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The Complete Guide to Personal Injury Protection (PIP) in Auto Insurance

Understanding auto insurance can be confusing, especially when it comes to coverage for injuries after an accident. Personal Injury Protection (PIP) is a type of car insurance that covers medical expenses and lost wages if you or your passengers are hurt in a crash.

PIP goes by other names like “no-fault” or “medical payments” coverage depending on your state. But in general, PIP pays for treatment regardless of who caused the accident. It also covers injuries to pedestrians or cyclists when an insured driver is at fault.

In this comprehensive guide, we’ll explain everything you need to know about PIP insurance. Read on to learn what’s covered, how to determine the right policy limits, and tips for saving on premiums. With the expertise of Mountain Plains Agency Inc., you’ll be an informed insurance consumer.

What is Personal Injury Protection (PIP) Auto Insurance?

Personal Injury Protection, commonly referred to as PIP, is a type of car insurance coverage that pays for the policyholder and passengers’ medical expenses resulting from injuries in an auto accident, regardless of who caused the crash.

PIP coverage also reimburses a portion of lost wages if injuries from an accident prevent you from working. This no-fault coverage pays without determining fault, providing immediate funds to treat injuries and cover bills during recovery.

Every state except New Hampshire requires drivers to carry some level of PIP insurance. Minimum coverage amounts vary widely, from $1,000 in Florida to $50,000 in Utah. Required PIP insurance provides benefits on top of what health insurance covers, including:

  • Doctor visits
  • Surgery
  • X-rays and diagnostic tests
  • Hospital stays
  • Prescription drugs
  • Physical therapy
  • Nursing/home health care

Some states mandate additional PIP benefits like funeral costs and replacement services for tasks like cooking and cleaning that you can’t perform due to injuries.

When shopping for car insurance, opting for higher PIP limits above state minimums provides greater protection after a serious accident. But it also increases premium costs. You’ll need to weigh the risks in your state.

What Medical Expenses Does PIP Insurance Cover?

After a car accident, PIP coverage pays for a wide range of medical expenses tied to crash-related injuries. This includes:

  • Emergency room and hospital treatment, including surgery, X-rays, CT scans and medications.
  • Doctor office visits for follow-up appointments and physical exams.
  • Physical, speech or occupational therapy sessions.
  • Chiropractic treatments and therapeutic massage.
  • Acupuncture or other alternative treatments.
  • Prescription drugs and medical equipment like crutches or wheelchairs.
  • In-home nursing care or nursing home care.

Most states set coverage limits on PIP medical benefits, such as $10,000, $25,000 or $50,000. Higher opt-in limits may also be available for added costs. Treatment costs that exceed the limit would need to be paid out-of-pocket or by health insurance if available.

What Lost Wages Does PIP Cover After an Accident?

In addition to medical expenses, PIP coverage also reimburses lost income if you’re unable to work due to injuries sustained in a crash. This can provide vital funds to cover bills while recovering.

The portion of your salary that PIP covers varies by state, but often falls in the 60% to 80% range. For example, if your PIP policy limit is $5,000 and you make $1,000 per week, you might receive $700 weekly while unable to work, up to the $5,000 total limit.

Benefits are paid for the duration of lost wages within the policy limits, until you’re able to return to work. These income replacement benefits help avoid financial hardship during medical leave or time off for doctor visits and physical therapy.

How Much PIP Coverage Should You Get?

Choosing appropriate PIP insurance limits involves weighing several factors:

  • State minimum required PIP coverage.
  • Healthcare costs in your state or region. Higher cost of living equates to pricier treatment.
  • Your existing health insurance coverage deductibles, copays, exclusions, and out-of-network costs.
  • Your income level and savings – can you cover bills if unable to work for an extended time?

It’s wise to consider opting for more than minimum PIP protection, such as $50,000 rather than $15,000. This provides a safety net for large medical bills or lost earnings. However, higher PIP limits raise your auto insurance premiums.

Review your potential out-of-pocket costs at various coverage levels when deciding. Mountain Plains Agency Inc. insurance agents can provide quotes for minimum and higher PIP limits.

How Does PIP Work With Health Insurance and Disability Insurance?

For auto accident injuries, your PIP coverage is primary and starts paying medical expenses immediately. PIP kicks in to cover your health insurance deductible, copays, uncovered services, and any out-of-network charges above what health insurance pays.

Once your PIP policy limit is reached, your health plan would become the primary payer. Disability insurance also comes into play if injuries cause you to miss more than the typical PIP coverage period for lost wages. The process may vary for group plans, so check with your health and disability providers.

Who is Covered by PIP Insurance?

