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Out of State Visitors Hurt in Car Accidents in Florida (Settlements)
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August 19, 2019 By Justin Ziegler, Lawyer Leave a Comment
If you’re an out of state visitor hurt in a Florida car crash, you may have a case. Your case may be different than the claim of a Florida resident who was hurt in Florida.
I wrote a separate article on international (foreign) visitors who are hurt in Florida accidents.
I’m going to talk about some facts that you need to know if you live an out of state and are hurt in a Florida car accident.
Handling a Florida car accident case for someone who lives out of state is similar in many ways to that for someone who lives in Florida.
This article focuses on some facts you may not know and some differences. Additionally, I’ll discuss Uber and Lyft accidents for out of state visitors to Florida. You’ll also hear about settlements for rental car accidents involving out of state visitors to Florida.
I’ve settled over $900,000 in personal injury claims for out of state residents who were hurt in Florida car accidents. And I’ve learned a tremendous amount on that journey. And now I’m going to share it with you.
What Can an Out of State Visitor Get Paid For After a Florida Car Accident?
Diminished Value of Your Vehicle
Replacement value of lost personal property (e.g. damage to your car, broken glasses, watch, etc.)
I’ll discuss many of the above types of “damages” further below.
Your Uninsured Motorist Insurance Follows You To Florida
You may own a car in another state, and have uninsured motorist (“UM”) insurance on it. If another driver is liable for your car accident in Florida, you should be covered under your own UM insurance policy.
Your UM covers you even if you’re not in your own car.
$300K Settlement for Georgia Resident (Florida Car Accident)
Ryan lived in Georgia. He flew to Florida for a business trip. While in Florida, he rented a car.
Ryan was driving down the road. Another driver, Howard, was heading in the opposite direction. Howard made a left hand turn into Ryan’s car.
Ryan was injured. A co-worker of his took the above photo at the accident scene.
An ambulance took Ryan to the hospital. He suffered a tibial plateau (top of the lower leg bone) fracture. While Ryan was at the hospital, he filled out our online form to see if we could represnet him.
I called him back the evening that he contacted me. Shortly thereafter, Ryan hired me as his personal injury lawyer.
The other driver, Howard, received a ticket for failure to yield the right of way. It was a left turn accident.
Allstate insured Howard with $100,000 of bodily injury liability (BIL) insurer. Shortly after the accident, Allstate paid the $100,000 limits.
Travelers Insurance insured Ryan’s personal cars in Georgia.
Medpay from an Out of State Policy Pays Medical Bills from a Car Accident (But Not for Work)
On Ryan’s auto policy, he had $5,000 in medical payments (Medpay) coverage. We made a Medpay claim for Travelers. However, Travelers denied Medpay coverage because Ryan was working when the accident happened.
If Ryan wouldn’t have been working at the time of the crash, his Medpay coverage would’ve paid $5,000 to his medical providers. This brings me to an interesting point.
Many tourists or out of state visitors who are hurt in a Florida car accident are confused as to how to get their medical bills paid. And rightfully so. Understanding which insurances apply is complicated.
Out of State Visitors to Florida May Get PIP Insurance from the Rental Car
We also made a personal injury protection claim (PIP) with Ryan’s rental car company. PIP insurance pays up to $10,000 of medical bills and lost wages after an accident. And PIP pays regardless of fault. PIP is also known as no-fault insurance.
Many people have a hard time understanding why the rental car’s PIP insurance pays if someone else caused the accident. The answer is simple:
That’s what the law says. Florida is a no-fault state.
If you’re hurt while occupying a rental car in Florida, you get the rental car’s PIP coverage. This assumes that there isn’t another PIP source that should pay first.
The rental car’s PIP coverage pays even if you are visiting from another state. Thus, the rental car’s PIP pays even if you are a tourist visiting Florida.
The rental car’s PIP coverage may be in addition to the Medpay coverage on your car insurance policy. In a moment, I’ll talk about how we got Ryan $10,000 of rental car PIP benefits. But first, let me talk about the settlement.
Ryan also had Georgia underinsured (UIM) insurance with Travelers. They paid $200,000 to settle. This was in addition to the $100,000 personal injury settlement with the other driver’s Allstate.
Some people think that an injured person’s attorney gets most of the injury settlement. I’m happy to report that this is rarely true.
After my attorney’s fees and costs, Ryan received $191,200. He got 63% of the settlement his pocket.
OK. As promised, let’s get back to the PIP benefits. The rental car company agreed that Ryan was entitled to $10,000 in PIP benefits.
As I mentioned earlier, Ryan was working at the time of the accident. This means that workers’ compensation (Sedgwick Claims) basically paid all of Ryan’s medical bills. If workers’ comp applies, the injured workers doesn’t have to pay any medical bills out of pocket.
