PIP, or “Personal Injury Protection”, coverage is required in states which have adopted the no-fault model for auto insurance. This is the part of the policy which pays for medical bills and lost wages incurred by the policyholder and the occupants of his or her vehicle. Unlike other types of auto insurance, PIP coverage follows the individual, as opposed to the vehicle.
When an accident occurs, a person covered under PIP coverage would make a claim to his or her own auto insurance provider. The company will look after paying out benefits.
Before making a claim for PIP coverage, the insured should pull out his or her policy and check the language carefully. The documentation will explain what types of benefits he or she is entitled to, and what the policy limitations are. No insurance policy will pay out for every type of loss. In the case of PIP coverage, the company will not pay out for injuries other than ones sustained in an automobile accident.
The insured may be required to pay for his or her own medical bills and wait to be reimbursed by the PIP coverage provider. When seeking treatment for injuries following the accident, the hospital or doctor will likely ask whether the medical care is being sought due to an accident. If the insured’s medical coverage pays for these doctor visits and hospital treatment, the insurance company making the payment is entitled to reimbursement from the PIP provider.
People who have been injured in car accidents and have had their medical bills paid under a different plan are not entitled to be reimbursed by their auto insurance company for the same services. This type of “double dipping” is not allowed.
PIP Coverage Limits
All PIP policies have coverage limits. In states where this type of coverage is required by law, policyholders must keep at least a minimum level of coverage in place. This level of protection may be sufficient for those who have a good health care plan, but people who do not have their own health insurance would be well advised to buy PIP coverage with a limit higher than the state minimum.
It may be possible for an injured person whose expenses are not covered under a PIP plan to sue the other driver involved in an accident for reimbursement for medical expenses, but this option is not available in all states. In jurisdictions where no-fault insurance is being used, specific rules apply for whether injured people have the right to sue and if their level of injuries much reach a specific threshold to do so.
PIP Claim Denied by Auto Insurance Company
If the PIP claim is denied by the auto insurance company, the policyholder should ask the insurance company about whether the decision can be appealed. The policyholder can also seek legal advice to determine whether suing the auto insurance company for PIP benefits makes sense.