If you were in a car accident, you may pursue a Massachusetts Personal Injury Protection (PIP) claim for lost wages, medical bills and replacement services regardless of who caused the car accident. This is otherwise known as “no fault insurance.”

Generally, you do not receive compensation for your medical bills and lost wages in a personal injury claim unless you obtain a favorable result by settlement or verdict.

Massachusetts Personal Injury Protection Claims

PIP provides compensation for up to $8,000.00 for people injured in a motor vehicle accident for three types of out-of-pocket expenses:

• Medical bills: PIP covers reasonable and necessary medical expenses incurred within two years of the car accident.
• Lost wages: PIP covers 75 percent of lost wages caused by injuries you sustain in the automobile accident. However, if you are eligible for a disability plan at work, you will receive only 75 percent of the difference, if any, between the disability plan and the amount you would otherwise be entitled to under PIP.
• Replacement services: PIP pays for reasonable expenses to pay non-family members to perform services that the injured person would otherwise have performed for the benefit of himself and/or family members of his household.

Health Insurance and PIP Claims

If you are injured in a car accident and you have health insurance, Massachusetts personal injury protection will pay up to $2,000.00 towards your medical bills. Any remaining medical bills must be submitted to your health insurer in a timely fashion (if not, some health insurance companies may deny payment of your bill). However, PIP may be available to pay medical bills not covered under your health insurance including co-payments.

You must also coordinate payment of your medical treatment between the health care provider, health insurer, and PIP as PIP won’t cover bills outside your health insurance plan.

Health insurance only impacts the payment of medical bills in Massachusetts personal injury protection claims. Massachusetts personal injury protection remains available for the payment of lost wages and replacement services until the $8,000.00 in PIP coverage is exhausted.

Duty to Cooperate

You must cooperate with the PIP insurer in order to obtain PIP benefits. This would apply to your car insurance, if you were operating your own vehicle.

• PIP Application: You must fill out, sign and submit a PIP application to the insurance company. (The insurance company will send the PIP form to you.)
• Medical Examination: The PIP insurer has the right to have you examined by a doctor selected by the insurer.
• Medical records, bills and lost wage information: You must submit evidence of your losses to the PIP insurer and authorize the insurer to obtain such information that is pertinent to the claim.
• Statement: The PIP insurer has the right to obtain your statement under oath. This is called an examination under oath (“EUO”). If the statement is not taken under oath, you are not obligated to give a statement.

Failure to cooperate with the insurance company may result in denial of your claim.

Free Personal Injury Consultation

If you want to talk to Attorney Bob Allison about your claim, you can contact him now for a free consultation by calling 978-740-9433 or filling out our free consultation form. We look forward to talking to you about your Massachusetts personal injury claim.

By Bob Allison ǀ Last updated December 8, 2015

Category:  Car Accident