How Does Personal Injury Protection Work?

What is Personal Injury Protection (PIP) Insurance?

Personal Injury Protection (PIP) insurance is a type of insurance that is required in all no-fault states. These states include Delaware, Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, Pennsylvania, Utah, North Dakota, and Oregon. In Utah, PIP insurance covers all passengers in a vehicle (including the driver), pedestrians, and bicyclists regardless of fault. Each state will set its own minimum requirements for personal injury protection insurance. In Utah, the minimum is $3,000. However, this limit can be exceeded quickly, especially if you received ambulatory services, or visited the E.R. following your accident. PIP can cover medical costs, replace lost wages, and provide death benefits (though the latter may vary state to state).

How Do I Access my PIP Benefits?

Following an auto accident, you should receive a PIP application from your insurance company. You will receive this application in the mail, or in your email. Typically, your adjuster will call you to ask your preference. If you have an attorney they can help you fill out this paperwork, or they can fill out this paperwork for you.

The application will ask for your contact information, social security number, details of your accident, and details of your recent medical history. The application will ask for your social security for Medicare reporting purposes. Supposedly, you don’t have to provide your social security number if you are not receiving Medicare coverage. Instead, you may provide your insurance company with a handwritten letter stating you are not a Medicare recipient. However, if you do not want to, or cannot provide a social security number, you should consult with an attorney

Medical History Release Forms

 You will also receive a medical history release authorization form. This form will allow the insurance company to view your medical records prior to your accident. Typically they will look about five years into your medical history. However, you can alter the dates of medical history that your insurance company can access. They only need to see the history relevant to your auto accident. An attorney can also help you adjust these dates to prevent unnecessary reductions in your insurance settlement.

After an auto accident, you will receive a claim number. This number will give you access to your PIP if you live in a no-fault state. When you receive medical treatment, give the provider your claim number. They will then forward the bills to your insurance. If you do not have your claim number at the time you receive medical treatment, get it to the provider as soon as possible. Until then, you may need to provide your health insurance details.

What Will PIP Cover in Utah?

In Utah, the minimum PIP policy limit is $3,000 in medical expenses per person; which can cover medical treatment, surgery, prosthetic devices, ambulance transport, rehabilitation expenses, hospital costs, dental services, and diagnostic testing

Utah PIP also provides death benefits in case a fatality occurs from the accident. It can provide at minimum $3,000 to the decedent’s dependents, and $1,500 in burial costs per decedent (this can also include cremation and various other funeral expenses).

Personal injury protection insurance can also provide compensation for lost wages if you can prove that you were unable to work due to your injuries; a doctor’s note is considered sufficient evidence. Utah PIP will cover 85% of lost income or $250 a week, whichever is lower for up to 52 weeks. It can also cover services meant to replace those that the injured person might have provided to their household prior to the accident; up to $20 a day for 365 days. These services may include tasks such as home maintenance, lawn care, laundry service, cooking, etc.

What Happens if I Exceed my PIP Limits?

If you have exceeded, or think you are going to exceed your PIP policy, you should strongly consider hiring an attorney. They can prevent you from having to front the costs of the rest of your care by entering into lien agreements, and/or issuing a letter of protection. A lien is an agreement facilitated by your attorney with your medical provider. It promises them repayment for their services after your claim has settled. Similarly, a letter of protection will prevent your medical bills from going to collections and will stop any legal action from being taken against you by those financially involved in your case for the duration thereof.

Your attorney can also help you file a personal injury lawsuit if you have met your state’s tort threshold limit. In Utah, you can meet this requirement if: your medical expenses exceed $3,000; the death of a passenger occurred; and/or you sustained a permanent disability, impairment, or disfigurement. If you meet any of these requirements you can pursue the at-fault driver to cover the remainder of your medical treatment.

What If I Don’t Hire an Attorney?

If you choose not to hire an attorney, you have a few options after your PIP limits have been exceeded. Firstly, you must understand that after your PIP runs out you will be responsible for fronting the cost of your medical treatment until you receive compensation from the at-fault’s insurance.

You can use your health insurance to help you cover the cost of your remaining medical treatment. However, you will have to pay the co-pays and/or deductibles associated with your policy. Once your case settles, your health insurance can claim a portion of your settlement equal to the amount of coverage they provided for your medical treatment.

You can work out payment plans with your medical providers. Some providers may be willing to work with you and set up a payment plan. However, you may have to find alternate care providers as not all will work with you on a deferred payment basis.

You can pay out of pocket for your medical care, and then request compensation for these costs in your insurance settlement.  

Finally, you can rely on other policies within your auto insurance. For example, if you have purchased underinsured/uninsured motorist coverage, you may use this policy to continue to front the costs of your medical treatment until you are properly compensated by the at-fault party

Were you or someone you know involved in a recent auto accident? Call Auto Accident Care Network now at 801-683-1948 to be connected with a live care advocate. Our team at AACN can connect you to trusted attorneys and doctors to schedule a free legal consultation, a free thirty-minute massage, and a no-cost medical exam

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