PIP insurance is a type of auto insurance that pays benefits to the insured regardless of fault. In other words, you are eligible to receive PIP insurance benefits even if you were the driver who caused the car accident. However, PIP auto insurance does not pay for all expenses related to a personal injury claim. PIP coverage only pays for certain expenses and losses related to the victim’s injury.
6 Expenses Covered by PIP Insurance
- Medical Expenses
- Lost Wages
- Rehabilitation Costs
- Funeral Expenses
- Car Repairs
- Home Care Expenses
PIP stands for Personal Injury Protection insurance coverage. In states that require no-fault insurance coverage for automobiles, PIP insurance is usually required. However, in states that require a victim to prove “fault” to recover compensation for an accident, PIP auto insurance is optional. As stated above, a PIP insurance claim does not pay all expenses related to a personal injury claim. Let’s discuss in more detail what no-fault insurance will pay after a car accident.
1. Medical Expenses
After a car accident, medical bills can be a significant financial burden for many accident victims, especially when the required medical treatment involves surgery, physical therapy, and other expensive medical care for the injured person.
By filing a PIP insurance claim, your medical providers can receive payment for medical bills immediately, even though you may still be receiving treatment and your liability insurance claim will not be settled for some time.
2. Lost Wages
Loss of income is another significant expense accident victims incur after a motor vehicle accident. Personal injury protection also covers loss of income sustained after an auto accident. Again, because you do not need to prove who caused the car crash to receive benefits, you can file a loss of income claim under your PIP coverage to recover lost wages quickly.
3. Rehabilitation Costs
Rehabilitation costs may also be covered under your PIP auto insurance policy. If you sustained injuries that result in a permanent impairment or require extensive physical therapy before you can return to work, you might need rehabilitation therapy. In some cases, PIP insurance covers this expense as medical costs.
4. Funeral Expenses
In the event of a wrongful death, no-fault insurance coverage may pay some or all the funeral expenses, including the funeral costs, cremation, and burial, for a loved one. Not all personal injury protection policies cover this expense, so you need to read your policy carefully to determine the applicable coverage.
5. Car Repairs
In a few no-fault insurance states, PIP insurance pays for car repairs. However, this PIP coverage may not be available in all states.
6. Home Care Expenses
You may also file a PIP claim for costs related to “substitute services” or home care expenses. These expenses include paying someone for lawn care, childcare, household cleaning, and other services that you are unable to perform yourself because of your injury. The types of services covered vary by policy.
It is important to note that PIP insurance coverage is not standard in all fifty states. PIP car insurance may cover all the above expenses in one state. However, in another state, PIP auto insurance may only pay medical expenses and lost wages.
Furthermore, some no-fault insurance policies limit the amount of benefits for loss of income. In other words, you are only entitled to receive compensation for a portion of your lost income.
Also, your insurance provider is only required to pay benefits up to the policy limits. States that require no-fault insurance coverage set minimum limits for personal injury insurance. If you carry minimum insurance coverage amounts, your personal injury protection benefits could be very low and run out quickly.
How to Make a PIP Insurance Claim
After a car accident, you may have several options for filing a personal injury claim. In no-fault insurance states, you are typically required by law to file a PIP claim with your insurance provider. In fault states, you may file automobile insurance claims with your insurance provider if you have PIP coverage and a liability insurance claim with the insurance company representing the at-fault driver.
The steps for filing a PIP claim differ slightly by state.
First, carefully read the personal injury protection section of your car insurance policy to determine the requirements for requesting PIP benefits. Most insurance policies require you to seek medical care within a specific period following the motor vehicle accident from a licensed health care provider. The policy also requires that the medical treatment you receive is reasonable and necessary.
Next, contact your insurance company to determine the procedure for filing a PIP claim. It is best to contact your PIP insurance provider as soon as possible after the crash to notify the company of your intent to file a claim. Your insurance provider may have specific PIP forms that you must complete or deadlines that you must meet. In all cases, you are required to provide proof for each item that you intend to include in your PIP claim.
You must provide proof of each expense that you request reimbursement for under your PIP insurance coverage. For instance:
- Medical Expenses – You need copies of all medical payments you intend to submit for payment.
- Loss of Income – You need proof of lost wages, such as a statement from your employer and proof of your income before the accident.
- Substitute Services – If you claim reimbursement for substitute services, you must have receipts for payments to each service provider. Some insurance companies may require you to provide a statement from your medical provider certifying that you cannot perform these tasks or need assistance performing these tasks because of the injuries sustained in a car accident in Utah. Also, some insurance companies require the service provider to be someone who is not a member of your household.
- Funeral Expenses – You need copies of each invoice and bill that you wish to receive reimbursement for from your PIP auto insurance coverage.
