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Personal Injury Protection Benefits Under No Fault Auto Insurance

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New Jersey requires each driver to have an auto insurance policy with “personal injury protection” or “PIP” benefits. As part of New Jersey’s no-fault auto insurance legislation enacted in 1972, the Legislature required all auto insurance policies to provide “personal injury protection” or “PIP” benefits.
What is Personal Injury Protection?

PIP was designed to reduce litigation and bring down insurance rates by providing that a driver’s own insurance policy will pay medical expenses for the insured’s own injuries sustained in auto accidents regardless of fault. Standard PIP policies provide up to $250,000 of medical coverage, plus limited benefits for income continuation, essential services, and death benefits. Coverage may be increased for additional fees.

If you are injured in an accident you must notify your insurance company to begin receiving benefits.

What benefits does Personal Injury Protection provide?

A PIP policy will typically pay all reasonable hospital, medical, and related expenses incurred for treatment of injuries sustained in an accident. Typically, PIP benefits will pay for doctors, chiropractors, dentists, psychologists, therapists, and skilled nurses.
You will still be required to pay some medical bills because most insurance policies contain a deductible. The deductible can range anywhere form $250 up to $1,000. In addition, PIP is only responsible for eighty percent of your medical bills for the first $5,000. You are responsible for the remaining twenty percent of the medical bill. PIP will then pay for all remaining medical bills in excess of $5,000 up to the policy limit.

You will still be required to pay some medical bills because most insurance policies contain a deductible. The deductible can range anywhere form $250 up to $1,000. In addition, PIP is only responsible for eighty percent of your medical bills for the first $5,000. You are responsible for the remaining twenty percent of the medical bill. PIP will then pay for all remaining medical bills in excess of $5,000 up to the policy limit.

A PIP policy can also pay for lost wages for a minimum of fifty-two weeks in the amount of $100 or more per week. However, an insured can increase the amount paid and the length of pay by increasing this benefit in the insured’s policy for an increased premium.
Under New Jersey law, a PIP policy can also provide reimbursement for payment made to others to perform tasks that you are now unable to perform. Benefits can range from housework, child care, food shopping, or food preparation. The extent of these benefits will be determined by the policy you purchased.

A PIP policy can also pay up to $1,000, in funeral bills incurred as a result of an auto accident and continuation of benefits/essential services benefits up to a maximum of $10,000.

What do I do when my car insurance wants to send me to a doctor?

New Jersey law allows an insurance company that provides PIP benefits the opportunity to have its insured examined by a doctor of the insurance company’s choice to determine if the insurance company should continue paying PIP benefits. You have a duty to cooperate with your insurance company and get examined.

The examining doctor may find that additional treatment will not cure the injury sustained and therefore opine that you do not need further treatment. At that point the insurance company will notify you that it will not pay for any further treatment. You do not have accept such a determination. Our attorneys can help you challenge these types of decision through binding arbitration under the American Arbitration Association or by filling a law suit in the Superior Court.

Trying to resolve all of these complicated matters when you or a family member are injured in an automobile accident can difficult and overwhelming. Our experienced New Jersey personal injury attorneys regularly represent people involved automobile accidents. To learn more about what we can do to help, please e-mail us or contact one of New Jersey lawyers at (973) 890-0004.