In Washington, all drivers need to hold a minimum amount of liability coverage. But that amount doesn’t protect you from out-of-pocket costs related to your own injuries or property losses. Having Personal Injury Protection (PIP) gives you coverage for medical expenses, wage loss/time loss and other costs. Learn more about how to navigate the aftermath of a car collision, including making claims through PIP policies, protecting your rights, and ensuring you receive all due compensation. We also answer questions like “Is PIP required in Washington state?” and “What is a PIP claim?” and many more items in this blog post.
What is PIP insurance? Personal injury protection policies cover up front medical expenses for either you as the driver or any of your passengers on a no fault basis meaning that whether you were at fault for the collision or the victim of someone else’s negligence, each individual in your car has access to their own PIP policy. Policy amounts vary but most consumers/clients have a $10,000 policy if it was elected on their declaration page prior to the collision, meaning it can’t be elected after the collision has taken place.
In some cases, an injured party can use the PIP for an at fault vehicle too. Pedestrian vs vehicle, bicycle vs. vehicle are two situations where the driver of a different vehicle extends PIP medical benefits to an injured party. However, if this is a traditional vehicle vs. vehicle collision, the only PIP that would be available to an injured party is the PIP benefits (if any) of the driver of the same vehicle one is riding or a claimant’s own PIP policy (if he/she had it elected prior to the collision)
While PIP isn’t required in Washington State it’s highly recommended for some of the situations which follow in this blog post.
Different areas of auto insurance are very tightly defined. Before you next renew your insurance, it’s important to review your policy and understand what is and is not covered. Personal injury protection coverage applies to you and your passengers. The primary expenses it covers can include:
Your PIP policy will have maximum payout amounts as a total cap or within specific categories. You can work with your insurance provider to raise or lower these amounts based on your personal risk tolerance.
However, there are some areas that a PIP generally won’t cover. These include:
Your insurance provider may also deny your claims if you have PIP insurance but were using your car in a professional context during the incident, such as ride-sharing or handling deliveries.
The basic process for filing a claim under PIP insurance is simple. You can report the incident to your insurer, gather all required or recommended documentation, and submit the claim. Your insurance provider will investigate the claim and provide payment based on the results of their investigation.
While the process itself is simple, it’s also easy to make a mistake. You might accidentally leave out details or expenses, describe the incident in unclear terms, or agree to a payout that is only a fraction of the costs. Some insurance providers are motivated to reduce their expenses, which means minimizing the payout you get under your plan.
Having a lawyer on your side can help you protect your rights and get fair compensation. Your attorney can notify the insurance company on your behalf, provide evidence, and handle conversations about the incident, expenses, and what you’re owed. Legal teams with experience in insurance have a more comprehensive understanding of what to do in the aftermath of an accident, the laws surrounding claims and payouts, and what should be covered under your policy. Especially if you’re injured or overwhelmed after an accident, your attorney can help you quickly navigate the process.
PIP Wage Loss/Time Loss Explained
The maximum amount of wage loss/time loss you are permitted to recover is directly related to whether one has a $10,000 PIP medical maximum or $35,000 PIP medical maximum. In my experience, 9 consumers out of 10 elect a $10,000 PIP maximum which generally covers most collision related claims. Obviously, if there’s extensive diagnostic testing or an overnight stay in the hospital, $10,000 goes really fast. However, for wage loss/time loss purposes, PIP will only pay an injured party 200.00 a week for a 10K PIP policy and 350.00 a week for a 35K PIP policy once the injured party has missed the first two weeks of work following the collision/injury. In addition, the maximum your insurance company will pay is no more than what is elected on the medical side (i.e. 10K or 35K).
It’s also important to know PIP medical and PIP wage loss/time loss are separate meaning your insurance company does not aggregate the total medical/wage loss payments and cut you off at 10K. Theoretically, an injured claimant could exhaust their PIP medical payments of 10K and their wage loss/time loss benefit of 10K too. However, when it comes to wage loss/time loss, your insurance company will only pay you during the weeks you miss work meaning the day you return to work a claimant can only get 200 for each week of missed work multiplied by the number of weeks missed from work (after the 2 week grace period has been satisfied). Lastly, a doctor’s note is essential to receive this benefit too. Your insurance company is not going to ‘take your word for it’ so seeing a doctor and making sure the reason for missed work is related to your injury is critical to get paid this benefit.
The Relationship Between PIP & Health Insurance
There is a hierarchy of payments to providers where PIP is always primary and Health Insurance is always secondary. An injured party could have access to two different PIP policies before health insurance begins to pay. If one is injured as a pedestrian, bicyclist or as a passenger in someone else’s vehicle, one may receive the other driver’s PIP benefits followed by your own PIP benefits before health insurance steps in as the third payment option. However, it’s incredibly important to have an attorney navigate this relationship as there is paperwork that acts as the ‘baton getting passed’ from one PIP to another or from one PIP to health insurance. All of these insurance entities want to make it incredibly difficult to pay your bills. A penny saved is a penny earned in their mind even though at some point they will have to pay. However, delaying payment and frustrating consumers/clients is what these entities do best. The bottom line is don’t try to do this on your own and call Feldman & Lee PS to help you out.
Do My PIP Benefits Ever Expire?
The simple answer is yes. This concept is known as the statute of limitations In the State of Washington, a claimant has 3 years to submit bills to their PIP carrier for payment. While the bills don’t necessarily have to be submitted in the three year time frame (i.e. the bills could be submitted outside of the 3 years) the treatment or bill itself cannot have a date for service beyond the 3 year statute of limitations. Consequently, it is incredibly important to use PIP during the time frame related to the injury during the three years it is available. Receiving treatment outside of the 3 year period of time is fine, but it’s likely to be covered by one’s personal health insurance policy but not by PIP.
Do I Need To Repay PIP At The End of My Personal Injury Case?
Another simple answer, yes. PIP is a no-fault medical benefit that, should you receive any portion of a settlement, you agree, under the insurance contract, to repay them the amount PIP paid for your medical bills. However, in Washington State, by virtue of retaining an attorney, you are permitted to repay them 1/3 less than the required amount if you have an attorney representing you. Without getting too complicated, in the same an attorney and client work on a 1/3 (for the attorney) and 2/3 (for the client) contingency agreement, PIP agrees to also work on the same 1/3 and 2/3 platform where the client will retain the 1/3 that should have gone back to the insurance cases. For example, if the client maxes out their PIP benefits of 10K, and he/she represents themselves receiving a settlement in any amount, he/she is required by law to repay PIP $10,000.00 for the PIP benefits extended to them. However, if one has an attorney, the same client would only have to repay PIP $6,666.66 leaving the $3,333.33 in their own pocket at the end of the case. This is a significant savings to the injured client trying to recover which is why an attorney at Feldman & Lee, PS can help navigate these complicated legal/insurance issues.
You don’t have to file PIP claims and manage the aftermath of an accident alone. At Feldman & Lee PS, we’re here to help people get fair compensation and feel safe after an auto accident. Contact us today to schedule a free consultation and decide what to do next.
Image Credit: New Africa // Shutterstock
A DUI charge in Washington state can have a lasting impact on your career. A…
A motorcycle crash is stressful and scary, but knowing what to do after a motorcycle…
Restraining orders don't always require a major criminal infraction to justify the order. In Washington,…
When you're facing domestic violence charges, your first priority needs to be creating a strong…
A spinal cord injury can have life-changing consequences. They can have extensive and serious implications…
A Traumatic Brain Injury (TBI) is damage to the brain caused by an external force,…