- Car Repairs – If your PIP insurance covers car repairs, you should check with the insurance company before making the repairs. Your PIP auto insurance policy may require you to submit several written estimates for approval, or you may be required to use a specific auto body shop for the repairs.
Insurance laws vary by state, including PIP coverage. You should always check the coverage before assuming an expense is covered by your no-fault insurance policy, including a motorcycle accident in Utah.
Many insurance companies limit the amount paid under PIP insurance. For instance, some states allow providers to limit PIP coverage for lost wages to a percentage of the actual lost income or cap the amount paid for loss of income.
Do I Need an Attorney to File a PIP Claim?
As with other insurance claims, you are not required to hire an attorney to file a PIP insurance claim. However, hiring a car accident attorney or personal injury lawyer can be very helpful.
A PIP insurance claim is like other insurance claims, except you are filing the claim with your auto insurance provider. For example, you may have difficulty proving medical expenses are reasonable and necessary if you have a whiplash injury regardless of whether you are filing a PIP claim or a liability insurance claim.
You must be careful when dealing with the insurance company to avoid making mistakes that could delay receiving payment or result in a denial of the claim. A PIP insurance attorney can help you file your claim and avoid those mistakes. First, an attorney reviews your personal injury protection policy to determine your coverage, deadlines, and the requirements for filing a PIP claim. Your attorney helps ensure that you have the correct documentation and proof required to receive PIP benefits to avoid delays in payments.
If your PIP insurance does not limit payment for certain items, a personal injury attorney can help you decide which categories of expenses should receive priority when filing the PIP claim. For example, if another driver caused a distracted driving accident, you may also be contemplating a liability insurance claim against that driver. Therefore, it might be best to apply your PIP insurance benefits to one category of expenses to maximize the compensation you may receive for your liability insurance claim.
It is not wise to assume that because you are dealing with your personal auto insurance provider that you do not need to consult an attorney about PIP insurance coverage. A personal injury attorney can provide legal guidance regarding all aspects of a car accident claim to protect your best interests. An insurance adjuster or claims adjuster, even one that represents your insurance provider, still protects the insurance company’s best interest first.
FAQ About PIP Insurance
How Much Do I Get for PIP Payments?
PIP payments may be limited depending on the insurance laws in your state. If you have questions about your PIP insurance coverage, you should read your insurance policy and contact your insurance agent. Your insurance agent can explain the benefits under your current personal injury protection policy.
It may be a good idea to schedule an insurance check-up with your insurance provider to discuss your current auto insurance coverage and whether you need to increase insurance coverage to protect yourself and your family. Having enough auto insurance coverage is crucial. You hope never to need the insurance benefits, but you want the benefits to be available should the unthinkable occur.
Will My Insurance Rates Go Up If I Use PIP?
In most states, insurance premiums do not increase when a person files a no-fault insurance claim, like a PIP claim or a Med Pay claim. For most individuals, their insurance rates only increase if they have a liability insurance claim filed against them by another party. However, as always, you should read your PIP insurance policy and ask your insurance agent to clarify under what circumstances your car insurance rates may increase.
Will My Insurance Rates Decrease After My PIP Claims Expire?
If you live in a state that allows insurance companies to increase insurance rates after a PIP claim is filed, your insurance premiums should decrease once the claim drops off your record. Three years is the typical period for a claim to remain on an insurance policy. However, if you purchased an insurance policy with accident forgiveness or other options, the timeline could be different in your case.
Why Do I Need Personal Injury Protection Insurance?
You may be required by the insurance laws in your state to carry no-fault insurance coverage. If so, you have no choice but to purchase injury protection insurance in at least an amount equal to the state minimum insurance amounts. If you are not required to carry PIP coverage, you may still want to consider purchasing the insurance coverage for several reasons.
First, it is a no-fault insurance policy. That means that even if you cause the motor vehicle accident, you are still eligible to receive benefits. Your PIP benefits typically do not have a deductible or copay. You can receive benefits for a PIP claim very quickly so that you can pay medical bills and other necessary expenses. A liability insurance claim could take months or over a year to settle.
How Much Does Personal Injury Protection Insurance Cost?
The cost of personal injury protection insurance varies by state and by the insurer. Depending on the coverage amount and other variables, the cost of purchasing PIP insurance could be relatively low. In a few states, you can purchase no-fault insurance that includes the right to sue or waives the right to sue another party for pain and suffering damages. If you choose to waive your right to sue, your insurance premium is lower for PIP coverage. However, as with other types of car insurance coverage, you need to weigh the coverage against the cost.
