Recovering damages for your car accident is often a difficult and complicated process. Dealing with medical bills, insurance adjusters, co-pays, deductibles and maximum coverage thresholds when you are struggling with an injury can be overwhelming. The following information is provided to help answer questions you might have regarding Personal Injury Protection insurance. For more detailed information regarding the facts of your accident, please contact our law firm to schedule a free initial consultation.
Q: What is Personal Injury Protection (PIP)?
A: Personal Injury Protection (PIP) is a form of no-fault insurance available to auto insurance policyholders and other qualifying people who are injured in auto accidents. PIP covers medical treatment expenses, wage loss and death benefits, among other benefits. If you are injured in an accident, it is important to determine whether you qualify for PIP insurance benefits given the extraordinary costs of medical treatment today.
Q: What does "No-Fault" insurance mean?
A: "No-fault" means that policyholders are entitled to receive PIP benefits immediately after an accident without regard to who was at fault for causing the accident. Thus, even if you are responsible for causing an automobile accident, you may be entitled to receive PIP benefits under your auto insurance policy. Of course, if you are responsible for causing an accident, you may not be able to sustain a separate personal injury claim against other driver(s) involved in the accident.
Q: What does PIP Cover?
A: PIP insurance may cover some or all of the following, depending upon the type of policy you opted for:
- Medical expenses
- Lost wages
- Essential services
- Funeral expenses
- Survivor benefits
Q: What is the required PIP coverage amount in New Jersey?
A: The current minimum in NJ is $15,000. You may purchase more coverage, up to a maximum of $250,000, typically in the following increments:
Basic PIP coverage covers up to $15,000 in medical expenses per person, per vehicle accident.
Standard PIP coverage provides benefits in addition to medical expenses. This includes wage replacement, essential services, and death benefits.
Low income motorists may qualify for a third class of PIP coverage known as a Special PIP policy. This offers less coverage than the Basic PIP, but unlike Basic, the Special class includes $10,000 in death benefits.
Catastrophic injuries are eligible for up to $250k in medical expense coverage.
Q: What type of injuries qualify for catastrophic coverage?
A: Certain injuries that are deemed catastrophic are eligible for up to $250,000 of medical expense coverage. Examples include the following:
- Spinal cord injury
- Significant and permanent brain damage
- Acute injuries that require emergency hospital treatment
Q: What medical expenses are eligible under PIP?
A: Medical treatment must be deemed “reasonable and medically necessary” in order to be covered by PIP insurance. Some of the following treatments may be covered by PIP:
- Medical treatment
- Rehabilitative care
- Diagnostic services
- Hospital expenses
- Ambulance services and other necessary transportation
- Remedial or non-medical treatments that are recognized as religious methods of healing
Insurance carriers may require precertification for some of the treatments you receive for your injury. Typically, emergency room care and medically necessary services you receive during the first 10 days after your auto accident are exempt from the precertification requirement.
Q: How much does PIP pay for wage replacement?
A: If you opted for a Standard PIP Policy, wage replacement is available. For the standard $15,000 policy, these benefits may not exceed $100 per week, up to a maximum overall limit of $5,200. This coverage must not exceed the net income of the disabled party receiving the wage benefits during the benefit receipt period.
Q: Can I collect wage reimbursement from other sources while I am receiving PIP wage income continuation benefits?
A: Double-dipping is not permitted. If you receive other wage replacement benefits, the amount of PIP wage replacement you receive may be set off by the amount you are receiving from other sources. These collateral sources may include the following:
- State temporary disability
- Workers’ compensation
- Military personnel benefits provided under federal law
Q: What types of services qualify as essential under PIP?
A: These are services that would normally be performed by the injured party, and must be reasonable and necessary. Examples include:
- House cleaning
- Lawn care
These services are performed for the benefit of the injured person and household family members. The daily reimbursement limit is generally $12, and the maximum limit is $4,380. Proof of payment to a third party for rendering of these essential services is typically required.
Q: Is it possible to sue for damages after an auto accident in New Jersey?
A: Yes. Under certain circumstances, you may be able to sue the negligent motorist who caused your motor vehicle accident injuries. This depends on a number of factors, including the extent of your injuries and whether the limited right to sue, or verbal threshold, applies to your claim. If you are interested in initiating a claim against the negligent parties who caused your injuries, you should contact an experienced motor vehicle accident lawyer to learn your rights and options.
You may be entitled to money damages for your injuries. The law limits the time for you to bring a claim, so don't wait.