Personal injury protection (PIP) insurance helps pay for your medical bills and lost wages when you or your passengers are injured in a car accident.
PIP coverage helps to pay for medical expenses regardless of who’s at fault in an accident. In some states, PIP is a required add-on to your coverage; in others, it’s optional. PIP varies significantly by state but typically covers you, your passengers and the drivers listed on your policy.
PIP also covers you if you are injured as a passenger in someone else’s car, or if you’re hit by a car while walking or biking. Keep reading to learn all about personal injury protection coverage.
- What is personal injury protection (PIP)?
- What does personal injury protection (PIP) cover?
- Is personal injury protection coverage mandatory?
- What happens if I don’t have personal injury protection coverage?
- How does PIP insurance work with other insurance?
- How much PIP insurance do I need?
- FAQ: PIP insurance
What is personal injury protection (PIP)?
Personal injury protection, or “no-fault insurance,” pays the medical expenses for you and your passengers after you’re injured in a car accident regardless of who is at fault. PIP also covers you when you’re a passenger in someone else’s car, or if you’re hit by a car while a pedestrian or cyclist.
Unlike bodily injury liability insurance, which pays for the medical bills of other drivers and passengers injured in an accident you’ve caused, PIP coverage pays for your own expenses.
PIP insurance may include some of the same coverage as your health insurance or Medical Payments policy. However, PIP coverage is written explicitly for car-related injuries, which are sometimes excluded from health insurance policies. PIP insurance covers a number of additional expenses not covered by MedPay insurance.
What does personal injury protection (PIP) cover?
PIP insurance pays a per-person benefit for injuries you and others specified in your policy sustain in an auto accident. Basic personal injury car insurance coverage is for the insured’s own injuries on a first-party basis, without regard to fault.
Parties typically covered by PIP include:
- Policyholder’s relatives in the same household
- Passengers (if they don’t have their own PIP coverage to place a claim under)
- Other authorized drivers of your insured vehicle
- Policyholders and family members if they are injured while riding in someone else’s car
- Policyholders and family members if struck by another vehicle when a pedestrian (in some states).
The exact benefits offered by PIP vary by state, and there may be a deductible due before the benefits kick in. Coverage varies widely among states, so the terms of your policy will note your specific benefits, but in general personal injury protection coverage includes:
- Medical expenses – May include reasonable charges for medical, hospital, surgical, nursing, dental, ambulance and x-ray services. Necessary medications, medical supplies and prosthetic devices may also be covered.
- Loss of essential services (also sometimes referred to as disability or replacement services)
- Loss of income
- Funeral expenses
- Survivor’s loss – some policies compensate an individual’s heir(s) if the person died from accident-related injuries.
Your PIP limits set the maximum amount paid per person for any combination of covered expenses. PIP limits vary by state; some states allow you to choose your PIP limits, and others set it to a certain amount, like $10,000, unless you choose to buy additional PIP coverage.
Is personal injury protection coverage mandatory?
It depends on your state. In no-fault states, personal injury protection coverage is required (typically called no-fault coverage). In other states, it’s optional, if available at all.
What states require personal injury car insurance?
Five fault-based states also require PIP coverage and there are five states where it is optional coverage.
These states aren’t at-fault states but do require PIP:
- New Hampshire
- South Dakota
The District of Columbia is neither an actual no-fault nor an add-on state. Drivers are offered the option of no-fault or fault-based coverage. Still, in the event of an accident, a driver who initially chose no-fault benefits has 60 days to decide whether to receive those benefits or file a claim against the other party.
What happens if I don’t have personal injury protection coverage?
If PIP coverage is optional in your state and you choose to go without, you may sometimes have to pay out-of-pocket for your medical bills, or turn toward medical payments coverage if you have that.
How does PIP insurance work with other insurance?
Unlike bodily injury liability insurance, which pays for the medical bills of other drivers and passengers injured in an accident you’ve caused, PIP coverage pays for your expenses.
PIP insurance may include some of the same coverage as your health insurance or Medical Payments (MedPay) policy. However, PIP coverage is written explicitly for car-related injuries, sometimes excluded from health insurance policies. PIP insurance covers several additional expenses not covered by MedPay insurance.
Medical payments and PIP are similar, but PIP is typically more comprehensive and pays for items such as lost wages that medical payments will not.
Medical payments coverage strictly pays for reasonable medical expenses, such as hospital, dental, nursing and X-ray bills incurred within a specified period after your accident (usually the first three years).
PIP typically covers reasonable medical expenses, loss of essential services and lost wages. The exact benefits offered by PIP coverage differ significantly by state, and a deductible and/or co-payment may be due before your benefits start up.
How much PIP insurance do I need?
When determining how much PIP insurance you need, consider how you and your family would be affected financially after a car accident that caused injuries.
