Auto Insurance Claims Process: PIP Claims

Posted on Oct 25, 2019
Auto Insurance Claims Process: PIP Claims

While not required for drivers in all states, PIP insurance is becoming an essential form of insurance protection for drivers in many states across the country.

Additionally, more states are beginning to require this specialized form of insurance to help drivers manage medical costs and/or funeral expenses associated with injuries arising from accidents for themselves – and, in some cases, for their passengers or even pedestrians.

Whether you are sold on the potential PIP benefits that exist for drivers or not, drivers in New Jersey, New York, and Pennsylvania are required under current laws to have specific minimal PIP insurance coverage. That means you need to understand what the coverage is, how it works, and how to file a claim.

What is PIP Insurance?

Personal Injury Protection, or PIP, claims come into play in a select few states that have “no fault” auto insurance coverage. Among those states are New Jersey, New York, Pennsylvania, and other states. Drivers with this protection can rest assured that their insurance will cover some or all of the medical bills and lost wages associated with an auto accident regardless of who is “at fault” for the accident.

In NJ, PIP applies when the injury takes place while operating or using  private passenger vehicle. So, for example, if you are injured in a taxi or a bus or motorcycle, the PIP coverage on your auto policy will not respond to pay bills associated with treatment or lost wages.

In the state of New Jersey, some PIP insurance is required by law of all drivers. However, for those living in other states that may list PIP as optional insurance protection, there are benefits to having this type of coverage, especially for drivers who frequently carry passengers or who do not, themselves, have great health insurance protection.

The better you understand your policy protection and the PIP claims process, the better prepared you are if you ever need to file a personal injury protection claim.

How Does PIP Work?

When you’re in an accident, you’ll file a PIP claim with your insurer to help you pay for medical bills and recover some of your lost earnings related to the accident.

When this occurs, depending on the laws in your state, your insurer will provide a PIP payment for the medical bills (up to the state limits) and reimburse your lost income – again up to the limits in your state for reimbursement. You will be responsible for medical bills in excess of your state’s limit for PIP coverage.

One of the first things drivers need to understand about PIP claims is that state laws related to them are different than they are for other types of insurance claims. Where drivers can follow the advice of their attorneys in personal injury insurance claims, PIP claims require cooperation with the insurance company.

You may be required by law to do the following in the event of making a PIP claim:

  • Submit a recorded statement.
  • Attend a medical examination by an insurer-approved or selected physician.

Failing to do so is considered serious and might result in the termination of your personal injury protection benefits. 

What Factors Affect a PIP Claim?

Depending on a few factors, your accident may or may not require a Personal Injury Protection claim.

The following can have a significant impact on the type of insurance claim to file:

  • Type of accident
  • Policy details and protections
  • Types of injuries sustained
  • Other healthcare coverage

In some states, personal health insurance, and PIP insurance work in concert with each other. Other states have specific requirements about which insurance offers initial protection and at which point the other type of insurance steps in to fill gaps.

With this in mind, some people choose their PIP insurance coverage after assessing their existing health insurance policies to make wiser choices about which specific PIP policy meets their needs best.

How to File a PIP Claim

Each insurance company will have its unique policy for filing PIP claims. However, some steps in the claims process are fairly standard, regardless of which company provides the insurance coverage.

  1. Report the accident to your insurer. If you work with a local agency, like Otterstedt, we can help with the insurance claims process but need to know as soon as possible after the accident.
  2. Make a statement about the accident. Offer as many details as possible and be accurate about the accident and the injuries sustained.
  3. Keep medical records. This includes treatment details and any information provided about your condition, treatment plans, medications, and future healthcare needs.

Since 1919, Otterstedt Insurance Agency has been serving the insurance needs of drivers in New Jersey and beyond. We understand the continually evolving needs of the people who live, work, and play in the area and can help you meet those needs as they change and grow.

We know the insurance claims process for PIP and more can feel intimidating. Especially at a time when all your energy and attention are focused on healing and recovery. Let us help you through the PIP claims process so you can deal with what matters most at a time like this, getting well.

Contact us today at 201-227-1800.

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