Personal Injury Protection Claims

Personal Injury Protection (“PIP”) is a provision on the insured’s own insurance policy that pays for medical expenses, lost wages, loss of household services, and funeral expenses following an accident. When the insured person is in a motor vehicle accident, regardless of fault, the insurance company pays for “reasonable and necessary” expenses as described above. The typical “reasonable and necessary” language in the PIP provision policy of the policy, can cause consternation as the claimant’s own insurance company may elect to deny payment for expenses their own insured incurs.

Minimum PIP coverage typically pays up to $10,000 in medical bills; $10,000 in lost wages, paid at amount of up $200 per week after the first fourteen days following the accident; $2000 in funeral expenses: and $5000 for loss of services, subject to a maximum of $40 per day and $200 per week. Loss of services would be such items as housekeeping or yard maintenance so if the injured person’s injuries prevented them from performing such tasks, the insurance company may reimburse the insured for these expenses.

PIP coverage is of great benefit to the insured when faced with significant expenses following the accident. While health insurance may be able to cover treatment caused by a motor vehicle accident, it does not cover all treatment, especially treatment such as chiropractic or massage, and PIP insurance is the primary coverage. The claimant’s health insurance company would likely make them provide proof of no PIP coverage, and only pay in the absence of coverage or once the PIP coverage has been exhausted, per the terms of the policy. PIP coverage typically pays expenses promptly, which is quite a contract to a third party insured. The at fault party’s insurer has no obligation to promptly pay the victim’s expenses as their only obligation is to their insured. Typically the do not pay for any medical expenses or lost wages, until the case with the injured party is settled or a court order is rendered, which can take months or years.

Under Washington State Law, PIP coverage must be waived in writing by the insured. In the absence of a signed waiver denying coverage, insurance companies may be compelled to retroactively extend PIP coverage. PIP can also be purchased for higher limits. In Washington, the higher optional level of PIP coverage pays up to $35,000 in medical bills; $35,000 in lost wages, paid at amount of up $700 per week after the first fourteen days following the accident; $2000 in funeral expenses: and $14,600 for loss of services, subject to a maximum of $40 per day.

PIP coverage may also apply in bicycle or pedestrian claims. The injured bicyclist or pedestrian is typically covered under the PIP provision of the driver’s insurance policy, regardless of fault. If the driver that strikes a pedestrian or bicyclist does not have insurance or is underinsured, the injured person may be able to use their PIP coverage or their parent’s PIP coverage to help pay for damages such as medical bills and lost wages following an accident.

Some auto insurance companies also offer med-pay coverage. This is more limited coverage than PIP and typically only covers medical bills up to $5,000, depending on the policy.

When a PIP insured’s insurance company delays payment of benefits or improperly denies coverage of a PIP claim, the injured person may be able to bring a bad faith claim against their insurer. Some insurance companies do all they can to avoid payment of claims. If you feel you are a victim of bad faith by your PIP insurer, you should contact a personal injury attorney who has experienced handling bad faith claims.

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