What to Do When Your PIP Coverage Runs Out?

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Standard personal injury protection, also known as PIP, often has a limit of $10,000 per accident, which can be exhausted quickly if the driver's or passenger's injuries are serious. There are several steps you can take to ensure continuation of service when your PIP coverage has been exhausted.

Keep Track of Charges

  • It is important to keep track of the amount that has been paid out under the PIP policy so you are not unprepared when benefits run out. Many people assume the insurance company will handle everything related to the accident and are surprised when treatment for injuries is denied or a bill for services is received that is much higher than the person expected. Simply document and keep a running total of all of the payments made by the car insurance company under your PIP coverage so you will be aware when you are getting close to the limit and need to make other plans for continuing your treatment without causing bankruptcy.

Transfer Care to Health Insurance

  • If intensive medical intervention is needed and PIP benefits have been exhausted, then the responsibility for paying for medical care can be transferred to your primary health insurance company or to Medicare, if you are eligible. Any treatments that occur under these plans must adhere to the plan's guidelines and any claims must be submitted to the health insurance company for reimbursement.

    Although health insurance companies will often cover the needed procedures with no issues, some insurers and Medicare require the reimbursement of the money paid for medical benefits from any settlement that you receive from the at-fault individual's insurance company. Benefits paid out under your PIP coverage are not subject to reimbursement. The reimbursement from the money obtained in the settlement will vary depending on the type of health insurance plan and the amount of money paid out by the health insurance plan for injuries directly related to the automobile accident.

Mandatory States

  • PIP coverage is mandatory in the following states:

    Delaware
    Florida
    Kansas
    Hawaii
    Texas
    Utah
    Kentucky
    Pennsylvania
    Oregon
    New York
    Massachusetts
    Minnesota
    Michigan
    New Jersey
    North Dakota

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