What Is PIP?

June 12, 2023 | Ed Bernstein
What Is PIP?

Personal injury protection (PIP) insurance, also known as no-fault insurance, covers a certain amount of damages resulting from a vehicle accident regardless of fault. Knowing more about PIP insurance can help you understand the coverage that comes with these policies and whether you need it. Consult a personal injury lawyer in Las Vegas to understand PIP coverage and its necessity for your situation.

What Is PIP Insurance?

Personal injury protection, or PIP, is auto insurance coverage that specifically covers some medical bills and other related costs resulting from a vehicle accident. Policyholders and their passengers benefit from this coverage in an accident, but it won't cover costs exceeding the policy's maximum coverage.

The requirements for PIP insurance vary from state to state, with some requiring a certain level of PIP coverage while others make this coverage optional for motorists. Some states don’t allow it at all, while others make it optional.

If a PIP insurance policy can't cover all the costs of an accident, it may be possible to recover additional compensation through health insurance policies. Filing a third-party insurance claim may also help individuals recover compensation from negligent drivers, depending on the state and the nature of the accident.

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What States Require PIP Insurance Coverage?

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Not all states require motorists to carry PIP insurance, but some no-fault and at-fault states make this mandatory for all vehicle owners. The following are the different rules regarding PIP insurance for each state:

No-Fault States Requiring PIP Coverage

All no-fault states require drivers to carry a certain amount of PIP insurance coverage as part of their auto insurance policies. States that operate on no-fault insurance laws are states where motorists must file insurance claims with their own companies following a motor vehicle accident, even if the other driver was at fault.

The following states require PIP coverage under no-fault insurance laws:

  • Florida
  • Utah
  • Hawaii
  • Kentucky
  • Kansas
  • New York
  • Massachusetts
  • Minnesota
  • Michigan
  • Pennsylvania
  • North Dakota

At-Fault States Requiring PIP Coverage

Certain at-fault states also require PIP coverage for motorists. In at-fault states, motorists can file a claim with their own insurers following an accident or a claim against the at-fault driver's insurer to recover compensation through liability coverage. At-fault states will require the at-fault party's insurer to pay for medical costs resulting from an accident up to the policy's limits.

At-fault states requiring PIP insurance coverage include:

  • Maryland
  • Delaware
  • Arkansas
  • Oregon

States Allowing For Optional PIP Insurance Coverage

Some states also allow individuals to carry a certain amount of PIP coverage without requiring it.

States that make PIP insurance optional include:

  • Texas
  • Washington
  • Washington D.C.
  • South Dakota
  • New Hampshire
  • Virginia

What Exactly Does PIP Insurance Cover?

PIP insurance coverage can cover different expenses from an accident, including medical expenses and other costs from your injuries.

Here are some of the specific items that these insurance policies may cover:

Medical Costs

The primary item that PIP insurance policies cover are medical expenses, including the cost of emergency care and ongoing care to help you recover from your injuries. In addition, PIP coverage may help cover a certain amount of the deductible on your health insurance policy.

Lost Income

If your injuries are serious enough to require you to take time off from work to recover or render you disabled and unable to work in the same capacity, PIP coverage may cover a certain amount of resulting income loss.

You may be able to get PIP coverage to help cover lost income even if you're self-employed, as you may need to hire contractors or employees to help you complete work if you're unable to do so because of your injuries.

Essential Services

Another type of coverage that PIP insurance policies may provide includes essential services required because of your injuries. For example, you might be unable to perform certain services such as housecleaning or transportation because of your injuries.

Expenses Resulting From an Individual’s Death

If an accident causes a person's death, PIP coverage may help cover the related costs of this death. For example, if a policyholder dies in an accident, the policy may help cover any lost income that could otherwise harm dependents. PIP coverage may also help cover funeral and burial expenses.

Also, keep in mind that PIP insurance coverage also extends to passengers in a policyholder's vehicle, meaning that passengers can also receive coverage in an accident.

What Will PIP Insurance Not Cover?

While PIP insurance can cover a few key costs from car accidents, it generally won't cover:

  • Injuries that other drivers sustain
  • Injuries to drivers who received payment for driving or who were committing a crime at the time of the accident
  • Property damage, including vehicle damage
  • Non-economic damages like pain and suffering

To supplement PIP insurance coverage and cover these items, individuals may also purchase bodily insurance liability insurance or property damage liability insurance.

The Differences Between PIP Insurance and Liability Insurance

PIP insurance differs from liability insurance in how it compensates drivers and others in vehicle accidents. While PIP insurance policies cover the medical expenses of policyholders and their passengers following an accident, regardless of fault, liability insurance covers a third party's costs if the policyholder is at fault.

Also, unlike PIP insurance, liability insurance is a requirement for all motorists in all states across the U.S. It can also cover any damage that the third party sustains that the at-fault policyholder causes. In contrast, PIP insurance doesn't cover any amount of property damage.

If someone else is responsible for an accident, victims may be able to file a third-party claim against the driver's insurer to receive compensation through liability coverage. The insurer would then determine whether the policyholder was at fault and pay compensation for medical expenses and other related damages, going beyond the limits of PIP insurance.

The Differences Between PIP and Health Insurance Coverage

Health insurance also differs from PIP insurance coverage in a few ways.

