Personal Injury Protection Insurance Claims
Personal Injury Protection (“PIP”) insurance is one of the cheapest and most important types of insurance you can purchase. Everyone should have PIP insurance. It’s as simple as that.
PIP insurance protects you and the passengers in your car if you are injured in a collision. It doesn’t matter who is at fault for the collision. PIP insurance should cover you even if you cause the collision. It also covers you if you are a pedestrian, a passenger in someone else’s vehicle, or if you are riding a bicycle. PIP insurance is one of the most comprehensive and important types of coverage you can buy – and, if you don’t have it, you will be sorry that you didn’t purchase it!
Here is what PIP insurance will do for you – it will pay benefits for:
- Medical treatment you need for injuries you suffer as a result of the collision
- Limited wage loss benefits
- “Loss of Services” benefits for things that you are unable to do due to your injuries
- Funeral benefits
There are, of course, limitations and fine print. Here are some of the limitations that generally apply to most PIP insurance policies:
- Medical care must be received within 3 years from the date of the collision
- Medical care must be “necessary” to treat injuries you suffered
- The cost of the medical care you receive must be “reasonable”
- The medical care must be provided by a licensed healthcare provider
- You must be out of work for two continuous weeks as a result of your injuries before you are eligible for PIP wage loss benefits
- Wage loss benefits last for only 52 weeks
- Wage loss is payable at only 85% of your regular wage with certain limits, depending on how much coverage you purchase
- You must be able to prove that you were receiving wages before the collision and the amount of those wages
- The person who performs the “services” you are unable to do may not be a member of your household
- There is a daily limit on the amount you may be reimbursed for “services,” depending on how much insurance coverage you purchase
- You must provide the name, address, phone number, and Social Security Number for the person who performs your “services”
- You may need to have a doctor’s note verifying that you are unable to perform the “services” yourself as a result of your injuries
- Funeral benefits are limited to a maximum of $2,000.00
You may be thinking “But I have health insurance, why do I need PIP?” The simple fact is that PIP insurance has many important benefits that you simply can’t get from your health insurance policy. Here are some of the benefits of PIP insurance:
- No preauthorization requirement
- No co-pays
- No deductible
- PIP insurance pays 100% of the medical bill
- You may see any healthcare provider you want
- You do not need a prescription in order to see a massage therapist, physical therapist, etc.
So – how much PIP insurance do you need? There are three basic levels of PIP insurance sold in Washington. The lowest level is $10,000. This means that PIP insurance will pay up to $10,000 in medical bills per person who is injured. The second level is $35,000. The third level is $100,000.
We think you should have at least $35,000 in PIP coverage. The cost of healthcare is rising. What if you were seriously injured in a collision and were transported to the hospital by ambulance and you had an MRI at the hospital and then needed to see your doctor and possibly have surgery afterwards? If you had only $10,000 in PIP coverage, it probably would have run out while you were at your doctor’s office, leaving you to find a way to pay for the surgery yourself. Even if you have health insurance which will start paying after your PIP is exhausted, you will still have a deductible, co-pays, preauthorization delays, and may be limited in the choice of your doctor or hospital.
One more important thing for you to know – if someone else caused the collision, neither that person nor their insurance company will pay you one dime until you are ready to settle your claim! This means that they will not pay any of your medical bills while you are getting treatment, regardless of how badly you are injured, how little money you have, how much money or insurance coverage the other person has, or how much at fault the other person is. In other words, you could be seriously injured by a drunk driver who has a $1 million insurance policy and need surgery, but that drunk driver won’t have to pay you a dime until you are ready to settle your case. If you don’t have PIP insurance and cannot afford medical treatment, you will end up settling your case for far less than it is worth and you won’t be able to ask for more money if you later realize that your injuries are not fully healed. The system may not seem fair to you, but this is the stark reality of the insurance world. It isn’t fair and you have to protect yourself.
We strongly urge you to contact your insurance agent and purchase PIP insurance today. It is one of the most important things you can do to protect yourself and your family.
If you have been injured in an automobile collision or have questions about your Personal Injury Protection insurance coverage, Call Nelson Boyd attorneys for a free consultation at (206) 971-7601.