After a car accident in New Jersey, medical bills and other expenses can begin accumulating quickly. Fortunately, most New Jersey auto insurance policies include Personal Injury Protection, commonly known as PIP insurance. Understanding what New Jersey PIP insurance covers can help you protect your rights and avoid unexpected financial problems during your recovery.
What Is PIP Insurance in New Jersey?
Personal Injury Protection is a form of no-fault auto insurance coverage. This means that PIP generally pays benefits for your accident-related injuries regardless of whether you or another driver caused the crash.
PIP may cover the policyholder, household family members, passengers, and certain pedestrians injured in an automobile accident. The exact coverage depends on the policy, the injured person’s circumstances, and whether another insurance policy applies.
Medical Expenses
Medical expense coverage is the most important part of New Jersey PIP insurance. Depending on your policy limits, PIP may pay for reasonable and medically necessary treatment, including:
- Emergency room care and hospitalization
- Doctor and specialist appointments
- Diagnostic testing and medical imaging
- Surgery and rehabilitation
- Physical therapy
- Prescription medications
- Medical equipment
- Certain chiropractic services
The standard PIP medical expense limit under a New Jersey Standard Policy is generally $250,000 per person, per accident. Drivers may select lower limits of $150,000, $75,000, $50,000, or $15,000 in exchange for a lower premium. A Basic Policy generally provides only $15,000 in PIP medical coverage, although additional coverage may apply to certain serious injuries.
Deductibles and Copayments
PIP does not necessarily pay every dollar of a medical bill. Most policies include a deductible, commonly $250, although higher deductible options may be selected. After the deductible, a 20% copayment generally applies to the next $5,000 in medical expenses.
Your policy may also designate your health insurance as the primary payer for accident-related medical treatment. If that option was selected but the required health coverage is no longer active, the auto insurer may apply an additional $750 deductible.
Lost Income Benefits
PIP may also provide income continuation benefits when an accident-related injury prevents you from working. These benefits replace only part of the income you lose and are subject to the limits stated in your policy.
Basic income continuation coverage is not automatically included in every policy. Drivers should review their declarations page to determine whether lost-wage coverage was purchased and what weekly and total limits apply.
Essential Services Benefits
A serious injury may prevent you from performing ordinary household responsibilities. Essential services coverage may reimburse the cost of hiring someone to perform tasks that you would normally handle, such as:
- Housekeeping
- Childcare
- Yard maintenance
- Laundry and meal preparation
These benefits are also subject to daily and total policy limits.
Death and Funeral Benefits
When an insured person dies from accident-related injuries, PIP may provide a death benefit based on unused income continuation and essential services benefits. Depending on the policy, reasonable funeral expenses may also be covered up to the selected limit.
What PIP Usually Does Not Cover
PIP primarily covers medical expenses and certain economic losses. It does not ordinarily compensate an injured person for pain and suffering, emotional distress, loss of enjoyment of life, or vehicle damage.
Compensation for these losses may require a separate personal injury claim against the driver or party responsible for the accident. The injured person’s ability to recover noneconomic damages may also depend on whether the policy includes the Limited Right to Sue or Unlimited Right to Sue option.
What Should You Do After an Accident?
Notify your auto insurance company promptly and request a PIP application. Keep copies of medical records, bills, proof of lost income, receipts, and all correspondence with the insurer. Follow your insurer’s treatment authorization procedures because certain services may require precertification.
PIP claims can become complicated when an insurer delays payment, denies treatment, disputes whether care is medically necessary, or claims that an injury was not caused by the accident. Speaking with an experienced New Jersey car accident lawyer can help you understand your coverage, challenge improper denials, and determine whether additional compensation may be available.
If you were injured in a New Jersey car accident, do not assume that the insurance company will automatically explain every benefit available under your policy. A legal review can help protect your rights and ensure that important filing and treatment deadlines are not missed.