How medical payments coverage and PIP work after a crash
From an auto injury benefits specialist
Medical payments coverage and personal injury protection, often called PIP, can help pay for crash related care. You don’t have to wait for a decision on who caused the crash. The two are different benefits. Medical payments coverage mostly sticks to medical costs. PIP may also cover lost wages or other costs where the policy and state allow it. Look at what you bought. [1, 2]
File with the right insurer
Ask your auto insurer which coverage applies to you and to each passenger who was hurt. Ask for the claim number, the benefit limit and any deductible or copay. Get the filing instructions too. In some places, the insurer of the vehicle you were in handles the first claim. Don’t assume every injured person goes through the driver’s personal policy. [2, 3]
Don't miss notice deadlines
Find out when the insurer must get notice and when providers must send in bills. Some states have short time limits. In New York’s no fault system, for example, written notice is generally due within 30 days unless a justified exception applies. That’s one example, not a national deadline. File quickly, even if you’re still in treatment. [3]
Keep a running tally
Give each provider the correct claim details. Ask for copies of bills and explanations of payment. Keep a running total measured against your benefit limit. If a bill is denied, ask whether it’s due to missing information, used up benefits or a coverage decision. Your health plan may be another payer, depending on the rules that apply. [2, 3]
Ask the adjuster
- Which people and costs does this cover?
- What forms and deadlines apply?
- How much of my benefit is left?
Start the claim today
Ask today for your injury benefit claim number and instructions for filing. [2]
Sources and further reading
- 1National Association of Insurance Commissioners, auto coverage types
- 2Texas Department of Insurance, medical payments and PIP
- 3New York Department of Financial Services, filing a no fault claim
The material here is general education from an auto injury benefits view. Whether coverage is available, which costs it covers, limits, filing forms and deadlines all vary by state and policy.
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