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What is Personal Injury Protection (PIP) Insurance?

Personal injury protection insurance or PIP coverage insurance is a type of auto insurance coverage which helps pay for medical expenses, lost income, child care, and services you cannot currently perform— like cleaning your home. Some states’ PIP insurance also includes funeral costs and a death benefit in the event of a tragic auto accident.

IS PIP COVERAGE MANDATORY?

PIP coverage is required in the 12 states which currently have no-fault insurance mandates. In other states, this additional insurance coverage can be offered and is optional in most cases. For instance, in Arkansas, Delaware, Maryland, and Oregon, PIP insurance is required even though these states do not have a no-fault insurance requirement. In places like Texas, New Hampshire, Virginia, South Dakota, Wisconsin, Washington, D.C., and Washington (state), PIP insurance coverage is offered and is optional.

HOW MUCH DOES PIP INSURANCE PAY?

PIP coverage provides added personal injury protection in the event of an accident, regardless of who is considered at fault for the accident. In no-fault states, PIP insurance helps provide personal injury coverage for both parties, as well as any passengers in their vehicles.

The extent of covered items and coverage limits will depend on which state you live in, where PIP insurance is either required or optional. For instance, here in Texas, PIP will pay 100% of all medical expenses as a result of auto accident injuries. Texas PIP payments also cover any dental or prosthetic devices, as well as funeral expenses.

Texas PIP insurance will pay 80% of any lost earnings if the injured person was employed at the time of the accident and unable to return to work. The insured is reimbursed up to their insurance coverage benefit limits, which could be $2,500, $5,000, or more in some cases.

WHEN CAN A CLAIM BE FILED USING PIP INSURANCE?

A claim can be filed right away following the auto accident for PIP coverage payments. Payments tend to start much faster since the claim is filed against your own insurance provider. Keep in mind, you may be required to submit proof of the medical bills and/or lost earnings in order to receive PIP payments.

IS PIP COVERAGE THE SAME AS MEDICAL PAYMENTS (MEDPAY) COVERAGE?

While both PIP and MedPay coverages can seem very similar, they are different. MedPay is optional coverage. There are no deductibles, co-insurance or co-pays to worry about. You can also use MedPay to cover the cost of deductibles, co-pays, and co-insurance.

With PIP insurance, the benefits paid could be reduced by deductibles, co-insurance, and co-pays. Another key difference between MedPay and PIP is PIP often covers non-medical expenses like child care services and lost earnings.

The two main similarities between PIP and MedPay coverages is they both provide fast payment for minor injuries sustained during your auto accident and there is no need to establish who was at fault.

CAN I HAVE BOTH PIP AND MEDPAY COVERAGES?

It will largely depend on where you live and what your state allows in regards to auto insurance personal injury coverages. In some states where PIP is required that also offer MedPay coverage, you may be allowed to have both types of coverages as part of your auto insurance coverage.

In other states, you may be required to have PIP insurance but cannot have MedPay. Yet in other states where PIP is optional, you may be allowed to only have one or the other or both. In states where you are allowed to have both PIP and MedPay, it is a good idea to get both coverages. This way, your MedPay will pay any deductibles on your PIP.

CAN I STILL SUE THE OTHER DRIVER IF THEY ARE AT FAULT?

Filing a PIP claim does not preclude you from being able to file a personal injury lawsuit against the other party if they were at fault for the accident, in most states. It will generally determine how the insurance injury laws are written for your state.

For example, you may need to reach an established threshold for medical bills prior to being allowed to sue the at-fault party. To illustrate, let’s assume your state has a threshold of $5,000 for medical bills before being allowed to sue.

Your PIP coverage will pay up to $10,000 for medical bills, lost wages, and other covered losses. Your total medical bills amount to $6,000, while your other losses amount to $8,000 for a total loss of $14,000. Since your medical payments are more than $5,000, you could sue the other party for the $1,000 difference. You may also be able to sue for the other $3,000 of additional losses you experienced.

On the other hand, let’s assume your medical bills were $3,000 and your other losses were $6,000. Since your PIP reimbursed you the $9,000, minus any deductibles, you would not have met the threshold requirement to sue the responsible party.

Additionally, in some states, even with PIP insurance you can still sue the at-fault party for pain and suffering, mental anguish, personal inconvenience, and other such types of losses which are not covered by PIP. In these states, it is not necessary to reach specific monetary thresholds to sue for these specific losses.

As you can imagine, knowing whether you can sue or not sue, threshold limits, and other information can be very confusing for most people. This is why you should consult with a qualified personal injury auto and truck accident attorney.

Most personal injury law firms offer a no obligation and free consultation so you can find out your legal rights, whether you can sue, and how much you could potentially receive by filing a lawsuit against the responsible party.

WHY NOT JUST USE MY OWN HEALTH INSURANCE AFTER AN ACCIDENT?

Some people might think they do not need PIP insurance or MedPay insurance coverage in states where these coverages are optional. If you are injured and the accident was the other person’s fault, you can simply file a claim against their personal injury liability coverage. If you were at fault for the accident, you can file a claim for your own injuries through your own health insurance.

Yet this is what most people do not consider: The timing to reach a settlement with the responsible party’s insurance company could take many months. While your own health insurance would cover a portion of your medical bills during this time, what about any lost wages, child care expenses, and other losses? Furthermore, if you were at fault, again, while your health insurance will help pay your medical bills, what if there were passengers in your vehicle who didn’t have health insurance?

To avoid having payments delayed or worrying about reimbursing your health insurance later after getting a settlement, it is better to have either PIP or MedPay coverage or both if it is allowed in your state. In addition, PIP and MedPay could help cover the medical bills for any passengers in your vehicle at the time of the accident.

I’VE BEEN INJURED IN AN AUTO ACCIDENT AND AM NOT SURE WHAT TO DO

Understanding the different types of auto insurance coverage you have, and whether to file against your own insurance, the other party’s insurance, or your health insurance can be very confusing during this stressful and difficult time. To help take the guesswork out of what you need to do, you can rely on assistance from the auto injury lawyers at Schechter, Shaffer & Harris, L.L.P.

Our experienced attorneys are available 24/7 to speak with you about your accident, provide solid legal advice, and recommend what you should do. Plus, it never hurts to get your own legal opinion from a non-biased source to find out if your insurance company or the other party’s insurance company is offering you a fair and just settlement for your personal injuries and other losses.

Feel free to contact us by calling 713-893-0971 now to arrange a consultation and speak with one of our motor vehicle accident lawyers. We will even come to you in the hospital or to your home to discuss your case in person.

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