In total, workers comp paid about $85,000 to the hospital and Ryan’s doctors.
However, workers compensation wanted to get repaid from the injury settlement. And based on Florida law, they were entitled to be. But at a small fraction of what they paid.
We agreed to pay them a little over $10,000. But I didn’t stop there.
I used the $10,000 in PIP benefits to pay most off the workers compensation lien.
It put an extra $10,000 in Ryan’s pocket! And boy was he happy.
I’ve given you the short version of Ryan’s car accident settlement. We’ve touched on some insurance and claim issues that can arise when an out of state visitor is hurt in Florida.
Throughout this article, you’ll see many other examples of claims for out of state visitors who were hurt in Florida car accidents.
Feel free to read more details about Ryan’s $300,000 settlement.
Ryan gave my law firm this awesome 5 star review:
I hired Justin to help me with my automobile personal injury case. He responded to me right away and he got started protecting my rights.
My case was very complicated involving my severe injury, multi-state involvement, car rental companies, several different insurance companies, workers comp, and probate issues due to the other driver passing away.
Justin and his assistant, Jenny, worked hard the whole way through and, importantly, were always responsive to me, even at night or weekends. I would highly recommend that you hire JZ Helps to handle your case!
$170K Settlement for West Virginia Man (Hurt in Florida Car Accident)
Zach lives in West Virginia. In June 2018, he was visiting Florida with his family.
He was a passenger in a Thrifty rental car in Sarasota, Florida.
The driver crashed into the back of a car ahead of them.
Zach broke his arm (humerus). Zach’s mom hired me as his personal injury attorney.
He had surgery. We made a claim against the insurance company (Ace American Insurance Company) for the Thrifty rental car. ESIS handles claims for Thrifty (Ace American Insurance). The rental car driver purchased Liability Insurance Supplement (LIS) when he rented the car. This means that Ace American insured the rental driver for up to $2 million for liability (injuries or property damage) to others.
Further below, I explain (in detail) how rental car insurance coverage works for out of state visitors who are injured in Florida car accidents.
Zach has a scar on his arm. Scars have significant settlement value. However, his scar wasn’t the biggest part of his claim.
Within just a few months, I settled Zach’s personal injury claim for $170,000. Here are the settlement checks:
Two Hertz Settlement checks totaling $170K
Zach got $113,000 in his pocket after my attorney’s fees and costs.
Read more about Zach’s $170,000 settlement.
Here is an image from Zach’s 5 star Google review of my law firm:
Here’s Zach’s entire review:
I definitely recommend Justin Ziegler. He was there for me after my I broke my arm in low impact collision on Sarasota, Florida.
He helped me receive a very sizable settlement. Should I ever need a lawyer again, I will go to Justin first.
Out of State Occupant in Miami-Dade Car Crash Gets $135K Settlement (Broken Wrist)
A passenger got $135,000 after another car crashed into the car that she was in. The driver of the other car got a ticket for failure to yield the right of way.
The accident caused our client’s wrist fracture and surgery.
$130K Settlement for Out of State Visitor Hurt in North Florida Car Accident
Maria (not real name) lived in a Mid-Atlantic state in the US. She and her friend, Sara, drove to Florida in her friend’s (Sara) car.
While in Florida, Maria was a passenger in Sara’s car. Another driver made an improper lane change.
His car struck Sara’s car (“host car”). The damage to Sara’s car can be seen in the photo below.
Picture of host car after the crash
Maria injured her shoulder, specifically her rotator cuff. The driver that caused the crash had no insurance.
Sara’s car had $100,000 with Nationwide Insurance.
Additionally, Maria had a car insurance policy with Nationwide Insurance Company on her car in the state where she lives. Maria also had uninsured motorist insurance on her car.
Maria had rotator cuff surgery.
Sara’s uninsured motorist (UM) insurance paid us $100,000 to settle. Additionally, Maria’s UM insurance paid us $30,000 to settle.
Thus, she got $130,000 for her shoulder surgery from this accident.
Her claim was for medical bills, lost wages and pain and suffering. I represented Maria.
$65K Settlement for Pedestrian from California (Hit By Car in Miami)
Doug, who lived in California, was on vacation in Miami Beach. While he was walking in a crosswalk, a car hit him. (My description below explains your rights when you’re hurt while on vacation in Florida.)
Thankfully, he was in a crosswalk when the car hit him. Getting hit while not walking in a crosswalk is one of many factors that can reduce the value of an injury case.
Here is the actual Florida crash report diagram:
Paramedics came to the scene. At the scene, the pedestrian complained of leg pain and other injuries.
