Personal Injury Protection (PIP)
PIP, or Personal Injury Protection, is a form of auto insurance that is mandatory for New York drivers.
PIP is not liability insurance since New York is a “no-fault” auto insurance state.
Instead, it covers you for your own losses in a traffic accident, no matter who is at fault.
Table of Contents
What Does PIP Cover?
The minimum amount of PIP insurance you can purchase is $50,000 per person, per accident.
This coverage includes you, your passengers, and any pedestrian involved in the accident.
- Medical bills,
- Psychiatric services;
- Lost earnings (up to $2,000 per month or 80% of your lost earnings, whichever is less, for up to 3 years);
- Up to $25 per day for daily tasks, such as child care and housework, that you can no longer perform.
- $2,000 for funeral and burial expenses if you die from the accident.
Remember, all of these benefits are subject to maximum per-person coverage limits.
What PIP Doesn’t Cover
PIP does not cover every loss arising from a car accident. You are generally not liable for losses that PIP doesn’t cover, even if the accident was your fault.
- Property damage to your vehicle or to someone else’s vehicle;
- The other drivers’ injuries, even if the accident was your fault;
- Any injuries from an accident that occurred while you were committing a crime, and
- Injuries in an accident that occurred while you were being paid to drive (Uber, DoorDash, etc.).
In most of the foregoing cases, other forms of insurance will cover these losses.
How Do You Get PIP Benefits?
PIP benefits don’t come automatically—you have to file for them. Below is a brief description of the rules.
The following deadlines apply:
- Medical expenses: Within 45 days after you start treatment, you must submit written proof to the insurance company. Your healthcare provider should be able to provide you with appropriate documentation.
- Lost earnings: You must submit your written proof of lost earnings within 90 days of the accident.
- Independent Medical Exam: The insurance company may or may not require you to submit to an IME.
Do not ignore these deadlines, or you could forfeit your claim.
Independent Medical Exams
Your insurance company might demand that you undergo an Independent Medical Exam (IME) with a physician of their choice. If you refuse, your insurance company might deny your claim. In this situation, you would need to take your claim to arbitration and win before collecting on your claim.
You will need to include the following paperwork in your claim:
- Form NF-2, Application for No-Fault Benefits.
- Form NF-3, a form submitted by your healthcare provider detailing the medical treatment they provided you.
- Form AOB, Assignment of Benefits form: The AOB form diverts insurance payments from you to your healthcare provider. It also relieves you of liability for any treatment that your insurer refuses to cover.
Check with the New York state government to find out if any new forms are required or if the state has re-issued any of the old ones.
How Much Does PIP Cost?
The cost of PIP insurance varies from person to person based on the following factors::
- Your location within the state of New York;
- The amount of your deductible;
- The total amount of your coverage;
- Your age; and
- Your driving history.
You might also want to add in other forms of insurance, such as Optional Basic Economic Loss (OBEL) insurance.
Can You Still File a Lawsuit Against the At-Fault Driver?
Normally, you can’t file a lawsuit against the other driver, even if you can prove they were at fault. That would defeat the purpose of no-fault insurance, which is to keep traffic accident claims from clogging the courts. Nevertheless, you can opt out of New York’s no-fault system if you suffered a “serious injury.”
Under Section 5102(d) of New York’s insurance law, a “serious injury” means:
- Any injury resulting in death,
- Loss of a fetus,
- Loss of a limb, serious disfigurement, or a bone fracture;
- A permanent or significant limitation on your use of an organ, function, or system of your body; or
- An injury that causes you “significant disability” for 90 days or more.
If you meet the “serious injury” threshold, you usually have three years from the date of the accident to file a personal injury lawsuit. Certain exceptions apply to this three-year deadline.
Schedule a Free Initial Consultation With a Car Accident Lawyer
In minor accidents, PIP coverage can be straightforward. In more serious cases, you might not understand what you are entitled to or whether you are liable for someone else’s injuries. Since most personal injury lawyers offer a free initial consultation, why not take advantage? Most personal injury attorneys will charge you zero in legal fees unless they win your case.