When you carry "personal injury protection" (PIP) car insurance coverage, your own insurer will cover certain losses related to your car accident injuries, regardless of who caused the crash. Here's how PIP claims work, and what policyholders need to know.
Personal injury protection or PIP car insurance coverage is coverage that applies to the policyholder (and certain others) after a car accident. PIP covers medical bills, lost income, and certain other economic losses resulting from the crash. Fault for the car accident is not at issue with a PIP claim, and the claim process is meant to be quicker than with other kinds of car insurance (i.e. a liability claim that you might file with the at-fault driver's insurance company).
Also called "no-fault" car insurance, PIP is available as an optional add-on to a car insurance policy in every state, but it's required in the dozen or so "no fault" car insurance states.
Get the basics on car accident injury claims.
In most states, vehicle owners are only required to carry liability car insurance coverage, which is activated when the vehicle owner causes a car accident, and which only covers other people (drivers, passengers, pedestrians, etc.) who suffered injuries and other losses in the accident. Liability coverage won't pay for the vehicle owner's own injuries and vehicle damage.
In the dozen or so states that follow some version of a no-fault car insurance system, PIP (or "no-fault") is usually mandatory, though a few of these states follow more of a hybrid/choice system. (Learn more about how no-fault car insurance works.) In other (non no-fault) states, PIP is available on top of other mandatory insurance, such as liability coverage.
Whether it's mandatory or optional in your state, when you're making a claim under PIP coverage it doesn't matter who caused your car accident.
(Note: Remember that PIP doesn't apply to vehicle damage after a car accident. You'll need collision coverage or other property-related insurance to get your car repaired or replaced after an accident.)
Your car insurer will pay your car accident-related medical bills and will reimburse you for some or all of your lost income up to the limits of your PIP coverage. Some states have a two-part medical bill limit, so that if the injured person has health insurance, the PIP insurer might only have to pay a small amount of the injured person's medical bills, and the health insurer will pay the remainder.
If the financial impact of your car accident injuries exceeds the limit of your PIP coverage, you can file a third-party car insurance claim with the at-fault driver's insurance company, or pursue a personal injury lawsuit against the at-fault driver.
If you live in a no fault state, you are not permitted to make a claim against the at-fault driver unless your medical bills reach a certain dollar amount, or your injury is deemed sufficiently serious according to the statutory definition in your state. For example, your state's no fault law might say that you cannot make a claim against the driver at fault unless your medical bills exceed $3,000, and/or you suffer a broken bone or permanent scarring after the accident.
Stepping outside of the state's no-fault system after meeting one or both of these thresholds means you can make a claim directly against the at-fault driver for your out-of-pocket losses. It also means you can seek compensation for non-economic losses like "pain and suffering." This category of damages (unavailable in a PIP claim) can be financially significant, especially after an accident involving serious injuries. Learn more about calculating pain and suffering after a car accident.
The details vary from state to state, and from policy to policy, but PIP usually covers the following kinds of losses resulting from a car accident:
The interplay between PIP and health insurance can be tricky, so pay attention to the fine print or ask your insurance agent for details.
As far as who is covered under PIP insurance, in addition to the policyholder (the vehicle owner and primary driver), a PIP policy usually applies to certain other individuals if they're injured while driving or riding in the policyholder's vehicle (and they don't have their own car insurance coverage):
The process for starting a PIP claim is basically the same as it would be for any other car insurance claim you file after a car accident. One of the first things you should do after any crash is notify your car insurance company about what happened.
If you have PIP coverage, often as part of this initial phone call the insurance company representative will instruct you on how to get the PIP claim process started. That might involve using a "Start a Claim"-style tool on the insurance company's website or app, or it might be something the insurance company rep can do over the phone.
With some PIP claims, once the process is up and running, you'll submit medical bills, proof of lost income, and receipts or invoices for other covered out-of-pocket losses as they come in, and the insurance company will compensate you for those losses under the terms of your coverage.
All states require policyholders to cooperate with their own insurance company when making PIP claims. That means responding in a timely manner to requests for information, and being truthful about the nature and extent of your injuries. It also means that the usual rules for dealing with the other side's (potentially adversarial) insurance company don't apply to a PIP claim.
In most car accident cases, you do not want to give a recorded statement to the other driver's insurance company, and you might want to fight any request that you attend an independent medical examination with a physician selected by the other driver's insurance company. But you could be required to comply with requests like these when you're making a PIP claim with your own insurance company.
If your injuries are fairly minor and it looks like your PIP coverage will be enough to cover your losses after a car accident, you can certainly handle the claim process on your own. But especially if your injuries are serious and the other driver was pretty clearly at fault, a PIP claim might not offer a satisfactory result.
Learn more about when it might make sense to get an attorney's help with a car accident case. And if you're ready to discuss your options, you can use the chat and information submission forms right on this page to get in touch with a car accident lawyer in your area.