When pursuing compensation after a car accident in Massachusetts, victims must navigate a no-fault insurance system. This means that, in most cases, individuals turn to their own personal injury protection (PIP) coverage for medical costs and lost wages, regardless of who was at fault. However, PIP benefits are limited, and victims who suffer more severe injuries may wish to step outside the no-fault system and file a personal injury lawsuit against the at-fault driver.

To do so, they need to meet the serious injury threshold, a legal standard that determines whether a claim qualifies for litigation. This threshold is essential because it serves as a gatekeeper for personal injury lawsuits, ensuring that only cases involving significant harm proceed to court. Below, we break down what the serious injury threshold entails, how it impacts accident claims, and what injured parties need to know to protect their rights.

Understanding Massachusetts' No-Fault System

Massachusetts operates under a no-fault car insurance system, meaning drivers must carry PIP insurance as part of their auto policy. PIP covers:

• Up to $8,000 in medical expenses, lost wages, and related costs.
• Medical bills up to $2,000 if the victim also has private health insurance (PIP covers the first $2,000, with the remainder processed through health insurance).
• Up to 75% of lost wages, capped at the $8,000 limit.

While PIP ensures immediate coverage, it does not provide compensation for pain and suffering, emotional distress, or other non-economic damages. For accident victims to seek full compensation beyond PIP, they must surpass the serious injury threshold.

What Qualifies as a "Serious Injury" Under Massachusetts Law?

Under Massachusetts General Laws Chapter 231, Section 6D, a car accident victim can file a lawsuit only if their injuries fall into one of the following categories:

Permanent and Serious Disfigurement

This includes visible scarring, burns, or facial injuries that result in significant cosmetic or functional impairments.

Fractured Bone

Any broken bone meets the threshold, regardless of severity.

Substantial Loss of Hearing or Sight

If an accident leads to measurable vision or hearing impairment, the victim can pursue a claim.

Death

In fatal accidents, the victim's family may file a wrongful death lawsuit against the responsible party.

Medical Expenses Exceeding $2,000

If an accident leads to more than $2,000 in reasonable and necessary medical costs, the injured party may seek damages beyond PIP.

The $2,000 medical expense rule is particularly significant. Many injuries that do not meet the other criteria still qualify if medical bills surpass this threshold. However, expenses must be justifiable and directly related to accident-related treatment.

How the Serious Injury Threshold Affects Personal Injury Claims

For accident victims, understanding whether their injuries meet the threshold is critical in deciding how to pursue compensation. Here's how it influences legal options:

• If injuries do NOT meet the threshold: Those injured must rely solely on PIP benefits. They cannot sue for additional damages, including pain and suffering.
• If injuries DO meet the threshold: Victims are able to move forward with a personal injury lawsuit against the at-fault driver, seeking compensation for:
  • Medical expenses exceeding PIP coverage
  • Lost wages beyond PIP limitations
  • Pain and suffering
  • Emotional distress
  • Permanent disability or impairment

Additionally, comparative negligence laws in Massachusetts play a role in these claims. If a court determines that the injured party was more than 50% at fault, they are banned from recovering damages. If they are less than 50% at fault, their compensation is reduced proportionally to their share of fault.

Common Misconceptions About the Serious Injury Threshold

There are several misunderstandings about how Massachusetts' injury threshold works. Here are some clarifications:

• Minor injuries with high medical bills can qualify. Even soft tissue injuries, such as whiplash, may meet the threshold if treatment costs exceed $2,000.
• Pain and suffering alone do not justify a claim. Unlike in some other states, victims in Massachusetts must meet the threshold before they can seek non-economic damages.
• All broken bones qualify, regardless of severity. Even a small fracture satisfies the requirement to step outside the no-fault system.
• PIP is mandatory, even if the accident wasn't your fault. Some drivers assume they can bypass PIP if another driver caused the crash, but all insured individuals must use their PIP benefits first.

Steps to Take If You Believe You Meet the Threshold

If you've been in a Massachusetts car accident and suspect your injuries qualify under the serious injury threshold, taking the following steps can strengthen your case:

1. Seek immediate medical attention. Proper documentation of injuries is essential. Even if symptoms seem minor, some injuries worsen over time.
2. Track medical expenses. Keep records of doctor visits, treatments, prescriptions, and medical bills to establish whether costs exceed $2,000.
3. Consult a personal injury attorney. An experienced lawyer can assess whether your case meets the threshold and guide you through the legal process.
4. Avoid speaking with insurance adjusters before legal consultation. Insurance companies often attempt to downplay your injuries to prevent a claim from surpassing the threshold.

Conclusion

The serious injury threshold in Massachusetts plays an important role in determining whether car accident victims can seek compensation beyond no-fault insurance. While the threshold limits the number of lawsuits, it also ensures that those with significant injuries can pursue full damages. Understanding these legal standards is vital for anyone involved in an accident, as failing to meet the requirements can mean missing out on necessary compensation.

Need Legal Help? Brandon J. Broderick, Attorney at Law is One Phone Call Away

Navigating Massachusetts car accident claims can be challenging. Fortunately, you don't need to do it alone. The experienced lawyers at Brandon J. Broderick, Attorney at Law, are available 24/7 to help you understand your legal options, gather necessary evidence, and build a strong case to secure the settlement you deserve.

Contact us now for a free legal review.