Full Coverage: Who is going to pay my medical bills, anyway? PIP Coverage.
Previously on this blog, I have posted about a whole range of different types on auto insurance in an effort to help educate the public about what types of coverage are available, what those types of coverage actually cover, and how and when they work in particular car accident cases. Look here for entries on UM (Uninsured Motorists), UIM (Underinsured Motorists), so called “Full Coverage,” liability coverage for personal injury, liability coverage for property damage, and collision coverage, all part of our FULL COVERAGE Series. This is the last in that series of entries on what is arguably the most complicated and misunderstood type of coverage, Personal Injury Protection (PIP), also known as No-Fault coverage.
The last type of coverage PIP or No-Fault (we will use these terms interchangeably as they mean the same thing) is unique in the car insurance world for one major reason: you can get it no matter who was at fault for the accident. In fact, that’s why they call it “no-fault” insurance. It doesn’t matter whether the other guy caused the accident or you did, you still get the benefit of this coverage. Also, it is actually paid by your insurance company or the company for the person in whose car you are riding at the time of the accident.
So, what does it get you? Well, for the most part, it gets your medical bills paid and covers some of your lost wages if you can’t work do to the accident. Usually, 99.9% of us have $10,000 worth of PIP coverage to work with. At this amount (the minimum amount allowed by statute in Kentucky) the coverage is called Basic Reparations Benefits. You can get more than this in $10,000 increments. $20,000 or more means that you have Added Reparations Benefits.
First, let’s talk about the wage loss. PIP will pay up to $200 per week of lost wages. Theoretically, you could use all $10,000 for wage loss, but usually, people are back to work before this happens or have some other source to cover their lost wages. To get you lost wages paid by PIP you need three things: 1) a completed PIP application, 2) a valid “off-work” prescription from a physician or chiropractor, and 3) some valid for of wage verification (a couple of pay stubs, a wage verification form filled out by your employer, tax returns, etc.) The insurance company has 30 days after getting all of these materials to get your check to you.
Second, let’s talk about medical expenses. You can use some or all of your PIP money for medical bills. This is extremely helpful for people who do not have health insurance (or for those that have Medicaid or Medicare – as some medical offices don’t take that type of insurance). It means that you can be seen by any doctor anywhere and know that you have money to pay for the visit. Usually all it takes is making sure that the doctor’s office or hospital has your auto claim information for you to be seen.
One of the best features about PIP is that you, as the insured, get to decide who to pay, when to pay them, and how much to pay. This can be a very tricky process and is something that you should work closely with your attorney on. Depending on the other types of auto insurance coverage you might have access to, other types of liability coverage (think homeowner’s or workers compensation), other kinds of disability (short or long-term from work), and other health insurance benefits you might have, it is critical to discuss how to best utilize the types of coverage that you have available to you so that you can get the most bang for your buck! Best of all, you don’t have to pay it back to anyone! Your insurance company or the company who is paying PIP for you will take care of that without the need for you to do anything at all.
Finally, PIP coverage is “use it or lose it.” You don’t get to put it in your pocket if you don’t use it all. What that means is that you have a great opportunity , if you have been in an accident, to at least get checked out by a doctor, hospital, or chiropractor. You have nothing to lose and you have the right to make sure that everything is OK from a medical standpoint.
If you have questions or concerns about a PIP/No-fault question or any issue related to a car accident, don’t hesitate to contact auto accident and personal injury attorney Brian D. Cook at Bahe Cook Cantley & Nefzger PLC to get some advice.
