Until you are involved in an accident, most people don’t take the time to sit down and read their automobile insurance policy and identify all the type of benefits available to them. In some cases, uninsured motorist, underinsured motorist, rental car coverage and PIP benefits are important types of coverages to have on your own personal auto policy. In this blog, I discuss PIP benefits:
1. Do I have PIP benefits?
PIP benefits are not required in Washington State and you need to look at your own automobile policy to see if you have PIP benefits. If you choose to reject PIP benefits, your rejection is required in writing, per the requirements set forth in RCW 48.22.085. If you do not remember rejecting PIP benefits in writing, make a written request to your insurance company to provide you a copy of your written PIP rejection. My office has made this request often and many insurance companies are unable to produce a signed rejection and must provide PIP benefits.
One common misconception about PIP benefits is that the person who caused the accident should pay for your medical expenses. Ultimately, that person, if they have liability coverage of their own, will pay for the medical expenses, but they will not pay for these expenses as they accumulate.
One exception to the above rule is if you are injured in an accident and you are a pedestrian or cyclist.
Another is if you are the passenger of a vehicle and the owner of the vehicle has an automobile insurance policy that has PIP benefits.
2. Pedestrian and cyclists-PIP coverage extended?
If you are a pedestrian or cyclist involved in an automobile accident there is another possibility that PIP benefits may cover your medical expenses. If the person who caused the accident has PIP benefits under their automobile policy, those PIP benefits will extend to pedestrians and cyclists. It is often difficult to find out from an insurance company if these benefits are available to you, but you should make the request for this information in writing to determine if this coverage is available to you.
If you have PIP benefits under your own automobile policy as well as the person who caused the accident, you have two policies available that will essentially “stack.” The person who caused the accident’s PIP coverage is primary and your PIP coverage is secondary if the primary coverage is exhausted.
3. What if I’m a passenger in someone else’s car?
If you are the passenger in someone else’s vehicle and are injured in an automobile accident, you need to look at the owner of the vehicle’s insurance policy. If the owner of that vehicle has PIP coverage you will most likely have PIP benefits available to you as a passenger of the vehicle.
Again, similar to the pedestrian/cyclist example, if you have your own PIP coverage as well, you will have two layers of PIP coverage to pay for medical expenses.
4. What do PIP benefits cover?
PIP benefits cover reasonable and necessary medical treatment related to injuries suffered in an automobile accident. PIP benefits will pay for ambulance bills, hospital bills, chiropractic bills, surgeon bills, diagnostic studies (x-rays, MRI’s, CT scans, etc.), massage therapy, physical therapy, acupuncture, etc.
One additional type of coverage with PIP benefits is wage loss. Policy language typically says PIP coverage will pay up to 80% of your wage loss to a maximum of $200.00 a week.
5. Opening a PIP claim
If you are involved in an automobile accident and are injured you need to contact your insurance company and open a claim. Your insurance company will take down some information about the accident and then provide you with a claim number. Shortly thereafter the claim will be assigned to a “PIP adjuster” who will handle your file. Once you receive this information make sure that all medical providers mail or fax all of the bills to this adjuster’s attention and reference the claim number provided to you by the insurance company.
6. “Independent” Medical Exams-“IME”
A lot of insurance companies, in an attempt to save the company money, will try to minimize the amount of medical bills they pay out on a claim. One way that an insurance company will try to minimize payments is to send you to an “IME.”
IME stands for Independent Medical Exam. This entails the insurance company sending you to a doctor they hire to examine you. This will not be your treating doctor, but someone paid by the insurance company. These truly are not “independent” as the doctors are paid handsomely by the insurance company to give them a favorable opinion. If the IME doctor says you are no longer injured, the insurance company relies on that opinion and terminates your PIP coverage.
If your insurance company begins threatening or hinting they want to perform an IME, contact an attorney who practices Personal Injury law quickly.