Auto accidents

Why do I have to use my own PIP insurance?


By July 28, 2016 November 14th, 2018 No Comments

Perhaps you were driving to work when you were rear-ended on the freeway by the driver behind you. You missed a few days of work and spent the night in the hospital for testing. Now your paycheck is short and you have medical bills to pay. Thankfully, you have Personal Injury Protection on your car insurance policy. However, to use this coverage, you must file a claim on your own insurance policy.

Why do I have to use My Own PIP Insurance?
It may not make much sense that you were not the one at fault and now you are filing a claim under your own insurance policy. This is the way this type of coverage was created, though. You cannot file a Personal Injury Protection claim under the other driver’s insurance policy because it does not matter who is at fault. Each driver’s own insurance company protects them with this type of coverage.

No-Fault States
In order to understand Personal Injury Protection (PIP) insurance coverage and how it works, you must understand how no fault insurance states work when it comes to a car accident. No fault insurance states include:
• District of Columbia
• Florida
• Hawaii
• Kansas
• Kentucky
• Massachusetts
• Michigan
• Minnesota
• New Jersey
• New York
• North Dakota
• Pennsylvania
• Utah

If you live in one of these states, the law requires that your own car insurance pays for at least some of your medical expenses and lost wages if you are in a car accident no matter who was at fault for what happened. The legislatures in these states have done this in order to make it easier for auto insurance claims to be filed and paid, especially smaller claims. Some states have a limit to how much your auto insurance company is required to pay you under your PIP coverage and some states do not.

PIP Claims
PIP claims are made against your own insurance company to help pay medical bills and lost wages. The insurance carrier will pay for medical expenses and should reimburse you for some or even all earnings you have lost as a result of the accident. The amount you get paid will be capped at the amount of your entire claim or at the state’s limits, whichever is the least amount. Once your medical bills have exceeded the state limit for no-fault insurance, you will be left to pay whatever is still due. If you have health coverage, you can then submit claims to your health insurance carrier and have them paid according to the terms of your health insurance policy.

In the majority of states, you are not allowed to make a claim for injury damages from a car accident against another party unless your medical bills are over a specified amount or you have a serious injury.

PIP Claims Process
The PIP claims process can vary depending on the state where you live and how your insurance carrier handles the smaller details. Your medical provider may be able to bill your auto insurance carrier directly for your claims or you may need to pay some of the bills up front and wait for your carrier to reimburse you. In order to get reimbursed for your lost wages, your car insurance company will likely require you to submit proof of your earnings and missed time off of work from your employer.

Cooperation is Key
It is also important to note that you should cooperate with your insurance carrier regarding your PIP claim. In fact, some states have enacted laws to support this statement. You may be required by law to give a recorded statement about the accident or your injuries to your auto insurance company. In some states, you may also be required to be medically examined by a provider of the insurance company’s choosing. Not cooperating with these conditions can cause the insurance carrier to legally terminate your PIP claim and benefits.

Although having to file a PIP claim with your own auto insurance carrier may seem like an undue burden or incorrect, it is just the way PIP coverage was created. It does not matter who was at fault, each driver will be covered for medical expenses and lost wages under their own insurance policy.

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