Everything You Need to Know About Personal Injury Protection (PIP)

Everything You Need to Know About Personal Injury Protection (PIP)

Steven Schwartzapfel -Founding Partner Jul 8, 2022

For more than 35 years, Steven Schwartzapfel, the founding member of Schwartzapfel Lawyers P.C., has been one of New York’s most prominent personal injury attorneys. Steve represents clients in all types of personal injury cases. His experience, skill, and dedication have enabled Schwartzapfel Lawyers P.C. to recover hundreds of millions of dollars for their clients.

Every New York driver needs to carry a certain amount of personal injury protection insurance (PIP). This critical coverage helps you pay for medical bills and other expenses in the event you are injured in an auto crash, regardless of who is at fault. Since New York is a no-fault state, each driver’s PIP policy is designed to cover their respective medical and accident-related bills.

But what if your PIP coverage runs out? Can it? And how do you know what personal injury protection covers? We’ll answer these questions and more in our in-depth exploration of personal injury protection insurance. Alternatively, to learn more and determine whether you should sue an at-fault driver for additional compensation, contact Schwartzapfel Lawyers today at 1-800-966-4999.

What Is Personal Injury Protection Coverage?

Personal injury protection coverage is a core component of New York car insurance policies. PIP pays for medical bills, essential services, lost wages, and other essential expenses for you and any passengers in your vehicle, no matter who was at fault for the crash.

PIP is part of New York’s broader no-fault insurance policies. New York became a no-fault state in large part to limit how many lawsuits are filed in the state. It was the view of the legislature that, while lawsuits are often necessary and justified, many car accidents are not significant enough to warrant legal action.

To reduce the number of unnecessary lawsuits being filed, New York then implemented a series of no-fault insurance laws. As a result, for most auto accidents in the Empire State, you can’t sue an at-fault driver, nor can you be sued if you are an at-fault driver. Instead, both drivers’ insurance policies foot the bills for medical expenses, property damage, and the like.

How Does Personal Injury Protection Insurance Work?

Imagine you’re involved in a New York auto accident. You have a legal New York car insurance policy, so personal injury protection is included by default.

If you’re injured due to this accident, your PIP coverage will pay your medical expenses up to your policy limit. So if you have $25,000 of personal injury protection coverage, $25,000 worth of your medical bills will be covered by that insurance policy.

Even if you’re found liable for another party’s damages, your PIP coverage will still pay for your damages. Additionally, it will cover those damages first. This is done regardless of who is at fault, as assigning fault is largely immaterial in the context of NYS PIP claims.

However, if the other party undoubtedly caused the crash, then the other driver’s liability coverage should cover your medical bills, as well as deductibles and limits from your health insurance. Significantly, in this type of scenario, PIP coverage can still play an important role in recovering monetary compensation. And when flipped to a scenario in which you are at fault, the payer-recoveree relationship would reverse.

In addition to immediate medical bills and lost wages, PIP insurance partially covers essential services such as household responsibilities that you can no longer complete because of your auto crash injuries (e.g., laundry, cleaning, yardwork).

Here’s an example from the other side:

  • You and another driver are involved in an auto crash. You are technically at fault.
  • Your PIP coverage pays for your injuries up to the policy limit.
  • The other driver’s PIP insurance then covers their injuries until your fault is confirmed.
  • At this point, your liability coverage kicks in to pay for the other driver’s medical costs, if any remain. Note: Liability coverage is not the same as your PIP coverage.

To learn more about PIP coverage, liability insurance, and your options, call Schwartzapfel Lawyers now at 1-800-966-4999. In one call, we can set you up with a free consultation and/or case evaluation!

What Does Personal Injury Protection Cover?

Personal injury protection covers three broad categories of damages: medical costs, economic losses, and death benefits. PIP can also cover expenses like house cleaning and child care when you are recovering from injuries due to a motor vehicle collision.

Medical Costs

PIP covers medical payments originating from a car accident that a policyholder goes through. PIP medical payment coverage limits include but are not limited to:

  • Necessary medical services
  • Dental services
  • Hospital expenses, including ambulance services
  • Surgical expenses
  • Both physical and psychiatric rehabilitation costs (i.e., costs for personal therapy or mental health therapy)
  • Diagnostic services such as X-rays
  • Additional treatment expenses in accordance with your religion

Put simply, PIP insurance covers your medical bills so that you don’t have to pay for them out of pocket.

Economic Losses

Personal injury protection insurance also covers accident-related economic losses. These can include lost wages of up to $2,000 per month or up to 80% of your total monthly earnings, depending on which is less. Note: This coverage only kicks in if you aren’t able to work due to your injuries. It’s also only available for up to three years after the accident date and your policy limit.

As an example, if you typically earn $5,000 a month, you can receive $2,000 per month of lost wages. Alternatively, if you earn $1,200 a month, you would instead receive $960.

On top of that, personal injury reduction coverage includes $25 per day so that you can take care of routine activities like laundry, home maintenance, and more. But again, this is only available if you aren’t able to do these activities because of your auto crash injuries.

Death Benefits

Lastly, when an insured driver dies from accident-related injuries, PIP coverage will provide up to $2,000 to their estate . This money can then be used to help pay for funeral expenses and/or burial costs.

Does Another Driver’s PIP Coverage Pay for Your Medical Bills?

Another driver’s PIP coverage won’t pay for your medical bills, but their liability coverage might. If the other driver was found to be at fault for the auto crash in question, and your PIP coverage is not enough to pay for medical bills, their liability coverage (as well as your own) could be used to recover financially.

