What Is Personal Injury Protection?

What Is Personal Injury Protection?

When you are the victim of a car accident, there is a multitude of damages you may incur that all come with a price tag. Between medical services for physical injuries and extensive vehicle repairs, the expense of getting into an accident is often more than drivers can afford. If your accident was caused by the negligence of another motorist or resulted in a catastrophic injury, the stress can become even more overwhelming. 

Personal Injury Protection is a type of car insurance designed to take some of the financial burdens off of an individual after a crash. Also referred to as “no-fault” insurance, Personal Injury Protection plans pay out benefits promptly to drivers, regardless of who was at fault for the accident, in three areas: medical expenses, economic losses, and death benefits.  

In New York State, all drivers are required to purchase a minimum amount of Personal Injury Protection for every registered vehicle on the road. These plans will not cover all of your expenses after an accident, but knowing which ones they do can help drivers start their recovery first and then determine which damages fall outside of their insurance claim.  

The Benefits of P.I.P. 

Regardless of who causes your car accident, Personal Injury Protection (P.I.P.), will help pay certain expenses for the driver and passengers involved in a motor vehicle accident. These no-fault benefits kick indirectly after an accident occurs and does not require injury victims to wait until liability for the damages is determined.  

P.I.P. policies were first introduced in the United States back in 1970. According to the Insurance Information Institute, the idea behind P.I.P. was to simplify the claims process by eliminating the need for proving fault after a crash. This kept the small claims out of court by allowing drivers to file directly with their insurance companies. It also allowed insurance companies to lower their costs to their customers.  

Injury victims benefit from P.I.P. by not having to wait for critical medical treatment based on their financial ability. Rather than shelling out funds for medical services that may not be awarded back, drivers can feel more at ease in seeking medical treatment when they need it rather than when they receive their benefits.  

New York State is one of 16 states across the country that requires their drivers to purchase P.I.P.; it’s not available in all states. Other than the states which mandate P.I.P. for drivers, only six others (including Washington D.C.) provide the option to enroll.  

What Costs Does PIP Cover 

P.I.P. focuses on supporting accident victims with financial costs associated with medical services, income loss, and other reasonable and necessary expenses after an accident. Examples of these expenses include:  

  • health insurance deductibles; 
  • loss of employment income as a result of the injury from the accident; 
  • expenses for medical services outside of the health insurance coverage; 
  • essential services affected by your injury (childcare, cleaning, transportation);  
  • funeral expenses.  

P.I.P. will cover the victim of a car accident if they are the driver, passenger, or even a pedestrian that is struck by a motor vehicle. It can also apply if you are injured as a passenger in someone else’s vehicle with an active NYS P.I.P. plan.  

P.I.P. does not cover expenses related to property and vehicle damage, or vehicle theft sustained in an accident. It also does not cover medical expenses that exceed your coverage limits. For these types of damages in cases of negligence and wrongdoing, accident victims may benefit from contacting a personal injury attorney to see if they qualify for additional compensation from their accident.  

How Much Does P.I.P. Cover in NYS 

Basic P.I.P. policies cover economic losses up to $50,000 per person. Examples of basic coverage required for a minimum auto insurance purchase listed under New York State Insurance Laws include:  

  • expenses related to medical and rehabilitation expenses (in accordance with established fee schedules); 
  • up to 80% of lost earnings from work, up to a maximum payment of $2,000 per month for up to three years from the date of the accident; subject to statutory offsets for New York State disability, Worker’s Compensation, and Federal Social Security disability benefits; 
  • up to $25 a day, for up to a year from the date of the accident, to reimburse other reasonable and necessary expenses, (e.g., household help, and transportation expenses to/from medical treatment) resulting from the auto accident; and 
  • a $2,000 death benefit (in addition to the $50,000 basic No-Fault limit), payable to the estate of a person eligible for No-Fault benefits who is killed in a motor vehicle accident. 

The monetary coverage an individual is rewarded after an accident will differ based on the level of P.I.P. a driver purchases. In most cases, individuals and families are negatively affected financially in multiple areas of their life after an accident. Before choosing a P.I.P. plan, it may be helpful for drivers to compare the benefits with their health insurance to fill any gaps in coverage.  

Is P.I.P. Different from Medical Payment Coverage 

New York motorists can often confuse P.I.P. and medical payment coverage; these are two separate plans. Where drivers in NY are required to purchase a minimum amount of P.I.P., medical payment coverage is an additional policy to help pay for medical expenses outside of your P.I.P. benefits.  

Medical payment coverage is not as comprehensive as P.I.P. This insurance only covers medical expenses associated with a car accident including, doctors’ visits, scans, surgery, and more.  

How Drivers Can Become Ineligible for P.I.P. Benefits  

The benefits of P.I.P. are not guaranteed. Though no-fault policies will cover car accident victims regardless of whether or not they caused the accident, there are a few exceptions that can make a driver or passenger ineligible to receive benefits from a policy. These situations stated by NYS.gov include:  

  • driving while intoxicated or impaired by the use of a drug that contributes to the accident, except for emergency health-related services performed in a general hospital or by an ambulance worker outside of a general hospital; 
  • intentionally causing his or her own injuries; 
  • riding an all-terrain vehicle (ATV) or a motorcycle as operator or passenger (a pedestrian struck by a motorcycle or ATV is covered); 
  • injured while committing a felony; 
  • injured while in a vehicle known to be stolen; or 
  • an owner of an uninsured vehicle. 

In the case where an impaired driver does receive emergency services for injuries provided in an accident, they are not off the hook. Insurance companies can recover the expenses of these services received if the driver is convicted of driving while intoxicated or impaired through the use of alcohol or drugs after the fact.  

When P.I.P. Is Not Enough  

When someone is seriously injured in a car accident at the fault of someone else, P.I.P. is not enough to cover the costs of the damages. For pain and suffering or medical bills that extend the cap of insurance coverage, injury victims will need to file a civil lawsuit against the driver who caused the accident to help cover these financial losses.  

Consulting with a personal injury attorney after an accident is one of the best ways to determine which damages fall outside of your P.I.P., as well as to ensure your insurance claim for the accident is adequately filed. Even in the most obvious cases of negligence, insurance claims can be denied when filed incorrectly. Experienced attorneys know the statute of limitations for car accident claims and the different requirements needed for insurance claims vs. civil lawsuits. They can help predict future costs you may not have considered after your injury and secure you the compensation you deserve to help get you back on your feet.  

New York City and Long Island Accident Attorneys  

Our personal injury attorneys at the law firm of Siler & Ingber, have over 20 years of experience serving clients across New York City and Long Island. We protect your rights by maximizing recovery and securing the financial support our clients need to succeed on their road to recovery. Our winning attorneys know how to navigate through the claim process using our past experience as insurance defense attorneys. We are not afraid to fight and are fully prepared to take your case to trial to get a justified verdict over settling for less.  

If you or a loved one has been injured in an accident due to the negligence of another, our team at Siler & Ingber is here to help. With a 98% success rate, we have the experience and the know-how to help our clients achieve a favorable outcomes. Contact us today at 1-877-529-4343, or schedule an appointment online anytime. We never charge a fee unless we recover money for you. 

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