Paramedics transported him to the hospital in an ambulance.
At the hospital, a doctor diagnosed Doug with a broken lower leg bone (fibula fracture). Below is an image of the fibula.
Surgery Would’ve Increased the Case Value
If he would’ve had surgery, his case would’ve been worth over $100,000. You can confirm this by researching recent Florida verdicts for surgery to a broken lower leg from an accident.
In addition, I settled a case for $325,000 where a pedestrian suffered a broken lower leg (and had surgery) after a car hit him. (That pedestrian was from another country.)
Doug complained of lower back pain after this accident. However, he had a back injury prior to this accident.
GEICO insured the careless driver.
The pedestrian found me after seeing our online ratings and looking out our website/blog. He hired me to represent him in his personal injury claim against GEICO.
Pursuant to Florida Statute 627.7137, I sent GEICO a letter asking for the driver’s insurance information.
GEICO responded in writing stating that the driver had a $300,000 bodily injury liability (BIL) policy.
GEICO accepted liability for the accident. Thus, our negotiation centered around the extent of the pedestrian’s leg (fibula) fracture.
Pedestrian Didn’t Need a Permanent Injury to Get Compensation for Pain and Suffering
Unlike most Florida car accident cases, here the pedestrian didn’t need a to meet the tort threshold to get money for pain and suffering. Thus, he didn’t need a permanent injury in order to get money for pain and suffering.
This is because a car hit him while he was a pedestrian in Florida visiting from another state that doesn’t have PIP.
Remember, he was from California. California doesn’t have PIP.
Many other states don’t have PIP. States like Tennessee, Iowa, West Virginia and many others don’t have PIP.
GEICO paid us $65,000 to settle the pedestrian’s injury case.
Doug owned a car in California. He had Medpay benefits (with Farmers Insurance) on that car. Doug had Medicare.
When it came time to pay them from the total settlement, they had to reduce their liens by my attorney’s fees and costs. This is one reason that a Medicare beneficiary should hire an injury lawyer.
California law required Farmers Insurance to reduce its Medpay lien by my attorney’s fees and costs. Lee v. State Farm Mut. Auto. Ins. Co. (1976) 57 Cal.App.3d 458, 465-466, 129 Cal.Rptr. 271. This is one unique aspect of a case if someone from California is injured in a Florida accident.
In general, if you’re from another state and you get injured in a Florida car accident, you often have different rights.
This is because you often have to deal with, at least, Florida law and the out of state law.
GEICO’s First Offer Was Only $14,780.15
GEICO low-balled me with their first offer for Doug’s personal injury claim. The adjuster was Tiffany Hall.
One of the 5 huge mistakes that injury victims make is to always believe what the adjuster tells you your case is worth.
I negotiated with GEICO. We settled with GEICO for $65,000. That was almost 4.5 times there for first offer.
Here is the GEICO settlement check.
GEICO $65K settlement check
Therefore, GEICO paid about $57,000 for the pain and suffering associated with his broken leg (fibula fracture). This is a typical settlement amount for pain and suffering for a broken lower leg.
If the driver had a better car insurance company, they would’ve likely paid more. For example, I think I would’ve had a bigger settlement if the driver was insured with Hartford, USAA, Nationwide, Lyft (Zurich American Insurance Company) and some others.
I’ve settled cases with all of those insurers. They tend to pay better than GEICO.
On the other hand, worse insurers would’ve offered less. Thus, Progressive (Uber’s current insurer), State Farm, Allstate, Infinity, United Auto would’ve offered likely less.
Doug gave my personal injury law firm a 5 star review on Google. He said:
Justin Ziegler did an excellent job handling my auto accident case. He and his senior paralegal, Jenny, kept me abreast on its progress throughout. I give his firm my highest recommendation.
$65K Settlement for Visitor from North-Central US (Orlando Car Accident)
Learn about a $65,000 Settlement for a lady who had surgery on a full thickness rotator cuff tear.
She was rear ended in Orlando, Florida while visiting from another state.
$10K Settlement for Michigan Resident Who Was Injured in Florida Car Accident
My client was visiting Florida from Michigan. She was driving her car.
Another driver crashed into her. She went to the hospital in Fort Pierce, St. Lucie County, Florida.
She later went to a chiropractor for several months in her home state. She had a soft tissue lumber (lower back) strain and sprain. GEICO insured the at fault driver.
GEICO initially offered $500. They then increased their offer to $800. We refused both offers. We later settled with GEICO for $10,000.
She found me on the Internet. My client’s health insurer wasn’t entitled to get paid back from the settlement. These reduced her case’s full value.
Tortura & Company handled the Personal Injury Protection (PIP) claim for our client’s insurer, AAA Auto Insurance.