If you can afford to purchase a PIP insurance policy, it can offer you a great amount of security in knowing that you can access money for expenses after a car accident quickly and without the requirements necessary for filing a liability insurance claim.
Do I Need Personal Injury Protection If I Have Health Insurance?
Personal injury protection insurance pays benefits regardless of fault and typically does not have a copay or a deductible. Your health insurance policy likely has a deductible and copay for benefits. Also, PIP benefits include coverage for passengers in your motor vehicle and replacement of lost wages, which health insurance would not cover. Many individuals use their PIP benefits first and then use health insurance coverage while they are considering filing a personal injury claim against the other driver.
How Much Liability Car Insurance Do I Need?
Liability coverage pays third-party claims when you are at fault for a motor vehicle accident. Your liability insurance carrier pays compensation to individuals hurt in the accident. It covers financial damages, such as medical expenses, lost wages, property damage, and non-economic (pain and suffering) damages. Your insurance provider is only responsible for paying damages up to the policy limits. Any damages exceeding the policy limits are your responsibility. Depending on your financial situation and the laws in your state, the accident victim could obtain a personal judgment against you for any damages not covered by insurance.
It is always a good idea to discuss your situation with your insurance agent to determine the amount of liability insurance you need to purchase. It is a good rule of thumb to purchase liability insurance in the highest amount you can afford to protect yourself and your assets if you are responsible for causing a car crash.
Can I Have PIP and Med Pay?
Yes, you can purchase PIP and Med Pay coverage if you live in an area that allows insurance providers to offer both types of insurance coverage. PIP and Med Pay are not the same type of insurance coverage. Med Pay strictly pays for medical bills after a motor vehicle accident. Some Med Pay policies also pay for funeral expenses. However, Med Pay does not reimburse you for loss of income or other expenses related to the accident or your injuries. Therefore, it is still a good idea to have personal injury protection coverage even if you decide to purchase Med Pay insurance coverage.
What Happens If I Lose My Personal Injury Claim?
Your insurance provider may deny your personal injury claim under your PIP auto insurance coverage just as it may deny a liability insurance claim filed by a third party. If you receive a notice denying your PIP claim, contact a personal injury attorney immediately to discuss your legal options. You may need to file an immediate appeal of the denial of claim with your insurance company. An attorney can help you prepare and file the claim and fight for coverage under your PIP insurance policy.
The same applies if another insurance provider denies your liability insurance claim. You need to contact an attorney immediately to discuss filing an appeal of the denial. Most insurance policies contain deadlines for filing insurance appeals. The insurance laws in your state may also have deadlines for appealing insurance denials.
Insurance claims are denied for many reasons. You may have failed to provide copies and documentation proving all damages or the insurance company may deny that its insured caused the crash. An insurance company could also deny an insurance claim simply because it is trying to avoid paying a large insurance claim.
Whatever the reason may be, contacting an attorney immediately can give you the best chance of successfully appealing the denial and receiving compensation for your insurance claim.
Do Insurance Companies Pay for Pain and Suffering?
Yes, an insurance company may compensate an accident victim for pain and suffering. Pain and suffering are considered noneconomic damages for an accident victim. Noneconomic damages include:
- Physical suffering and pain
- Permanent impairment and disability
- Loss of enjoyment of life
- Mental anguish
- Scarring and disfigurement
- Emotional distress
- Loss of consortium
- Loss of quality of life
PIP claims do not include pain and suffering damages. You can only receive pain and suffering damages by filing a liability insurance claim against the party responsible for causing the motor vehicle accident.
What Should I Tell My Insurance Company After a Car Accident?
When you file your insurance claim, the insurance agent or claims adjuster will request details of the accident. Because anything you say in a recorded or written statement can be used later in your case, you should be careful when providing details to the insurance company.
Be honest when you make your statement, but do not offer any information that is not requested. If possible, avoid making a statement until you discuss your case with an experienced personal injury attorney. An attorney can review your statement and help you avoid making statements that could be misleading or misconstrued by the insurance company or other parties. You want to present the facts to the insurance company, but you do not want to accept blame or fault for the car accident.
Navigating a Personal Injury Protection Insurance Claim
Have you been injured in a motor vehicle accident? If so, you may be wondering what your next step should be regarding an insurance claim. Should you file a PIP claim first or should you file a liability insurance claim against the other driver? What are the PIP laws in your state, and how do they affect your accident claim? How do you protect your right to full compensation for all damages?
A personal injury attorney with Acadia Law Group can answer all your questions during a free consultation. Call our office at 1-800-653-4600 to speak with a representative.
We are here to help you navigate the claims process. You do not need to handle your accident case alone. Our legal team is ready to provide the support you need so that you can focus on your recovery instead of dealing with the stress of an insurance claim.