How Does My Personal Health Insurance Coverage Interact With My Receipt of PIP Benefits?

Under Massachusetts law, after the first $2,000.00 of PIP coverage is exhausted to pay medical claims, an injured person’s health insurance company must afford coverage for medical care for injuries received in a motor vehicle accident. If the health insurance company pays benefits under its plan but there remain outstanding bills or balances, the PIP insurance will resume payment up to the $8,000.00 maximum assuming that the remaining benefits have not otherwise been paid out to reimburse lost wages. If there is no personal health insurance coverage available, the PIP insurance continues payment after the first $2,000.00 of benefits is exhausted. However, the second layer of $6,000.00 of PIP is also available for lost wage replacement. Accordingly, the application of that layer to medical bills or to wages should be carefully evaluated.