This case involved a tourist from another state in the United States.
You’re Resident Relative’s UM Insurance Follows You To Florida
Perhaps you live with a relative in another state, and that relative has uninsured motorist insurance on a car.
If a careless driver caused your crash in Florida, your resident relative’s UM insurance should cover you. This is true even if you aren’t in your resident relative’s car at the time of the crash in Florida.
I settled a case for an out of state resident who was hurt while in a Hialeah, Miami-Dade County, Florida car crash. She was in someone else’s car at the time of collision.
She had a hand injury. The careless driver had no bodily injury (“BI”) liability insurance.
She lived with a relative in another state. That relative had cars that had over $130,000 of UM insurance on them.
Even though she wasn’t in her relative’s car at the time of the crash, we settled the case with her relative’s UM insurer for over $130,000.
What if You’re Car Insurance is from Another State, But Your Car Is Kept in Florida, and You’re in a Florida Accident?
Any person who has a vehicle in Florida for more than 90 days during a 365-day period must buy personal injury protection and property damage liability insurance coverage. The 90 days don’t have to be consecutive.
To better illustrate the 90 out of 365 day rule, I’ll use this example:
Kate owns a car. It’s registered in Maine. State Farm insures it. When Kate got her auto insurance policy, she told State Farm that the car is garaged in Maine. (Garaged simply means that the car is kept there.) Since State Farm believes that the car is garaged in Maine, it issues a Maine auto insurance policy for Kate.
In the past year, Kate was working in Florida for 200 days out of the past 365 days. And during those 200 days, her car was in Florida. Maybe she is a seasonal employee, who sometimes works in Florida, and at other times works in Connecticut.
In this instance, Kate’s car must have PIP insurance.
Because it was kept in Florida for over 90 days out of the prior 365-day period.
However, there’s likely a bigger issue for her personal injury or insurance claim. The bigger issue is that when bought her Maine auto policy, Kate didn’t tell State Farm that the car was kept in Florida.
Thus, if Kate is hurt in a Florida car accident, State Farm may deny coverage. If State Farm asks what Kate was doing in Florida at the time of the accident, she must tell the truth. In other words, she should not say that she was on vacation or visiting a friend if it’s not true.
Why Does Kate need to tell State Farm (or any insurance company) the truth?
Because lying to an insurance company is considered insurance fraud. Insurance fraud is a 3rd degree felony! It’s serious business.
It’s better than Kate tells the truth, rather than her winding up in jail.
If you happen to be someone like Kate, and are considering hiring me as your lawyer, and you want me to go along with your lie to the insurance company about why you were in Florida at the time of your crash, please don’t contact me. I won’t take your claim. I don’t represent people who commit insurance fraud.
No one case is worth my integrity or law license. Not even a million dollar case.
Out of State Car’s UM Insurance Will Cover You in Florida
Take the first example above with Maria. She was a passenger in a friend’s, Sara. Sara owned and kept the car in another state.
It’s being driven in Florida. Sara’s uninsured motorist insurance should cover Maria, even if the crash happens in Florida.
As I said earlier, Maria had a shoulder injury. She had surgery on her torn rotator cuff.
Sara’s uninsured motorist insurance paid $100,000 for Maria’s UM case. Sara’s UM insurance paid before Maria’s UM insurance.
This was in addition to $8,433 in payments under Sara’s medical payments coverage in her policy.
Host Vehicle’s Bodily Injury Liability Insurance Pays Damages
Assuming Sara was at fault for the accident, her BI liability insurance would pay for Maria’s damages.
When You’re ‘Occupying’ a Florida Rental Car, You Get PIP
If you’re hurt while in a rental car in Florida, the rental car company should pay your Personal Injury Protection (PIP) benefits. (This is because Florida is a no-fault car insurance state.)
This is true even if you live in another state and were visiting Florida.
Nonresidents May Not Need To Meet No-Fault Threshold for Pain and Suffering…If They Have UM.
In Florida, UM coverage typically doesn’t cover you for your pain and suffering unless you meet the tort threshold requirement. Sternberg v. Allstate Insurance Co., 900 So.2d 732 (Fla. 4th DCA 2005).
However, if you live in a “fault state” ( without no-fault insurance), and an uninsured vehicle driver’s negligence causes your injury in Florida, you don’t have to meet the no-fault threshold in order to get money for pain and suffering from your UM insurer. Dauksis v. State Farm Mutual Automobile Insurance Co., 623 So.2d 455, 456 (Fla. 1993).
In a soft tissue injury or smaller injury case, the pain and suffering component of a nonresident’s (from a fault state) case may be worth more if he or she has UM insurance and the careless driver is uninsured.
