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How does PIP work?

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PIP, or Personal Injury Protection is no fault insurance that covers medical expenses, regardless for who is at fault in a car accident.  Any person making a claim for PIP benefits must first submit a PIP application. This application asks for basic biographical information, information about the accident, health insurance information, etc. Keep in mind the insurer paying PIP has the right to require you to attend an Independent Medical Exam (IME). This is a quick visit to a doctor chosen and paid for by the insurance company. 

PIP payments can be used exclusively on medical bills, lost wages, or a combination of the two. That doctor will write a report for the insurance company documenting his findings from the medical examination of the claimant. Based on that report, the PIP carrier will either stop or continue paying the claimant’s medical bills. As well, the PIP carrier can also require the claimant to submit to an Examination Under Oath (EUO). This is similar to a deposition, but operates under slightly different rules. Failure to attend the IME or EUO can jeopardize your rights to PIP. The reason for this is an auto insurance policy is a contract between the insurer and insured. If the insured (accident victim) fails to cooperate under the terms of the policy, the insurer can claim the insured is not entitled to PIP benefits under the policy. PIP will pay the first $2000 in your medical bills if you have private health insurance such as Harvard Pilgrim, Blue Cross Blue Shield, etc. 

In that situation, after the car insurance carrier pays the first $2000 in bills then the rest of the bills will be submitted for payment to the health insurance company. Any bills health insurance does not pay are then sent to PIP for payment. If you have MassHealth coverage, then PIP will pay up to $8000 in your medical bills. If your medical bills are less than $2000 you can still file a PIP claim. However, if you want to bring a claim for pain and suffering against the person that caused the accident, then your medical bills stemming from the accident must be at least $2000. There are exceptions to this “tort threshold” amount if any scarring or fractures were caused by the crash.

If you’ve been in a car accident, call our office today at 617-338-7400 for free access to our resources and a no obligation, free consultation. 

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