This, however, only applies if the other driver was partially or mostly at fault for the crash, not if no one is truly at fault.

What If They Were Uninsured or Underinsured?

If the other driver was uninsured or underinsured, your legally necessary uninsured motorist coverage will provide you with compensation (more on that below). Note: While New York State does not require you to purchase underinsured motorist coverage, it is usually wise to make sure you have your insurance bases covered.

Is Personal Injury Protection Required in New York?

Personal injury protection is required in New York State, as are various other elements of full auto insurance coverage. This is because New York is a no-fault state. Outside of the Empire State, PIP coverage is also required in Arkansas, Delaware, Maryland, Kansas, Michigan, Florida, Oregon, Massachusetts, Kentucky, New Jersey, and several other states.

The minimum auto insurance coverage amounts for New York drivers are as follows:

  • $50,000 of personal injury protection coverage
  • $25,000 of bodily injury liability per person in an accident
  • $50,000 of bodily injury liability per accident
  • $10,000 of property damage liability per accident
  • $25,000 of statutory uninsured motorist bodily injury coverage per person
  • $50,000 of statutory uninsured motorist bodily injury coverage per accident

In short: To drive in New York, you are legally required to carry $50,000 of PIP coverage. Also, you should remember that this coverage limits how much your insurance policy will pay for medical and other accident-related bills after an auto crash.

Therefore, it is often worth considering insurance policies with higher limits. Because, while your monthly premium may increase, this kind of coverage will provide you with more peace of mind given the cost of many medical procedures.

For more on policy limits, speak with a Schwartzapfel Lawyers auto accident expert directly. Simply dial 1-800-966-4999 and allow us the honor and privilege of helping you find the policy that is right for you and your loved ones.

When Should You File a Personal Injury Protection Claim?

Personal injury protection coverage only applies if you file a claim on time. Generally, you have 45 days after the beginning of your medical treatments to submit proof to your insurance company and start receiving benefits.

For lost earnings, however, you have up to 90 days to submit written proof in order to recover that portion of your PIP benefits. In the event that you are unable to write or find it otherwise difficult to file a personal injury protection claim, your lawyers can take care of this for you. Schwartzapfel Lawyers can help you file a PIP claim, beginning with a free case evaluation when you call today at 1-800-966-4999.

Note, too, that the faster you submit your PIP claim, the faster you can receive payouts from your insurance company. This is significant, as your insurance company has up to 30 days to pay you after receiving a PIP claim or to ask for proof for more details of your injuries or medical costs. Also, you should understand that that informing your insurance company promptly lowers the likelihood of them trying to deny coverage.

Can You Sue the At-Fault Driver Anyway?

Although New York is a no-fault state, that doesn’t mean lawsuits are completely off the table. Remember, the point of the no-fault insurance system is to reduce the number of frivolous lawsuits the courts have to churn through each month.

However, New York State law still allows for certain circumstances in which you can sue an at-fault driver or another negligent party. To sue an at-fault driver or party:

  • Your injuries must be especially severe or debilitating. Serious injuries are typically defined as death, dismemberment, permanent loss of the use of a limb or organ, the loss of a fetus, or the permanent impairment of the function of a limb or organ.
  • Your medical expenses are so high that there’s no way your insurance coverage can reasonably provide financial stability. As well, if the at-fault party is financially well-off, you may be allowed to file a lawsuit to recover monetary compensation.
  • The at-fault party was grossly negligent or malicious, in which case you may be allowed to file a civil lawsuit.

It can be difficult to determine whether a person is permanently impaired or can’t perform daily tasks from a legal perspective. Generally, if you want to sue an at-fault driver because of your injuries, you will have to provide medical proof and/or expert testimony from a doctor attesting to the severity of your injuries.

How Can Auto Accident Attorneys Assist Throughout This Process?

Auto accident attorneys can help you through the lawsuit process by:

  • Determining whether you have grounds for a lawsuit in the first place. Even though you were involved in the accident, it can still be difficult to know whether a lawsuit is a wise idea or if you are likely to recover compensation from the at-fault party;
  • Informing you of how much you may recover damages. Note, however, that this is never an exact science;
  • Offering sound counsel throughout the legal process, from beginning to end;
  • Gathering evidence to bolster your claim, such as eyewitness accounts and traffic camera footage;
  • Filing claims with your insurance provider;
  • And more!

Given these benefits, you should always contact an auto accident attorney right away. After being medically stabilized, contact your attorneys and review your options with them.

The more experienced a law firm is, the likelier it is that they will be able to successfully handle your case. That’s why you should call Schwartzapfel Lawyers today at 1-800-966-4999 for a free case evaluation by one of our tried-and-true trial attorneys.

Contact Schwartzapfel Lawyers Today

While personal injury protection coverage is an important part of your auto insurance policy, it doesn’t always pay for all your medical bills, nor does it typically cover property damages like the cost of repairing or replacing your vehicle.

If you need to recover additional damages after an auto accident, Schwartzapfel Lawyers can help. As experienced New York City auto accident attorneys, we will work with you to mount a successful lawsuit against any at-fault driver(s) or organization(s). Additionally, we can defend you if you are being accused of causing the accident-related injuries of another.

Contact us today online or at 1-800-966-4999 for a free case evaluation and more!


Schwartzapfel Lawyers, P.C. | Fighting For You

Personal Injury Protection (PIP) Definition | Investopedia

Minimum Auto Insurance Requirements | Department of Financial Services

New York Car Accident Laws | Nolo

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