This is because your out of state UM car insurance likely won’t require that you have a threshold injury in order to get money for pain and suffering.
Nonresident Pedestrians Hit By Car in Florida May Have an Easier Case
Learn if you can get paid for your medical bills, lost wages, pain and suffering if a driver causes your injury while you’re a pedestrian, visiting Florida.
Out of State UM Insurance May Not Apply if No Impact With Other Car
There are exceptions to the general rule of UM coverage for out of state residents who are hurt in Florida car wrecks.
Some out of state insurance policies require that there must be physical contact between two vehicles for UM insurance to apply.
Georgia UM insurance law has this requirement. However, it has an exception. If there is no contact between the 2 vehicles, but there is an independent corroborating witness, this should qualify you for UM coverage.
In addition to the above corroborating witness requirement, if there is no contact with another vehicle, some other states have two additional requirements.
For example, Oregon uninsured motorist coverage requires the accident to be reported to the police within 72 hours of the accident. Additionally, a statement under oath must be filed with the uninsured motorist insurer within 30 days stating that the insured or his or her attorney has a claim arising out of the accident against a phantom vehicle. The insured must give facts in support as well. 2017 Oregon Laws Chapter 742.504
If you miss these requirements, you lose your uninsured motorist coverage. You don’t want to lose this valuable coverage. After all, uninsured motorist coverage can be very valuable. To the tunes of hundreds of thousands or millions of dollars.
This is yet another reason to quickly speak with an injury lawyer after an accident.
You’re Covered by Your UM Insurance (Even if You’re Driving a Rental Vehicle in Florida)
If you live in a state other than Florida, and you’re an occupant of a rental car, you UM insurance on your out of state auto policy should cover you. This is true even if you’re working.
If You Live in Another State, and Are Hurt in a Florida Car Accident, How Long Do You Have to Sue?
The time limit to sue the at fault party from an auto accident in Florida is usually 4 years from the date of the crash. Cases against a government entity have shorter deadlines.
Someone who lives in another state, but is hurt in a Florida car crash, has 5 years to sue an insurer of a Florida uninsured motorist (UM) auto policy.
If the visitor to Florida has an out of state UM policy, the out of state law will determine how long the visitor has to sue that UM insurer.
What If You’re Injured in an Uber or Lyft Accident While Visiting Florida?
If you’re injured in an Uber or Lyft accident in Florida, while visiting from another state, the claim gets more complex. The out of state visitor is typically in Florida for one of two reasons.
They are either here for a:
Vacation (or pleasure)
Business (work related)
In either instance, the injured person is even more likely to need a Uber or Lyft personal injury lawyer to protect their rights. This is because you’ll be dealing with multiple insurance coverages and different state laws.
The injured Uber or Lyft passenger should make a Personal Injury Protection (PIP) or Medpay claim with his or her personal auto insurance. This is true even though the injured person was not in his or her own automobile at the time of the accident.
If the out of state visitor was within the course of his or her employment at the time of the accident, the out of state Medpay insurance likely won’t cover the visitor.
However, he or she should still make a claim for PIP or Medpay with his or her personal auto insurance so that they can deny coverage.
Why do you want a letter denying PIP or Medpay coverage?
Because this denial can be given to the injured person’s health insurance company (and Lyft’s insurance company) so that they can pay benefits. Otherwise, the health insurance company (or Lyft’s insurance company) may continue to deny paying medical bills that they believe the injured person’s auto insurer (or Lyft’s insurer) should pay.
Lyft’s PIP insurer will pay a Lyft passenger’s PIP benefits before the passenger’s health insurance pays medical bills. Thus, an injured Lyft passenger should also make a PIP claim with Lyft.
The injured person should quickly send Lyft an affidavit of no insurance if appropriate. I use different affidavits depending on whether or not the injured passenger owned an automobile on the date of the accident.
Here is a Lyft PIP affidavit that I may use if my client didn’t own an automobile on the date of the accident:
If the injured passenger only owned an automobile in his home state, I change the affidavit so that it looks more like this one:
However, the Lyft “No PIP” Insurance affidavit’s wording will depend on the specific circumstances of the injured person. Thus, it needs to be a custom fit.
Don’t wait for Lyft’s claim handler (York) to send you this form. The injured person needs to edit the form (as appropriate) and sign it in front of a notary. It needs to be notarized.
If the injured person has a Lyft accident attorney, he or she should do this quickly. This is one of the many advantages to hiring an injury lawyer.
Then, send the PIP affidavit to York fast. This can lead to a faster settlement for the injured person.
How Could Quickly Completing a PIP Affidavit Lead to a Faster Injury Settlement?
