Personal injury protection coverage, commonly referred to as “PIP coverage,” is no-fault insurance coverage governed by Massachusetts law to benefit you and certain other people who are injured or killed in a motor vehicle accident. Pursuant to Massachusetts General Laws Chapter 90, Sections 34A and 34M, PIP coverage provides injury victims with a payment of up to $8,000 for medical expenses, lost wages and replacement services.
Each of these out-of-pocket expenses should be examined separately. Medical expenses include “reasonable and necessary” medical expenses that are incurred within two years of the accident. In wrongful death cases, funeral costs fall under this category of out of pocket expenses.
Next is lost wages. PIP will cover 75% of lost wages for a person who is unable to continue working in light of an accident. Conversely, for injured persons who were not working at the time of the accident, PIP will cover 75% of lost earning potential.
Finally, PIP provides coverage for replacement services. Replacement services are those services that an injured person would have completed on his or her own had he or she not been injured in an accident. PIP covers the cost the injured person must incur to hire outside servicers to complete this work.
If you or a loved one has been injured in an accident, PIP coverage will pay only the first $2,000 in medical expenses if you have private health insurance. The remaining $6,000 allowed under PIP can be allocated to other out-of-pocket losses as necessary, and normally will be used to pay for expenses not otherwise covered by health insurance, in addition to lost wages and replacement services. For example, PIP coverage can be used to cover copayments and deductibles.
If you have been injured in an accident, regardless of who was at fault, your PIP claim will usually be made against the insurer of the vehicle that you were occupying at the time of the accident. For pedestrians, the claim would fall against the insurer of the vehicle involved in the accident.
People eligible for PIP include: any persons occupying your vehicle with consent; any pedestrian struck by your vehicle in Massachusetts; you and anyone living in your household if occupying another vehicle not covered by PIP; you or anyone living in your household if struck by a vehicle not covered by PIP; or a Massachusetts resident who is struck by your vehicle outside of Massachusetts.