Your state-required PIP minimum coverage amount is likely sufficient if you and family members in your household already have health insurance with excellent benefits. But remember that extra PIP protection will kick in to help cover lost income and to pay for household service expenses.
If you and your family don’t have health insurance or a plan that doesn’t offer all the benefits of PIP, consider getting as much PIP coverage as you can afford.
PIP insurance may include some of the same benefits as your health insurance plan or Medical Payments policy. PIP coverage, however, is written explicitly for car-related injuries, which are sometimes excluded from health insurance policies. PIP insurance covers some additional expenses not covered by MedPay insurance.
FAQ: PIP insurance
How much does PIP insurance cost?
Below is an example of a safe driver living in Tampa, Florida, to show you how much PIP insurance costs. The rates include PIP insurance for up to $10,000, $100,000 for bodily injury liability, up to $300,000 per accident, and comprehensive and collision with a $500 deductible. The average rate for PIP for a full coverage policy in Tampa was $366, among the insurers analyzed. That turns out to be about 16% of the total rate.
Do I need PIP insurance if I have health insurance?
If you live in one of the states where PIP coverage is required, you must file a claim under that policy before you turn to your health insurance. Regardless of where you live and if PIP is required, PIP insurance offers several benefits you won’t get from a health insurance policy, such as coverage for lost wages and funeral costs.
Does PIP insurance cover pain and suffering?
No. PIP insurance doesn’t reimburse you for pain and suffering after a car accident.
What are some PIP-related coverages?
Additional personal injury protection is available in some states (and by only some carriers) where PIP is available. Additional PIP acts as a supplement to the PIP coverage required by your state. It allows you to raise your PIP maximum limit amount.
Extended personal injury protection is available in Florida, where personal injury protection coverage typically pays 80% of medical expenses and 60% of lost wages. Purchasing an extended PIP allows you to amend your PIP so that 100% of medical expenses and 100% of lost wages will be paid (up to the maximum limits of your PIP coverage). The Florida Department of Financial Services Insurance Library gives more information on increased PIP benefits.
Guest personal injury protection is available in Kentucky and covers guest passengers in your vehicles. It is required when all drivers on your policy have rejected no-fault coverage. (Kentucky is a choice, no-fault state).
You must choose a Personal Injury Protection Plan in states like New Jersey. Here is a description of those choices:
Full PIP Primary is the primary coverage for injuries you or your passengers sustained in an auto accident. This option also covers income continuation, funeral expenses, death benefits, and essential services expenses.
Full PIP Health Primary should be purchased if another health insurance provider is the primary coverage for injuries sustained by you or your passengers in an auto accident. This option also covers income continuation, funeral expenses, death benefits, and essential services expenses, as detailed below.
Full PIP primary coverage is not available if you use Medicare or Medicaid as your primary health insurance or are an active military member. In addition, some health insurers do not cover injuries related to car accidents. If you are unsure of what your health insurance covers, you should select full PIP primary or medical-only PIP primary.
Medical Only PIP Primary is the primary coverage for injuries you or your passengers sustained in an auto accident.
Medical Only Health Primary should be purchased if another health insurance provider is the primary coverage for injuries sustained by you or your passengers in an auto accident.
Medical-only primary coverage is unavailable if you use Medicare or Medicaid as your primary health insurance or are an active military member. In addition, some health insurers do not cover injuries related to car accidents. If you are unsure of what your health insurance covers, you should select full PIP primary or medical-only PIP primary.
What is the PIP definition of a resident relative?
The definition of a resident relative can differ depending on state laws and an auto insurance policy’s language (terms).
A typical insurance policy defines a resident as someone who has a physical presence in your household with the intention to continue living there. Unmarried dependent children, while temporarily away from home, to attend college for example, usually are still considered residents if they intend to continue to live in the parent’s household during breaks from the school year. A relative is someone related to you, so a relative resident would be someone related to you who lives in your home.
Who will be considered a resident relative for your personal injury protection (PIP) coverage will depend upon the definition of a “resident relative” your state has in place and the language of your policy regarding this term and your PIP coverages and exclusions.
In general, if you have a child that lives with you, he or she would usually be considered a resident relative and be covered by your PIP insurance. If you had a child that moved out and lived on his or her own, then this child would not usually be covered as a resident relative any longer under your PIP coverage.
Resident relatives and their insurance versus your PIP car insurance
If your resident relative has his own insurance policy, your PIP coverages may not extend to him, depending again on state laws and your policy’s terms. Read over the terms of your policy, specifically the PIP portion.
What is PIP fraud or no-fault fraud?
PIP fraud is when a system is set up to illegally get payment for PIP claims from an insurance company on behalf of the policyholder.
One type of PIP fraud involves staging a fake car accident to pay out bogus injury claims through a person’s PIP coverage. In this example, clinics are set up to sign off on the fake injuries, making it appear that the person was treated so that both parties will receive money from the driver’s PIP policy.
— Michelle Megna contributed to this story.