Navigating the aftermath of a New Jersey car accident can be stressful, particularly when dealing with injuries, medical bills, and insurance claims. Luckily, in NJ, all drivers are required to carry Personal Injury Protection coverage (or PIP for short) that aims to make recovering your losses easier. Many people do not understand what PIP coverage is and how it works.
At Brandon J. Broderick, Attorney at Law, we will provide clarity on Personal Injury Protection (PIP) insurance to help you understand your rights and options. Below, we answer some common questions about PIP insurance in New Jersey.
While becoming more knowledgeable about PIP is important, you should consult with an NJ personal injury attorney if you have specific questions or need legal help. Our attorneys are here for you. Call us today with any questions.
What is Personal Injury Protection (PIP)?
Personal Injury Protection (PIP) is a type of no-fault insurance available to auto insurance policyholders and other eligible individuals injured in car accidents. PIP covers medical expenses, lost wages, and even death benefits.
If you're injured in a vehicle accident, it's important to determine your eligibility for PIP benefits to help manage the often large costs of medical care today.
What Does "No-Fault" Insurance Mean?
In New Jersey, a no-fault insurance state, policyholders can receive PIP benefits immediately after an accident, regardless of who was at fault. This means you can access medical and other benefits even if you were responsible for the accident.
However, being at fault might limit your ability to pursue a separate personal injury claim against the other involved parties.
What Does PIP Cover?
The extent of PIP coverage depends on your specific policy but generally includes:
- Medical expenses
- Lost wages or income
- Essential services
- Funeral expenses
- Survivor benefits
What Services Qualify as Essential Under PIP?
Essential services include those the injured party would typically perform:
- Childcare
- House cleaning
- Laundry
- Lawn care
The daily reimbursement limit is usually $12, with a maximum of $4,380. Proof of payment to a third party is generally required.
Does PIP Cover Pain and Suffering?
Under New Jersey's no-fault system, suing for pain and suffering is generally not allowed unless you suffer a "serious injury" as defined by state law. The specifics of your insurance policy and the nature of your injuries can affect your eligibility.
Consulting with a New Jersey personal injury attorney can provide legal advice for your specific situation and your options.
What is the Required PIP Coverage Amount in New Jersey?
New Jersey law mandates a minimum PIP coverage of $15,000, with options to purchase up to $250,000 in coverage, typically in increments of:
- $50,000
- $75,000
- $150,000
- $250,000
Basic PIP covers up to $15,000 in medical expenses per person per accident, while standard PIP offers additional benefits, including wage replacement and death benefits. Low-income drivers might qualify for a Special PIP policy, which includes $10,000 in death benefits but offers less overall coverage than the Basic PIP.
Can I Choose Lower Coverage Limits for My PIP Insurance?
Yes, you can select a lower coverage limit, with the minimum being $15,000. However, considering the high costs associated with severe accidents, it's advisable to opt for more comprehensive coverage.
Do I Need PIP Coverage if I Have Health Insurance?
Yes, PIP coverage is mandatory in New Jersey, even if you have health insurance. PIP offers benefits like wage loss coverage and essential services that health insurance typically does not cover. Some policies might allow you to designate your health insurance as primary, affecting how claims are processed.
What If My Health Insurance Denies Coverage of My Medical Bills After an Accident?
If your health insurance does not cover motor vehicle accident injuries or if it denies a claim, your auto insurance should step in as primary coverage. You should confirm that your PIP policy would provide coverage in this scenario to avoid paying significant out-of-pocket expenses.
What Types of Injuries Qualify for Catastrophic Coverage?
Catastrophic injuries eligible for up to $250,000 in medical expense coverage include:
- Spinal cord injuries
- Dismemberment
- Significant and permanent brain damage
- Disfigurement
- Acute injuries requiring emergency hospital treatment
What Medical Expenses Are Covered Under NJ PIP?
PIP covers medically necessary and reasonable treatments such as:
- Medical treatment and surgery
- Rehabilitative care
- Diagnostic services
- Hospital and ambulance expenses
- Medications
- Recognized non-medical treatments
Precertification might be required for some treatments, except for emergency care within the first 10 days post-accident.
How Much Does PIP Pay for Wage Replacement?
For a standard $15,000 policy, wage replacement benefits can be up to $100 per week, with a maximum of $5,200. These benefits cannot exceed the injured party's net income during the benefit period.
Can I Collect Wage Reimbursement from Other Sources While Receiving PIP Wage Benefits?
No, double-dipping is not allowed. PIP wage benefits will be offset by other wage replacement sources such as state disability, workers' compensation, military benefits, or Medicare.
Am I Legally Required to Talk to an Insurance Agent After a Car Accident in New Jersey?
While not legally required to speak immediately, you must report the accident to your insurance company promptly. However, consult an attorney before talking to the other party's insurance agent to avoid potential issues with your claim.
What Happens When My PIP Coverage is Exhausted?
If your PIP coverage limits are reached, you may need to explore other compensation sources. This might involve filing a claim against the at-fault driver’s liability insurance or pursuing a personal injury lawsuit. A skilled personal injury attorney can help identify additional compensation avenues.
Can I Sue for Damages After an Auto Accident in New Jersey?
Yes, under certain circumstances, you may sue the negligent driver responsible for your injuries. This depends on the severity of your injuries. Consult with a New Jersey personal injury attorney to explore your legal options.
Do I Need an Attorney If I Have Car Insurance?
Yes. An experienced personal injury lawyer can help navigate sometimes complex cases for PIP claims, negotiate with insurers, and ensure you receive fair compensation. If your injuries are significant or if the insurance company denies your claim, a lawyer can protect your rights and pursue additional compensation if needed.
For legal assistance with your PIP claim, contact Brandon J. Broderick, Attorney at Law, to schedule a free initial consultation with one of our NJ personal injury attorneys. We are dedicated to helping you understand your rights and helping secure the compensation you deserve.