Because the medical bills will get processed (and paid) faster. Thus, the injured person will know the amount of his or her out of pocket medical bills. In order to value a personal injury case in Florida, the injured person needs to know their out of pocket medical bills.
In Florida, the injured person is only entitled to compensation for their out of pocket medical bills (and any liens). The injured person can’t get compensation for the full billed charges. This Florida law is different from that of many other states.
The injured person may also be entitled lost wages and pain and suffering.
Uber’s Insurance Won’t Pay PIP Benefits to Passengers in Florida
Uber’s insurance company doesn’t give PIP benefits to Uber passengers in Florida auto accidents. This is based on Progressive’s insurance policy, which is below:
You’ll notice that PIP insurance coverage isn’t on Progressive’s Florida policy when the Uber is engaged in a ride. Also, Florida’s rideshare law doesn’t require PIP.
As you can see from the above image, Progressive is currently Uber’s insurer in Florida.
However, the injured passenger should still make a claim with Uber’s insurance company. Uber’s insurer will deny PIP coverage in a letter to the injured passenger. Here is what the PIP denial letter looks like:
That letter was Uber’s former insurer in Florida. However, Progressive’s letter will look similar.
Regardless, the injured person should quickly send the insurance company PIP coverage denial letter to the his or her health insurance company. Otherwise, the health insurer might not pay medical bills.
If You’re Relative was Driving and Caused Your Injury, Will His Insurance Company Pay You?
It depends on whether you were living with your relative. It will also depend on whether the out of state law allows insurance companies to exclude BIL insurance coverage for resident relatives.
Some states, like Tennessee, allow insurance companies to exclude coverage if a driver causes injury to his resident relative. Tennessee Farmers Mutual Insurance Company v. Estate of Archie, Tenn: Court of Appeals 2016. Tennessee’s law is similar to Florida’s law in this aspect.
On the other hand, some other state’s do not allow an insurance company to exclude BIL coverage if a driver causes injury to his resident relative. It really all depends on the state where the driver’s policy was issued.
Whether You Have to Pay a Health Insurer From the Settlement Depends on Out of State Law
Many injured people use their health insurance to pay their medical bills related to the accident. As you can imagine, sometimes health insurance pays a large amount of medical bills. This is particularly true if the injured person had surgery.
The type of health plan that you have will determine if you have to pay back your health “insurer”.
Was the health “insurance” secured through someone’s job?
If the answer is “Yes”, and it is not a government job, then the member needs to find out if the health plan is self-funded.
Assuming the health plan is self-funded, then the plan language will determine how much the member is required to reimburse the health insurer.
Large employers typically have self-funded health plans. Examples of large employers are Walmart, Target, Publix, Costco, CVS, Whole Foods, big banks (Bank of America, etc.) and others.
If the health plan is self-funded, then the reimbursement aspect of the visitor’s claim is treating just like a Florida resident.
Example – Out of State Law Determines if Injured Person Must Repay Health Insurance (Acquired via Work)
However, if the health insurance isn’t self-funded, then the state law that governs the contract will determine if reimbursement is required.
As an example, let’s assume John lives and works in New York. He works for an accountant with 3 other employees. He purchased his health insurance through his job.
John travels to Florida. While in Florida, he takes an Uber car to go eat. The Uber driver crashes into the back of another car. John injures his hand and foot in the accident.
John’s health insurer pays $10,000 of his medical bills. John makes a claim against the Uber driver for his medical bills, lost wages and pain and suffering.
The Uber car’s insurer, James River Insurance Company, pays $45,000 to settle John’s injury claim.
In this case, John doesn’t have to pay back his health insurer any of the $10,000 that they paid for his medical bills. This saves John $10,000!
Why Doesn’t John Have to Repay His Health Insurance Company?
He doesn’t have to pay back his health insurer from because John’s health plan is an insured health plan. I know that it is insured because John’s employer is very small (4 employees). Since John worked in New York (NY), his health insurance is subject to NY’s antisubrogation law.
The result is the same if John got his health insurance because he (or a family member) was a city or state employee. This is because city and state health insurance plans are subject to the out of state law.
And again, New York has a very good antisubrogation law for people who are injured in Florida.
I used Uber in the example above. However, the result would be the same if it was Lyft or any car insurance company.
(Fun fact: I settled a similar case for $70,000 except it wasn’t against Uber. It was against Lyft’s underinsured motorist insurance for $45,000, and GEICO’S policyholder for $25,000. There were some other different facts, such as John (not real name) was a Florida resident. Also, the Lyft driver wasn’t at fault.
Ok. Let’s get back to health insurance repayment.
