Florida no-fault coverage applies to the named insured or any family member  with respect to injuries sustained while occupying any motor vehicle or as a pedestrian through being struck by a motor vehicle. Other persons are covered for injuries sustained while occupying the named insured's covered auto or as a pedestrian through being struck by the named insured's covered auto.

As defined in the endorsement, a  “named insured” includes the person named in the declarations and that person's resident spouse. A “family member” is defined as “a person related to the 'named insured' by blood, marriage or adoption who is usually a resident of the 'named insured's' household,” including wards or foster children.

Coverage under the named insured's policy does not apply to anyone else who must maintain statutorily required no-fault coverage or to anyone else, other than the named insured or any family member, who is entitled to no-fault benefits from the owner of another vehicle, whether the owner actually has no-fault insurance or not.

Other exclusions rule out coverage 1) for the named insured or any family member while occupying a motor vehicle owned by the named insured but not insured under the policy; 2) for anyone operating the named insured's covered auto without the named insured's consent; 3) for anyone injured while occupying a motor vehicle located for use as a residence or premises; 4) for anyone who injures himself intentionally; and 5) for anyone injured while committing a felony. There is also no personal injury protection coverage for any pedestrian, other than the named insured or any family member, who is not a legal resident of Florida .

Endorsement PP 05 54 provides four types of personal injury protection benefits: medical expenses, work loss, replacement services expenses, and accidental death. These benefits are paid to or for an insured who sustains bodily injury caused by an accident arising out of the ownership, maintenance, or use of a motor vehicle.

Medical expenses include reasonable expenses for medically necessary medical, dental, ambulance, hospital, nursing and rehabilitation services, and prosthetic devices. “Medically necessary,” as defined, “refers to a medical service or supply that a prudent physician would provide for the purpose of preventing, diagnosing or treating an illness, injury, disease or symptom” within certain guidelines.

Recovery is limited to 80 percent of such expenses, the level of benefits prescribed by law. Also, medical benefits include necessary remedial treatment and services recognized and permitted under Florida law for an insured who relies upon spiritual means through prayer alone for healing in accordance with that insured's religious beliefs. Paying such expenses does not affect the determination of medically necessary medical expenses.

Work loss applies to loss of income and earning capacity from inability to work proximately caused by injury. Endorsement PP 05 54 provides recovery of 60 percent of such loss, the legally required minimum, and offers the named insured the option of eliminating (with a corresponding premium reduction) work loss benefits altogether for either the named insured alone or for the named insured and dependent family member. Work loss does not include any loss after the death of an insured.

Replacement services expenses are all expenses reasonably incurred in obtaining ordinary and necessary services to replace those that the insured would have performed for the benefit of the household had he or she not been injured.

An accidental death benefit of $5,000 per individual is the final personal injury protection benefit available.

Except for the death benefit, no specific dollar limits are prescribed for the individual benefit categories contained in the endorsement. However, the limit of liability for all loss to any one person in any one accident is $10,000.

While a Florida anti-stacking law exempts from its provisions—and therefore allows stacking of benefits under—automobile policies insuring different named insureds, a state district court of appeal refused to apply this exemption to no-fault insurance in Travelers Indemnity Co. v. Gorman, 404 So. 2d 1147 ( Fla. App. 1981). The court held that the Florida no-fault statute prescribed a total limit on no-fault benefits to any one person for any one injury of $10,000. (See Development of No-Fault Automobile Insurance for an illustration of how an overall no-fault limit governs recovery in individual benefit categories.)

Benefits payable under the endorsement are reduced by the amounts of workers compensation recoveries.

When no-fault benefits are available from more than one insurer, the liability of each is prorated. If injury occurs to a person occupying or hit by a leased or rented automobile, no-fault benefits provided under the lessor's policy are primary unless a declaration to the contrary is printed in bold type on the face of the lease agreement.

Endorsement PP 05 54 also states that the premium is provisional and subject to recomputation. This comes into play in the event of any change in the rules, rates, rating plan, premiums, or minimum premiums applicable because of an adverse judicial finding as to the constitutionality of the Florida no-fault law.

Benefits not paid within thirty days after written notice of loss will be overdue. The insurer may pay any benefits directly to the insured or to the person or organization providing services or supplies. Claims will not be paid to brokers, persons making claims on behalf of brokers, or clinics not registered with the Florida Department of Health that are required to do so.

If a person seeking personal injury protection coverage is charged with committing a felony, the insurer can withhold benefits until the prosecution formally decides not to prosecute the case, the charge is dismissed, or the person is acquitted.

The endorsement defines a “motor vehicle” as any self-propelled vehicle with four or more wheels that is designed and required to be licensed for use on Florida highways, including trailers and semi-trailers. The endorsement further states what a motor vehicle is not: any motor vehicle that is used in mass transit; that is designed to transport more than five passengers; and that is owned by a municipality, transit authority, or political subdivision of the state. A mobile home is also not considered a motor vehicle.

A covered auto means a motor vehicle owned by the named insured and for which security is required to be maintained under Florida law. For the purposes of this endorsement, a motor vehicle is deemed to be owned by a person if that person holds legal title, is a debtor having the right to possession, or is a lessee having the right to possession.

Higher levels of coverage than are provided by endorsement PP 05 54 may be obtained under the extended personal injury protection coverage endorsement PP 05 66.

While retaining the $10,000 overall limit, PP 05 66 increases medical expense recovery to 100 percent and work loss recovery to 80 percent for the named insured and any family members. For any other insured, the amounts of payment remain at 80 percent and 60 percent respectively as on PP 05 54.

The exclusions, definitions, and conditions of both forms are the same.

A further extension of benefits may be arranged through the use of added personal injury protection endorsement PP 05 55, which eliminates the $10,000 overall maximum and substitutes a schedule of overall limits applicable to medical expenses, work loss, and replacement services expenses for each automobile covered under the endorsement. This additional coverage, like that provided under the extended personal injury protection endorsement, applies only to the named insured and family members. Coverage afforded under this endorsement is excess to any applicable extended personal injury protection benefits.

Provisions of the Florida no-fault statute creating tort liability exemption for owners, registrants, operators, and occupants of motor vehicles in compliance with the law do so on the basis of a verbal threshold rather than a dollar amount. Damages are covered only when the injury involves significant and permanent loss of an important bodily function, significant and permanent scarring or disfigurement, permanent injury other than scarring or disfigurement, or death. (See Development of No-Fault Automobile Insurance for a general discussion of tort liability exemption in connection with no-fault coverage.)

Vehicle damage remains under the tort system.