Last reviewed: 2026-05-15 against F.S. § 627.736, F.S. § 627.737, F.S. § 627.732(16), F.S. § 627.739, and F.S. § 817.234 (with the 2024 HB 5051 repeal-attempt outcome noted).