Pennsylvania Car Accidents & PIP for Medical Bills – Whose PIP Pays?

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Order of PIP Benefits After a Pennsylvania Car Accident

1. Your own auto insurance policy (you’re a named insured or co-insured).
2. A relative’s policy (you’re a member of their household).
3. The policy covering the car you were in.
4. If you were a pedestrian or bike rider, the policy on any car involved in the accident.

PIP in Pennsylvania

PIP (Personal Injury Protection) is one type of coverage required on every car insurance policy issued in Pennsylvania and other states like New Jersey. PIP covers things like medical bills, lost wages and funeral expenses in the event of death. The minimum amount required under Pennsylvania law is $5,000 per person, per accident. Many PA residents choose higher PIP coverage amounts, such as $50,000. Get more legal info about medical bills and PIP in Pennsylvania.

PIP claims work like medical insurance claims. At the hospital or doctor’s office, you provide your auto insurance info and claim number. The office will bill your auto insurance company directly. You won’t get billed for co-pays or deductibles like you would if you used your health insurance.

PA is a No-Fault State

No-fault is a special term that applies to PIP benefits in Pennsylvania. It basically means that if you’re injured in a car accident, you can access PIP benefits, without regard to fault. So, even if you cause a car accident, you can make a PIP claim under your own car insurance policy, if you have one. If you don’t, you could still make a claim if you’re in the household of someone who has a car insurance policy (parent, spouse, etc.).

Isn’t the At-Fault Driver Supposed to Pay?

For individuals who’re injured in a car accident that was caused by another driver, there’s often confusion about who pays for medical bills. Oftentimes, innocent, injured victims assume that the other, at-fault driver is supposed to pay. The truth is that the at-fault driver isn’t on the hook for your medical bills, at least up to the $5,000 minimum amount (or whatever amount you elected on your policy). That’s how PIP works. You’re supposed to make a claim for PIP benefits until the amount you’ve purchased exhausts. After that, your own health insurance kicks in, and the at-fault driver would be on the hook for those bills.

Will My Car Insurance Rates Go Up by Making a PIP Claim?

One question many Pennsylvania residents ask is whether their car insurance rates can go up for making a PIP claim. The official answer is no, your insurance rates aren’t affected by making a PIP claim. In other words, you can’t be singled out for making a PIP claim. However, insurance rates can rise based on an insurer’s own assessment of all claims paid out in your state or area.

More: Left Hand Turn Car Accidents in Pennsylvania, Vehicle Code Laws and Fault

PIP Follows the Occupant (Driver or Passenger)

What happens when there are multiple sources of PIP? This is a common question when multiple people are in the car. For example, a Philadelphia resident, Mr. A, is driving the car of his best friend, Mr. B, who is also in the car. Mr. A’s brother, Mr. C, is riding in the car. Mr. A has his own car insurance policy. Mr. B’s car is insured under his own policy. Mr. C is covered as a driver under his parents’ car insurance policy. Who pays for PIP if each occupant is injured and needs medical treatment?

This issue is called priority of coverage, and Pennsylvania’s Motor Vehicle Financial Responsibility Law provides the answer. Under Section 1713, which is provided below, the level of priority begins with 1 below, and continues down the list until one of the PIP policies applies.

1. Your own policy (you are a named insured or co-insured).
2. A relative’s policy (i.e., you’re a member of their household).
3. The policy covering the car you were riding in.
4. If you were a pedestrian or bike rider, the policy on any car involved in the accident.

Ineligibility for PIP

In some instances, a driver, passenger or non-occupant (pedestrian or bike rider) won’t be eligible. Under Pennsylvania law, you are ineligible for PIP if you were driving or riding a recreational vehicle (ATV), motorcycle, or other type of motorized cycle. In these situations, you’d have to use your private health insurance to cover your medical bills. If another party caused the accident, you could seek compensation.

In addition, you’d be ineligible for PIP if you have a car registered in PA, but don’t have insurance coverage for it. For instance, let’s say that the driver in our example above, had his own car insurance policy, but it had lapsed because he forgot to pay his premium. He wouldn’t be able to make a PIP claim at all and instead would have to use his own health insurance to cover the bills. This situation tends to be rare.

For more info, visit the Pennsylvania & New Jersey Auto Accident Law Library.

Philadelphia, Pennsylvania Car Accident Law Firm

Our Philadelphia law firm handles car, truck and pedestrian accidents in Pennsylvania. We’ve recovered over $200 million for our clients. For a free case review, call (866) 641-0806.

Pennsylvania Motor Vehicle Financial Responsibility Law § 1713. Source of benefits. (Current as of May 31, 2018)

(a) General rule.–Except as provided in section 1714 (relating to ineligible claimants), a person who suffers injury arising out of the maintenance or use of a motor vehicle shall recover first party benefits against applicable insurance coverage in the following order of priority:

(1) For a named insured, the policy on which he is the named insured.

(2) For an insured, the policy covering the insured.

(3) For the occupants of an insured motor vehicle, the policy on that motor vehicle.

(4) For a person who is not the occupant of a motor vehicle, the policy on any motor vehicle involved in the accident. For the purpose of this paragraph, a parked and unoccupied motor vehicle is not a motor vehicle involved in an accident unless it was parked so as to cause unreasonable risk of injury.

(b) Multiple sources of equal priority.–The insurer against whom a claim is asserted first under the priorities set forth in subsection (a) shall process and pay the claim as if wholly responsible. The insurer is thereafter entitled to recover contribution pro rata from any other insurer for the benefits paid and the costs of processing the claim. If contribution is sought among insurers responsible under subsection (a)(4), proration shall be based on the number of involved motor vehicles.