You may be asking ‘what is PIP?’

You may be asking, “what is PIP?” Pursuant to Massachusetts General Laws chapter 90, Sec. 34M, all Massachusetts automobile insurance policies must carry Personal Injury Protection (PIP) coverage, which offers certain coverage to occupants in a vehicle at the time of an accident. PIP coverage can also extend to individuals injured while entering or exiting a vehicle.

PIP is a form of ‘no-fault’ insurance, meaning that it does not matter who is at fault for the accident or injury, you can still receive PIP benefits. PIP coverage applies to all occupants of the vehicle at the time of the accident. PIP coverage also extends to pedestrians who are struck by a vehicle with PIP coverage. PIP coverage includes the following:

  • Reasonable and necessary medical treatment related to injuries sustained in an accident;  
  • Funeral expenses in the unfortunate scenario when someone passes away from the accident;
  • 75% of lost wage reimbursement;
  • Copay and deductible reimbursement; and
  • Certain replacement services (payment to non-family members to perform services that the injured vehicle occupant would otherwise have performed themselves).  

Occupants and/or pedestrians are entitled to up to $8,000 in PIP coverage, however, the amount of that $8,000 that will be used towards your medical bills depends on the type of health insurance you carry. If you have private health insurance (i.e., through your employer, spouses or parents' employer), you will receive $2,000 in medical coverage, and the remaining $6,000 can be used for co-pay reimbursement, deductible reimbursement and/or 75% of lost wage reimbursement. If you have health insurance through Medicare and/or Medicaid (for example MassHealth), or if you have no health insurance, you are entitled to the full $8,000 in medical coverage.

There are some exclusions to PIP coverage, and they include the following:

  • Motorcycles: They are excluded from PIP coverage as they are considered inherently dangerous and insurance companies will not afford PIP coverage to motorcycles.  Suggestion to all motorcycle owners is to purchase MedPay coverage. MedPay stands for medical payments, and it’s a form of optional coverage you can purchase that will pay for reasonable and necessary medical treatment for an accident.
  • Operating Under the Influence (OUI): Your automobile coverage can deny you PIP coverage if it is shown 1) operating a motor vehicle while under the influence, and 2) that your conduct contributed to your injury. Moral of the story: don’t ever drink and drive!
  • Work Injury: If you are in a car accident during your employment, you will not receive PIP benefits. The reasoning is that workers’ compensation will pay your medical bills associated with the accident.  

Unfortunately, a policy owner can choose to waive PIP benefits, in whole or in part, by taking a PIP deductible of up to $8,000. The most common reason for choosing a waiver is people incorrectly believe that they will save a significant amount of money on their annual premium. This is false as the money saved is nominal in exchange for the essential coverage they are giving up. The consequences of waiving PIP include:

You receive limited to no PIP coverage, including no medical coverage and/or wage reimbursement;  

A PIP deductible not only applies just to you, but applies to household members; and

A PIP waiver and/or deductible significantly devalues your personal injury case against an at-fault driver. If injured in an accident and pursuing a personal injury case against the at-fault driver and their insurance policy, their policy will be entitled to an offset. Usually, the at-fault driver’s insurance company has to pay back your insurance company for the PIP benefits they paid on your behalf. When they pay those benefits back, they get an offset under the law (they get credit for paying your insurance back). The problem is when you take a PIP deductible, the at-fault driver’s insurance company is STILL ALLOWED to take credit for paying your insurance company back, even though you didn’t receive (or received limited) PIP benefits. This in turn devalues your personal injury case and leads to less money in your pocket.  

If you or a loved one has been involved in a car accident and would like to speak to one of our attorneys, call Pellegrini, Seeley, Ryan & Blakesley at 800-785-5399 today.

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