Under the Pennsylvania Motor Vehicle Financial Responsibility Law (MVFRL), every car insurance policy issued in this state must provide a minimum of $5,000 of medical bill coverage for auto accident injuries. This coverage is available without regard to fault. In other words, it doesn’t matter who caused the accident. As long as you’re covered under a car insurance policy issued in this state, you can make a PIP claim for medical bills if you’re injured in a car, truck, pedestrian or bike accident.
Example 1: You are driving your own car in downtown Philadelphia and run a red light, causing a car accident. You hurt your neck and need medical treatment.
Example 2. You are driving your friend’s car on I-76 in Montgomery County (you have your own car insurance policy). You are injured in a car accident caused by someone else who veers into your lane and sideswipes you.
In both examples, you would make a PIP claim for at least $5,000 of medical bills (the state minimum) under YOUR OWN car insurance policy. This is how Pennsylvania no-fault insurance works. If you’re injured, you make a claim for medical benefits under your own policy, even if, as in the second example, another person caused the accident.
Personal Injury Protection (PIP) Benefits
Aside from the mandatory state minimum of $5,000 for medical benefits, car insurance companies are required to offer additional PIP benefits, which include:
- additional medical benefits (up to at least $100,000),
- extraordinary medical benefits (over $100,000, up to $1,100,000),
- wage loss (up to at least $2,500/month, to a max of at least $50,000),
- death benefits (up to at least $25,000),
- funeral expenses ($2,500).
These additional PIP benefits, which are also known as First Party Benefits, are optional. So, it’s important to check your most recent car insurance policy to know whether you opted for these benefits.
No-Fault Insurance Ineligibility
No-fault law doesn’t apply to accidents involving:
- motorcycles or other motorized bikes,
- off road vehicles, or
In addition, if you are the owner of a car that’s currently registered in PA and you don’t have car insurance, you’re barred from making any no-fault insurance claims for medical bills. This applies if you mistakenly let your car insurance policy lapse.
What to Do After PIP Exhausts (or You’re Ineligible for PIP)
What happens after the $5,000 minimum amount of PIP benefits runs out, or you’re ineligible because you were injured in a motorcycle accident? Your own private health insurance, Medicaid or Medicare would apply. This means that you’d be responsible for any co-pays or deductibles.
If the accident was caused by someone else, you may have legal rights to recover your financial losses and pain and suffering caused by the injuries. By filing a car accident injury lawsuit in Pennsylvania, you may be able to obtain compensation for:
- medical bills (not paid by PIP),
- lost wages,
- out of pocket expenses, and
- pain and suffering.