Out of State Law Determines if Injured Person Has to Repay Health Insurance (That Wasn’t Purchased Through Work)
If the health insurance wasn’t purchased through work, then the state law of the health insurance contract will determine the amount of reimbursement. For example, individual and ACA (Obamacare) plans are subject to the state law of the resident.
Let’s change the facts of the case involving John a little bit. Assume John didn’t buy his health insurance through work.
Assume he got his own individual plan or an Affordable Care Act (ACA) health insurance. Since New York state law applies to individual and ACA health insurance plans for New Yorkers, John doesn’t have to repay his health insurer. This saves John $10,000.
Some states have antisubrogation laws that don’t allow a health insurer to get repaid from a personal injury settlement.
If the injured person lives in a state with antisubrogation laws, and he or she has an individual or non-ERISA health plan, it usually results in a bigger net settlement for the injured person. This assumes that the case has settlement value.
Some states with antisubrogation laws in regards to health insurance are:
New York (Wurtz v. Rawlings Co., LLC, 761 F.3d 232, 239 (2d Cir.2014)
North Carolina (Bush v. Nat’l Union Fire Ins. Co. of Pittsburgh, PA, 124 F. Supp. 3d 642 (E.D.N.C. 2015))
Virginia (Va.Code Ann. § 38.2-3405; Va.Code Ann. § 38.2-3406; Whitlinger v. Cont’l Cas. Co., 129 F.Supp.2d 924 (E.D.Va.2001).
Out of State Law Will Determine If You have to Pay Back Medpay Benefits
Let’s assume that an out of state visitor is hurt in a Florida car accident. His Medpay from his out of state car insurance policy pays some of his medical bills. The out of state law will likely determine if he has to repay the Medpay insurer.
However, some states do not allow the Medpay insurer to claim a lien on the settlement. Virginia is one state that follows this rule. Code of Virginia § 38.2-2209
Let me give you an example. Assume Mike lives in Virginia. While visiting Florida, he is injured in a car accident. He breaks his wrist, or suffers a herniated disc.
Assume Mike’s Virginia car insurance company pays some of his bills under its Medpay coverage. If this happens, Mike doesn’t have to pay his car insurance company back if he settles his personal injury case with the responsible party.
However, an injured person doesn’t have to repay Medpay benefits an uninsured motorist insurance settlement.
North Carolina doesn’t allow a car insurance company to require its insured to pay it back for Medical Payments coverage if he or she settles an injury case. 11 N.C.A.C. § 12.0319. Thus, a North Carolina resident who is injured in Florida doesn’t have to pay back his or her auto insurer if he reaches a settlement with a driver.
States that require the injured person to repay the Medpay auto insurer are:
California (but must reduce by attorney’s fees and costs). Lee v. State Farm Mut. Auto. Ins. Co. (1976) 57 Cal.App.3d 458, 465-466, 129 Cal.Rptr. 271.
Georgia (but must reduce by attorney’s fees and costs, and injured person must have been made whole) O.C.G.A. § 33-24-56.1(b)
Illinois (but must reduce by attorneys fees and costs) Manago ex rel. Pritchett v. County of Cook, 2016 IL App (1st) 121365
Oregon (but only if the total PIP payments are greater than the damages suffered by the person. (Oregon Statute 752.544)
Which Rental Car Companies Offer $1 Million in Uninsured Motorist Insurance to Out of State Visitors to Florida?
If you purchased Liability Insurance Supplement (LIS) with Thrifty, Dollar or Hertz, it includes $1 million in uninsured/underinsured (UM/UIM) motorist coverage.
Most uninsured motorist cases aren’t worth anywhere near $1 million. That is a lot of money.
Which Injuries May Be Worth $1 Million or More?
Some claims may be worth $1 million (or more). The most common cases that have a full settlement value above $1 million (or more) are if you’ve suffered one of the following:
Brain injury that required surgery to your skull
Several surgeries to a body part and you’ve developed chronic regional pain syndrome (CRPS)
Paralysis from the waist or neck down
Above the knee Amputation, or arm amputation
Also, the death of a minor child or spouse, or the death of a parent has a full settlement value of over $1 million.
Why does a brain injury (with surgery) case have a full settlement value of over $1 million?
First, the hospital charges may easily be over $500,000. Additionally, the neurosurgeon and other doctors will have high bills.
But the bigger damage is for pain and suffering. Additionally, if the injured person was a big wage earner, that adds tremendous value. The past lost wage claim will be big. The future lost earning capacity claim may be even bigger.
Out of State Visitors to Florida Should Not Quickly Settle With the At Fault Driver
Assume that the at fault driver has $50,000 in BIL coverage. Assume that the out of state visitor to Florida has a brain injury and surgery. Here, the out of state visitor’s (to Florida) personal injury claim is worth much more than the at fault driver’s $50,000 BIL coverage limit. In this instance, the out of state visitor should not quickly settle his or her injury case for $50,000 with the at fault driver.
