Florida PIP & No-Fault

Why did PIP only pay 80 percent of my bills?

Attorney-Reviewed Answer
Reviewed by Jeff T. Gorman, Criminal Defense Attorney & Former 19th Circuit Prosecutor (Fla. Bar #538183). Last reviewed: September 2026
Short Answer
Because that's what the statute provides — 80 percent of reasonable and medically necessary medical expenses.

It isn't an error or a denial. Florida's statute sets PIP medical benefits at 80 percent.

Who covers the other 20 percent depends on your situation. Health insurance may pay it, subject to its own terms and to reimbursement rights. Some providers bill you directly. Some accept a letter of protection and wait for the case to resolve. And where there's a claim against an at-fault driver, that remaining balance becomes part of the damages sought.

What to watch. Providers sometimes bill the 20 percent aggressively, including sending balances to collections while a claim is pending. That's worth addressing rather than ignoring, because a collection account creates its own problems.

Two other reductions that get confused with the 80 percent: a policy deductible, and the reduction of a bill to what the insurer determines is a reasonable amount, which is a separate dispute.

Keep every explanation of benefits. Reconstructing what was paid, reduced, and denied months later is difficult without them.

Keep every EOB. Reconstructing this later is much harder than saving the paper. ---

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This page answers a common question for general informational purposes and is not legal advice, and no attorney-client relationship is formed by reading it. Florida law changes; while this answer is reviewed by a licensed Florida attorney, the right answer depends on the specific facts of your situation — consult an attorney. Serving Martin, St. Lucie, Palm Beach, Indian River, and Okeechobee Counties.