PIP medical and wage loss benefits cover:

  • The policyholder and resident family members injured while driving or riding as a passenger. Passengers don’t need to reside with the policyholder to receive coverage.
  • Pedestrians struck and injured by the insured driver’s vehicle.
  • Cyclists hit by the insured vehicle.
  • The insured drivers themselves if injured while riding as a passenger in another vehicle or if hit as a pedestrian.

Whether motorcyclists injured in a crash are covered by PIP depends on local laws. Some states require motorcyclists to carry PIP coverage. Others mandate riders wear helmets to receive benefits.

In a few states, passengers must meet certain criteria to get coverage, like not already having PIP insurance themselves. Policies vary, so Mountain Plains Agency Inc. can clarify passenger PIP rules in your state.

When Can PIP Be Denied or Limited After an Accident?

In serious crashes, insurance companies may investigate details to confirm injuries merit the claims made. PIP benefits could be denied or reduced if:

  • The policyholder or passenger was under the influence of drugs or alcohol. Blood alcohol content over the legal limit may nullify claims.
  • Fraud is committed, such as exaggerating injuries to generate excessive or false bills.
  • Passengers don’t qualify for coverage due to policy restrictions or lack of required motorcycle helmet.
  • The pedestrian or cyclist was at fault for the initial collision.

PIP coverage can’t be canceled due to filing claims for legitimate injuries. But ultimately the insurer determines validity on a case-by-case basis.

How Much Does PIP Coverage Cost?

Just like other types of auto insurance, PIP premiums vary based on your state’s minimum required limits, the coverage options you select, and risk factors like driving history and age.

On average, PIP represents 5-10% of your total auto insurance premium. But in states with high minimum required PIP coverage, the proportion is larger. Optional increased PIP limits also raise your overall premium.

Mountain Plains Agency Inc. provides customized PIP rate estimates based on your unique profile and limits needed in your state. This allows comparing pricing options to make informed decisions.

How Can I Save on PIP Insurance Premiums?

A few simple strategies can help minimize the PIP portion of your car insurance bill:

  • Comparison shop for competitive rates when policies renew. Insurers regularly update pricing models and discounts.
  • Ask about discounts like multi-policy, defensive driving course completion, good student, and low mileage. Every discount helps maximize savings.
  • Consider raising your PIP deductible to lower the premium, but be sure you can cover the deductible costs if injured.
  • Maintain good credit, clean driving history, and minimum required car insurance limits. High risk means higher premiums.
  • Bundle home and auto insurance policies with the same provider for multi-policy discounts.
  • Discuss with Mountain Plains Agency Inc. to regularly reassess optimal coverage, limits and premium costs.

We hope this detailed guide has helped explain how Personal Injury Protection works and what it covers after an auto accident. Connect with a Mountain Plains Agency Inc. agent to discuss your state’s requirements, costs, and how much PIP coverage makes sense for your situation.

Frequently Asked Questions about PIP Insurance

Still have questions about Personal Injury Protection coverage? Here are answers to some commonly asked questions:

Q: Does my health insurance cover auto accident injuries so I don’t need PIP?

-No, PIP and health insurance differ significantly in accident coverage. PIP covers deductibles, copays, and treatment your health plan may not.

What if I’m at fault for the accident – will PIP still pay?

-Yes, because PIP is no-fault coverage it pays covered medical and lost wage benefits regardless of fault.

Q: Do PIP benefits cover passengers in rideshares or taxis?

-It depends on state regulations and policy limits. In some cases rideshare passengers may need to rely on their own auto policies’ PIP coverage.

Q: Can I sue the at-fault driver if my PIP limits don’t fully cover all my medical bills?

-Yes, you can pursue compensation above the PIP limits from the at-fault driver’s liability insurance. PIP provides immediate assistance, while a liability claim helps recoup further damages.

Q: Does PIP coverage extend to medical bills I incur months after the accident?

– PIP policies place time limits, often 1-2 years, during which treatment is covered. Care outside the window may be claimed against the at-fault driver’s liability insurance.

Q: I have good health insurance. Is purchasing PIP necessary?

– PIP still provides valuable benefits like wage loss, deductibles, and immediate coverage for injuries. It provides an added layer of protection after an accident.

Q: If I opt out of PIP coverage, can I still sue the at-fault driver for my medical bills?

– Most states require PIP coverage to legally pursue further compensation. Opting out of PIP prevents you from claiming damages.

Q: Will PIP raise my car insurance rates even if I don’t make any claims?

– No, your PIP premium won’t increase just for carrying the coverage. However, filing one or more PIP claims could impact your renewal rate.

Q: What if the accident occurs out of state? Which state’s PIP coverage applies?

– The requirements of your home state where your car is registered take precedence. Your insurer pays out based on your policy terms.

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