What is Personal Injury Protection (PIP)?

Personal injury protection coverage, or PIP insurance, is no-fault insurance that protects you and the occupants of your vehicles when you are involved in an automobile collision. It is typically available in increments of $2,500.00 of coverage.

Do I Need PIP?

PIP is not required. However, having PIP can help cover initial medical expenses, deductibles, and lost income after an unexpected wreck occurs. It is no-fault insurance that pays upon showing evidence of expenses and does not require proving liability. Simmons and Fletcher, P.C., recommends that you carry a minimum of $10,000.00 per person in PIP coverage if you drive in the state of Texas.

Personal Injury Protection vs Health Insurance

Many people who choose not to carry PIP insurance, do so because they believe it is the same as other coverage like health insurance. PIP is not the same as health insurance.

People often do not realize that many health insurance plans contain a clause that makes them secondary to any other form of liability coverage. What this means for someone who is involved in a motor vehicle collision, is that their health insurance may well deny the claim expecting them to look to the other driver’s auto policy. The other auto policy may dispute liability. If it does, who pays out of pocket for the medical bills? The answer is: you do.

Even if the other driver’s policy accepts liability, they do not pay for your care as you go. They only pay to settle the claim once you have ‘completed’ your medical care and submitted a claim. Some people never ‘complete’ their care. They may have issues for years. As a result, your bills pile up with no one paying them but you.

If you have personal injury protection coverage, you can make a PIP claim to cover some of your initial out-of-pocket losses due to an accident. It will cover medical bills and lost income up to the amount of the PIP policy.  The more PIP you have, the better.

Another benefit of PIP coverage is that if you make a recovery against a negligent third party who caused or contributed to the accident, you do not have to reimburse your PIP carrier. That money is yours to keep. On the other hand, health insurance has to be paid back out of a settlement or judgment that you recover from the tortfeasor.

How Do I File a PIP Claim on My Own?

To file a PIP claim on your own, follow these 4 simple steps:

  • Review the declarations page to determine whether or not you purchased PIP coverage since it is optional insurance.  If your policy indicates there is coverage it will tell you the limits of coverage. The minimum you can purchase is $2,500 in Texas if you choose to purchase it. If you cannot locate this, call your insurance agent and ask them to send you a new declaration of coverage or ‘dec. sheet’ as it is commonly known.
  • Contact your insurance company and tell them you wish to open a PIP claim in relation to an auto accident. They will provide you with the form they prefer to file the claim and any authorizations they may want to verify your lost wages or medical bills.
  • Find medical bills demonstrating that the amount you owe exceeds your maximum limits of coverage. If this is not enough, you may wish to document your lost wages and submit them as well.
  • Mail all of the above documentation in with the completed PIP claim form. Be sure the form is 100% accurate as insurance fraud is a crime and it is no laughing matter. If you have questions, speak to a Texas car accident attorney before you file.

Should I File A Personal Injury Protection Claim?

A file folder marked "claims."You are paying a separate premium for PIP insurance. You might as well use what you paid for. If the PIP premium goes up substantially due to your PIP claim, you can always drop just that part of the coverage or seek alternate insurance rate quotes. But why are you paying for personal injury protection if you are not going to make a personal injury protection claim when you need it?

Why is My Medical Doctor Refusing to Bill Health Insurance After A Car Wreck?

Liability insurance companies usually want to settle the case all at once, not in parts. So they generally will not pay your bills as you go. This results in a delay in the bills getting paid. Many doctors are aware of the delays in getting paid when an auto collision is the source of the injury. As a result, your primary care doctor who has treated you for years may refuse to treat you because she knows that the health insurance company is going to deny payment. Your doctor might be able to submit his bill to the auto liability carrier and get paid, but why would he want to waste his time and resources chasing payment? Instead, we often see doctors refuse to treat patients who have been injured due to a car wreck making it necessary for them to hire a personal injury attorney to file a lawsuit and force the insurance company to accept responsibility for their insured’s actions.

PIP Protects You

Personal injury protection (PIP) coverage is insurance designed to cover some of the initial medical expenses and losses to help injury victims get the care they need and get back on their feet. You buy a set amount and it pays first when your car is in a collision. You do not have to go to the other driver’s insurance or your health insurance carrier to seek payment first. This is a first party insurance claim.  If you do not have personal injury protection covering you, and the people in your vehicle, you should get it today.

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