First, the injured out of state visitor does not want to give up the right to make a UM claim. This can happen if the you don’t follow a particular UM claim procedure. The tourist can also lose his UM claim if the settlement release with the at fault driver’s insurer is poorly worded.
Second, the injured out of state visitor does not want to end up in Federal court in Florida. He or she wants to keep the case in Florida state court. There are many advantages to keeping your case state court (instead of Federal court).
Budget’s website says that UM/UIM are not provided by the policy except in states where mandated by law up to maximum amount of $1MM in Florida or in such amounts as mandated by law.
However, Florida doesn’t require UM coverage. Therefore, I assume Budget’s SLI does not have UM coverage. However, I’m not sure.
If You Live in Another State, and You’re Injured in Florida, Do You Have to Pay Back Your Disability Insurer for Benefits It Paid?
I use the same analysis for short or long term disability “insurance” as I do for health insurance above.
Some states have antisubrogation laws in regards to disability insurance are:
Let’s assume a North Carolina resident is injured in a Florida car accident.
If the North Carolina resident has a individual disability insurance, he or she doesn’t have to pay the disability insurer back if he settles a personal injury case.
People From Connecticut Who are Injured in Florida Car Accidents
Let’s look at another state, Connecticut. Connecticut Medicaid can allegedly collect not only medical bills paid for the injury, but also any cash assistance from the Connecticut’s state department of social services.
Connecticut Medicaid’s lien can’t be greater than 50 percent of the amount recovered by the Medicaid recipient from the responsible third party, less the costs of the lawsuit, as provided in §17b-94(a). Rathbun v. Health Net of the Northeast, Inc., 315 Conn. 674 110 A.3d 304 (2015)
The law says that the 50 percent of the amount recovered is “after payment of all expenses connected with the cause of action.”
For example, assume that a Connecticut Medicaid beneficiary is hurt in a Florida car crash. He settles against the at- fault driver, before a lawsuit, for $10,000. Medicaid paid $400 in medical bills.
Connecticut Medicaid can’t get more than 50 percent of the settlement (minus costs). In this example, Medicaid can’t get more than the half of $5,000.
If you live in Tennessee but you’re injured in a Florida car accident, there are several very important things to know. I’ll discuss two of them here.
First, don’t settle the personal injury claim against the at fault driver if you want to make a UM claims based on a Tennessee car insurance policy. Doing so could kill your UM claim.
Second, you likely have four years to sue the uninsured motorist insurer. To learn more, read my article for Tennesseans injured in Florida car accidents.
Do Massachusetts Residents Have to Pay MassHealth from a Florida Car Accident Settlement?
Yes, for medical assistance benefits that MassHealth paid. Massachusetts General Laws Chapter 118, Section 22(b). In Massachusetts, Medicaid and the Children’s Health Insurance Program (CHIP) are combined into one program called MassHealth.
Additionally, the claimant must repay the costs attributable to services provided to the claimant that were paid by the Health Safety Net Trust Fund established in section 66. Massachusetts General Laws Chapter 118, Section 22(e).
Moreover, if the claimant was not receiving financial assistance benefits before the accident, then the claimant must repay the total of all financial assistance benefits provided by the department on and after the date of the accident to or on behalf of the claimant. Massachusetts General Laws Chapter 118, Section 22(f).
So far I’ve focused on claims for people who live out of state, and are injured in Florida.
But what happens when the opposite occurs?
I wrote an article for Florida residents who are hurt in an out of state car accident.
Read these articles if you’re injured in Florida, and you live in one of these states:
California Residents Hurt in a Florida Car Accidents
Georgia Residents Hurt in Florida Car Accidents
Illinois Residents Hurt in Florida Car Accidents
New Jersey Residents Hurt in Florida Car Accidents
New York Residents Hurt in Florida Car Accidents
Texas Residents Hurt in Florida Car Accidents
Check out my article on my settlements for tourists from other countries who are injured in a Florida car accident.
I’ve discussed several fact patterns where someone from a particular state was hurt in a Florida car accident. However, I haven’t included examples of people from every state. In the near future, I hope to add fact patterns for people who are hurt in Florida car accidents while visiting from:
Colorado, Delaware, Hawaii, Idaho, Indiana
Kansas, Kentucky, Louisiana, Maryland
Minnesota, Mississippi, Missouri, Montana
Nebraska, New Hampshire, New Mexico, North Dakota
Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina
South Dakota, Utah, Vermont, Washington, Wisconsin, Wyoming
Injured in a Florida Car Accident While Visiting from Another State?