Personal Injury Protection Law

For a relatively small amount of insurance, there is a lot of confusion, complexity, and litigation regarding Personal Injury Protection. Commonly called PIP, it is a required coverage on your auto insurance designed to pay up to $8,000.00. When you are in a car accident, it will pay for medical bills and lost earnings for injured drivers, passengers and pedestrians. The coverage applies regardless of fault. So, even if you drive your car into a tree,, you still will be eligible for Personal Injury Protection.

If you or a loved one is hurt in a car accident, the biggest concern at first is medical bills. PIP was intended to provide quick payment for medical bills. PIP will cover the first $2,000.00 of your medical bills. PIP will also pay 75% of your lost wages, as long as your employer doesn’t pay you. But the maximum payout under Personal Injury Protection is $8,000.00.

Sounds simple. It isn’t. In 1991, the legislature amended the law to introduce “coordination of benefits”. After the first $2,000.00 of medical bills, your health insurance is supposed to pay whatever is left. But, if you have a co-pay or deductible, PIP still is available to cover those out of pocket expenses. But the administrative issues that are created can be a nightmare.

At the same time, if you have certain types of health insurance such as Medicare, Mass Health, or certain types of health insurance through your job, coordination of benefits does not apply.

But, watch out! If you have private health insurance, medical bills after the first $2,000.00 of PIP are not covered if your doctor is outside of your health insurer’s network. That means you get stuck with the bill forever.

The law also allowed car owners to get cheaper insurance by opting for PIP deductibles. Lawyers are mocked for avoiding straight answers. Here is a straight answer. The biggest mistake you can make when buying auto insurance is to try to save a few dollars by getting a PIP deductible. It can cost you thousands.

When Progressive Insurance was tricking on-line customers into opting out of PIP coverage, Marcotte Law Firm was in the front lines successfully protecting consumers. We first brought the practice to the attention of the Division of Insurance and Attorney’s General’s office, and later provided expert testimony in a class action.

There are other exceptions to PIP coverage, e.g. causing injury when you are intoxicated, being injured in an auto accident that falls under workers compensation. There are also exceptions to the exceptions.

You need a well-versed attorney to navigate you through these twists and turns. The amount of litigation that has flown from PIP has created a cottage industry for some lawyers on both sides of payment issues. You don’t want that. You want to see your doctor or therapist, have the bill paid, and have no loose ends. At Marcotte Law Firm, we know the law like the back of our hand. Michael Najjar literally wrote the book on PIP controversies with a 50+ page chapter for MCLE (Massachusetts Continuing Legal Education).

When you are hurt, you don’t want to figure out a Rubik's Cube. You just want your hospital bill paid. You need a knowledgeable and skillful attorney, to guide you through your personal injury case. At Marcotte Law Firm, we field questions from other lawyers on how to deal with the complexities of the process, and stubborn insurers. If they trust us, you certainly can.