First, health insurance plans require policyholders to see designated licensed medical professionals under the policy's coverage. On the other hand, PIP coverage doesn't have this requirement individuals can see any professional they choose to diagnose and treat accident injuries. Additionally, PIP coverage doesn't come with the same fees that health insurance policies have to help manage the costs of treatments and prescriptions.

Another key difference is that you have limited time to use your PIP insurance coverage, unlike health insurance. This window will depend on the state's requirements, with most giving you a set number of days following an accident to seek an assessment from a qualified medical professional. This time limit makes it essential to seek treatment as soon as possible after an accident, even if symptoms appear minor.

What Is Property Protection Insurance (PPI)?

While PIP insurance coverage can help pay for medical costs, lost wages, and other losses extending from injuries or deaths after an accident, it won't cover property damage. Depending on the state, you may benefit from purchasing property protection insurance (PPI) in addition to PIP insurance to cover damage to different types of property.

This coverage may compensate for damage to property, such as your home, after a collision, but it can also help cover the damage that your vehicle causes to a parked car in an accident. However, PPI insurance doesn't cover the costs of damage to your vehicle or any other types of vehicles involved.

Is MedPay Insurance Necessary if You Have PIP Coverage?

MedPay, short for medical payments, resembles PIP. It covers a certain amount of the medical expenses resulting from an accident for the policyholder and passengers without regard to fault. However, it's different from PIP coverage in that it only covers medical bills, while PIP coverage covers other losses. This difference makes it more like health insurance.

In states where PIP insurance is optional, it's still often better to get PIP insurance over MedPay as it covers more expenses beyond medical costs.

How to File a PIP Insurance Claim?

Following an accident, there are specific steps to collect PIP insurance. These steps include the following actions:

1. Seek a Professional Medical Assessment

The first step after an accident is to seek treatment as soon as possible from a qualified medical professional. Remember, you can see any medical professional you want under PIP coverage if you're not on a health insurance plan. Otherwise, you will need to see a medical professional that your health insurance policy covers.

Even if your injuries appear minor and you don't believe you need treatment, it's still in your best interest to seek a professional assessment to determine the exact nature of your injuries. Your injuries may be more severe than you initially thought, and the condition may worsen to the point where it's potentially life-threatening.

Also, seeking treatment soon after an accident will help you avoid the issue of filing too late, as you only have a set number of days after an accident to file a PIP insurance claim.

Once you've sought treatment, retain copies of all medical records your medical provider generates. This documentation, along with medical bills, receipts, and other relevant documents, will help prove the nature of your injuries when filing a claim.

2. Consult an Attorney

To begin a case, you should speak with an attorney to discuss the accident and your injuries. An attorney can help determine if you have a case worth pursuing and can represent you when negotiating with insurers.

3. Reach Out to Your PIP Insurance Carrier

The next step is contacting your PIP insurance carrier to file a claim. When speaking with adjusters, focus on the facts of the case and be as honest as possible about the nature of the accident and your injuries. Specifically, you should discuss the types of injuries you sustained, the amount of lost income resulting from the accident and injuries, and other losses sustained that PIP insurance may cover.

Your attorney can begin negotiations and provide statements on your behalf, which can help ensure you don't inadvertently do anything that might otherwise compromise your case.

4. Wait for the Investigation to Complete

Once you and your attorney file a claim with your insurer, the claims process will begin, and the insurer will likely begin investigating the accident and your injuries. The company will review all evidence to determine the extent of your injuries and other losses. Throughout this process, adjusters may request additional information from you to help with the investigation as the company makes a decision. You should provide as many documents and details as possible at this time.

5. Determine if the Settlement Is Right

At some point, the insurance adjuster may make an offer if the company accepts the claim. You and your lawyer can review the settlement and determine the right amount based on the losses you sustained from an accident.

If you're not sure how much your case is worth, an accident lawyer can review all evidence and losses. Based on these details, the attorney may help you accurately calculate the total settlement amount to negotiate with insurers.

6. Appeal a Claim Denial

If the insurer denies your claim and you believe you still have a valid case, you can appeal this decision. If you're still unable to get the outcome you want, you may take legal action against the insurer to seek compensation.

Again, an attorney can assist you in this process, which will be particularly important if you want to take your case to court.

Seek Help From an Accident Attorney

If you get into an accident and want to recover compensation through a PIP insurance claim or a third-party liability claim, seek help from an experienced auto accident attorney to help recover the compensation you deserve.

An experienced and skilled personal injury lawyer in Las Vegas can meet with you during a free case evaluation to discuss your situation and determine if you have a valid case. In the process, the attorney will outline your options and the compensation you can pursue. Depending on the circumstances, the lawyer may also represent you in your fight for compensation.

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Ed Bernstein

Edward M. Bernstein, Esq. is the owner and founding partner of Edward M. Bernstein & Associates, and one of the most recognizable figures in Nevada. Ed is one of state’s premier personal injury attorneys and has hosted The Ed Bernstein Show for over 31 years. He has served the Las Vegas community for decades with dozens of community appointments and terms of service. In the year 2000, he was Nevada’s Democratic nominee for the United States Senate.

Ed received his B.A. from Long Island University in 1971 and his J.D. from Widener University in 1975. Since then, Ed’s professional accolades include numerous publications, honors and awards, court appointments, and has been named one of America’s Top 100 High Stakes Litigators.