PIP (Personal Injury Protection) Claims After a Car Accident

PIP can cover certain car accident injury-related losses regardless of who caused the crash.

Updated by , J.D. · University of San Francisco School of Law

With "personal injury protection" (or "PIP") car insurance coverage, your own car insurance company will cover certain financial losses related to your car accident injuries, regardless of who caused the crash.

In this article we'll explain the basics of PIP coverage, including who can make a claim, the types of benefits that are often available, and tips for handling the claim process.

What Is Personal Injury Protection (PIP) Car Insurance?

Personal injury protection (or "PIP") car insurance coverage applies to medical bills, lost income, and certain other economic losses resulting from a car accident, up to policy limits.

PIP is often referred to as "no fault" car insurance, since fault for the car accident giving rise to the injuries is not at issue with a PIP claim.

The PIP claim process is also meant to be much 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). The idea is that the covered driver can get their car accident-related medical bills (and other crash-related expenses) paid as soon as possible.

Get the basics on car accident injury claims.

What's the Difference Between PIP and Liability Car Insurance?

In most states, vehicle owners are only required to carry liability car insurance coverage. This kind of coverage applies when the insured vehicle's owner (or someone driving the insured vehicle with the owner's permission) causes a car accident, and anyone else involved in the crash:

  • suffers injuries in the accident ("bodily injury liability" coverage applies here), and/or
  • has their vehicle damaged in the accident (triggering "property damage liability" coverage).

Put another way, liability coverage only applies to losses suffered by other people (drivers, passengers, pedestrians, etc.) in an accident caused by the insured person (or someone using the insured person's car). It won't pay for the insured vehicle owner's own injuries and vehicle damage.

What Does Personal Injury Protection (PIP) Insurance Cover?

The details sometimes vary from state to state, and from policy to policy, but PIP usually covers the following kinds of losses resulting from a car accident:

  • medical bills stemming from car accident injuries
  • income that was lost due to an inability to work because of car accident injuries, or in order to attend medical appointments (lost income damages are typically capped)
  • reimbursement of certain expenses incurred because of the accident, such as the cost of having someone else perform housework, or the cost of transportation to and from medical appointments, and
  • the cost of funeral/burial expenses, if the policyholder or a covered person died as a result of the car accident.

When it comes to paying for medical treatment for car accident injuries, the interplay between PIP and health insurance can be tricky. Pay attention to the fine print of your respective insurance plans or ask an insurance company representative for details.

What Does Personal Injury Protection Insurance Not Cover?

The big category of car accident related losses that is not covered by PIP is "pain and suffering" (mental and physical) resulting from the crash. We'll get into more detail on the a little later.

PIP also does not cover:

  • injuries or vehicle damage suffered by other drivers, or by passengers in another vehicle
  • vehicle damage to your own car (you'll need collision coverage or other property-related insurance to get your car repaired or replaced after an accident), and
  • a car accident resulting from your intentional or criminal conduct (you were cited for driving under the influence in connection with the crash, for example).

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), including:

  • the policyholder's family/household members
  • anyone driving the policyholder's vehicle (with permission), and
  • passengers in the policyholder's vehicle.

Also, with PIP, the policyholder might be covered if they're hurt in an accident while riding as a passenger in someone else's car, or as a pedestrian or bicycle rider.

Should You Get PIP Insurance?

The first thing to know here is that the decision to get personal injury protection car insurance might not be one that's in your hands. Depending on where you live, PIP might be:

  • required (as it is in no-fault car insurance states and in a few other, non-no-fault states)
  • available and optional, or
  • not available at all as part of a car insurance policy.

We provide state-specific information a little later on in this article.

If you do have the option of purchasing personal injury protection, one big consideration is whether you have health insurance, and if so, the specifics of that coverage. You can always use health insurance to get medical care for car accident injuries.

If you don't have health insurance, or your coverage isn't great, then it probably makes sense to carry PIP if you have the option to do so. And remember that unlike health insurance, PIP car insurance will pay for other financial losses resulting from the accident (like lost income and certain crash-related expenses), up to your coverage limits.

If you can't get PIP in your state, "medical payments" car insurance coverage (also known as "MedPay") might be another option.

Do I Need MedPay Coverage If I Have PIP Car Insurance?

"Medical payments" (or "MedPay") car insurance coverage is similar to PIP in that it pays for the car accident-related medical bills of the insured vehicle owner and any passengers.

The main difference is that, as we mentioned above, PIP covers other financial losses resulting from a car accident (lost income and certain expenses). MedPay benefits are limited to payment of crash-related medical bills.

You probably don't need both MedPay and PIP, and PIP is usually the better choice between the two since it covers more accident-related losses than just medical bills. But practically speaking, in many states you won't have the luxury of choosing. In California, for example, insurance companies are prohibited from issuing PIP coverage, but MedPay is an option for drivers in the state.

How Much Personal Injury Protection Coverage Should I Get?

In states where PIP coverage is mandatory, the minimum you're required to carry is set by state law. Especially in no-fault car insurance states, the minimum is usually in the range of tens of thousands of dollars. In New York, for example, vehicle owners are required to carry $50,000 in PIP coverage.

Where PIP is optional, insurance companies might be required to offer a certain minimum coverage amount. In Texas, car insurance customers must be given the option of adding at least $2,500 in PIP coverage onto any policy they purchase, but Texas customers are also free to opt out of PIP.

In some situations—and especially if you don't have health insurance— you might want to consider paying for more than the minimum PIP coverage requirement in your state.

Which States Require PIP Car Insurance?

As we touched on above, PIP is required in some states, optional in others, and not available at all in many.

In the ten states that follow a traditional no-fault car insurance system, PIP ("no-fault) coverage is mandatory, since it's the foundation of this kind of insurance scheme. (Learn more about how no-fault car insurance works.):

A few states follow more of a hybrid/"choice" no-fault system, so PIP coverage might not always be required in these states, which include:

A handful of states (including Delaware, Maryland, and Oregon) require vehicle owners to carry PIP coverage as an add-on to any car insurance policy.

Finally, insurance companies in a few states (like Texas) are required by law to offer car insurance customers the option of PIP coverage, but in many other states (including California) PIP isn't available as a coverage option.

Remember, whether it's mandatory or optional in your state, when you're making a claim for PIP benefits, it doesn't matter who caused your car accident.

How Does a PIP Car Insurance Claim Work?

Your car insurer will pay your car accident-related medical bills and will reimburse you for some or all of your lost income and other crash-related expenses 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 (like the deductible), and the health insurer will pay the remainder.

Learn more about who pays medical bills after a car accident.

If the financial impact of your car accident injuries exceeds the limits of your PIP coverage, you might want to 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.

Keep in mind that 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 car accident-related 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.

How to Start Your PIP Insurance Claim

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.

It's Important to Cooperate With Your Insurer In a PIP Claim

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 of caution when 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.

Getting a Lawyer's Help After a Car Accident

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 as long as you're comfortable doing so.

But when your injuries are serious and the other driver was pretty clearly at fault, a PIP claim might not offer a satisfactory result. It might make sense to discussion your situation, and your options, with an experienced legal professional.

Learn more about getting an attorney's help with a car accident case. You can also use the tools on this page to get in touch with a car accident lawyer in your area.

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