What No-Fault Insurance Covers in New Jersey

If you are injured in a car accident in New Jersey, you may be eligible for no-fault insurance coverage for medical treatment, lost wages and other damages provided by applicable Personal Injury Protection insurance.

Personal Injury Protection (PIP)

pip insurance njOn a basic level, PIP is no-fault insurance coverage for medical treatment that is provided under your own automobile insurance policy. This means that, subject to your coverage limits, PIP will cover all or a portion of your medical expenses if you are injured in a car accident, no matter who is at fault or responsible for the accident.

While PIP primarily covers bills for emergency services and medical treatment, you may be able to obtain additional PIP coverages when purchasing your auto insurance policy. Additional PIP coverages may include coverage for lost wages and home services.

Policy holders select the level of PIP medical coverage they want when purchasing the policy, starting at $15,000, up to a maximum of $250,000. If you are injured and must look to your PIP insurance coverage, your medical bills are generally only covered up to the limit you chose when you bought your policy. Thus, given the high cost of medical services today, it is typically advisable for policyholders to opt for the maximum medical benefits coverage of $250,000. You will also be responsible for a 20% co-pay on up to $5,000 of medical expenses after the chosen policy deductible is paid.

PIP as Secondary Insurance

If you have your own private health insurance, you may be able to waive PIP coverage and designate your private health plan as the primary insurance for medical treatment in the event of an auto accident. This, however, is not always the best option as health insurance plans may have specific provisions limiting coverage, and will often assert a lien on the injured person’s recovery in a personal injury lawsuit to recoup all or a portion of the monies expended for plaintiff’s care and treatment.

Using your Coverage

If you are injured in an auto accident, in addition to contacting a personal injury lawyer, you should contact your insurance company and request a PIP application. Fill it out completely and submit it to your insurance company in order to obtain the benefit of the coverage you pay for. Pre-authorization may be required for certain non-emergency services, and you will have to treat with medical professionals selected by your insurance company. If any dispute as to necessary treatment arises during the course of treatment, you may be able to appeal or arbitrate the dispute with the insurance company. Because of the inherent tension between the injured plaintiff who needs treatment, and the insurance company that is losing money the longer it provides benefits to the plaintiff, it is always advisable to consult with an experienced personal injury lawyer immediately after an accident to ensure that your treatment regiment is properly handled.

The Bergen County car accident lawyers at The Reinartz Law Firm help clients secure the “no-fault” medical coverage that they are entitled to after a New Jersey car accident. If you have been involved in an accident and have questions regarding your rights, please call for a free and confidential consultation.