Hundreds of car accidents happen every day in Philadelphia and the surrounding counties, like Delaware and Montgomery counties. When serious accidents happen, injured drivers, passengers and pedestrians will need medical treatment, and in some cases, severe injuries result in lost wages. For example, a driver in Philadelphia is hit at an intersection and suffers a serious shoulder injury and a fracture in her dominant, right arm. As a result, she is out of work for 3 months due to surgeries and physical therapy. Her medical bills add up to $50,000, and her lost wages add up to $12,000.
PIP Claims for Medical Bills & Lost Wages
Every car insurance policy issued in this state is required to provide a specific type of coverage known as PIP (Personal Injury Protection). This coverage kicks in when an insured (or family member) is injured in an accident.
There are different types of PIP benefits available:
- medical bills,
- home help costs,
- lost wages, and
- funeral benefits.
Under PA law, PIP MUST cover medical bills, but PIP is optional for all other types of coverage, like lost wages. Insurance companies are required to at least offer the other types of PIP benefits. Some people opt out of PIP coverage for lost wages or funeral expenses and only get basic PIP coverage for medical treatment. PA law requires a minimum of $5,000 of PIP coverage for medical bills, although many PA residents choose higher PIP coverage amounts.
PIP is available regardless of fault. If you’re injured and need medical treatment, you’re eligible for PIP benefits on your own policy, regardless of whose fault the accident was.
Looking at the above example, who pays for the $50,000+ medical bills and her lost earnings of $12,000? The answer depends on who caused it and the types and amounts of auto insurance coverages at play.
You Caused the Accident
Let’s say that the driver caused the accident by running a red light. Accordingly, she is limited in her ability to seek compensation. Her own auto policy would be the sole source of any benefits. Her PIP coverage would kick in and cover the medical bills, up to the amount she purchased. If she bought $5,000 of PIP, then she’s maxed at $5,000. If she bought $10,000 of PIP, then she’s maxed at $10,000. She may be able to receive some of the $12,000 in lost wages if her PIP coverage allows for it. PIP claims for lost wages only provide a percentage of the loss, and there are other limitations, like a 5 day waiting period. In addition to, or in lieu of PIP for lost wages, the individual in this example could seek coverage under any applicable short or long term disability plans.
Someone Else Caused the Accident
Using the same example above, let’s say another driver caused the accident. The person in our example could still make a PIP claim for the $50,000 of medical bills, subject to her PIP coverage limits (i.e., the amount of coverage she bought). The same thing goes for the $12,000 of lost wages.
However, because another driver caused the accident, our injured driver can seek compensation from the at-fault party. What the injured driver can obtain depends on a very complex law known as limited tort. Learn more about limited tort law in Pennsylvania. Assuming our injured driver gets over the limited tort law, she could seek financial compensation for:
- all medical bills and lost wages that weren’t otherwise covered by PIP,
- out of pocket expenses, and
- pain and suffering.
In some cases, an injured driver can make a Pennsylvania UIM/UM (underinsured/uninsured motorist) claim against their own car insurance company. This claim kicks in when the other, at-fault driver didn’t have enough of their own car insurance to provide compensation for the injured person (underinsured) or didn’t have any coverage at all (uninsured).
Although UIM/UM coverage is optional in Pennsylvania, it’s one of the most important car insurance coverages available. Unfortunately, many PA residents opt out.
Philadelphia Car Accident & Injury Law Firm – Top Rated by Super Lawyers
Call Namerow Law for a FREE CONSULTATION. We’ve recovered max car insurance policy amounts for clients injured in car, truck and pedestrian accidents. Firm partner Jordan Namerow is a Top Rated Personal Injury Lawyer. (215) 985-0777