This is Seattle Personal Injury Attorney Matt Dubin. In a recent post, the topic of personal injury protection, or PIP coverage, was covered in detail. PIP is a component of your auto insurance coverage that you can purchase, which pays for all reasonable and necessary accident-related medical bills for injuries sustained in a car accident, regardless of whose fault the accident was.
Some people have suggested that if you have good health insurance, you do not need to pay for PIP coverage with your auto insurance. That is simply not true. Here are several important reasons why you need PIP coverage, even if you have very good health insurance.
1. No Out-of-Pocket Expenses
With most health insurance plans, you have copays and deductibles, which can be pretty significant expenses, especially when you are possibly missing work due to injuries sustained in the accident. With PIP coverage, there are no out-of-pocket expenses. As long as the treatment is reasonable, necessary, and accident-related, it is covered one hundred percent.
2. No Network Restrictions
Another advantage of PIP coverage over health insurance is that there are no network restrictions. More and more, health insurance policies limit you to doctors within a participating network. With PIP coverage, you can see whatever specialists you need, even if they are not in your health insurance network.
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3. No Referral Requirement
With most health insurance plans today, you need a referral to see any kind of specialist. But you probably already know what kind of specialist you need to see. With PIP coverage, as long as the treatment is reasonable and necessary, your coverage will pay for it, whether you have a referral or not.
4. You Get to Keep More of Your Settlement
Perhaps the most important benefit of PIP coverage comes down to how much money from your settlement you actually get to keep.
Under Washington State law, when you make a recovery from the person who caused the accident or from their insurance, that recovery includes all of your medical bills, whether they have been paid or not. Out of that settlement, you are required to pay back your health insurance, your PIP coverage, or whoever else paid the bills.
Washington law also states that if the insurance benefits from the attorney’s work, they should share in the cost of hiring that attorney. This ultimately reduces the amount of the attorney fee you need to pay out of your recovery.
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However, more and more health insurance policies today are organized under federal law, which exempts them from state law requirements. This means they cannot be forced to share in the cost of hiring an attorney, which ultimately means less money in your pocket.
In a case with $30,000 in medical bills, which is all too common, this difference could result in an additional $10,000 in your pocket simply from having PIP coverage instead of relying solely on health insurance.
Frequently Asked Questions (FAQ)
Q: What is PIP coverage?
A: PIP stands for Personal Injury Protection. It is a component of your auto insurance that pays for all reasonable and necessary accident-related medical bills for injuries sustained in a car accident, regardless of who was at fault.
Q: Do I need PIP coverage if I already have health insurance?
A: Yes. Even with good health insurance, PIP coverage offers significant advantages including no out-of-pocket expenses, no network restrictions, no referral requirements, and better financial outcomes in a settlement.
Q: Does PIP coverage have a deductible or copay?
A: No. As long as the treatment is reasonable, necessary, and accident-related, PIP coverage pays one hundred percent with no out-of-pocket costs to you.
Q: Can I see any doctor or specialist with PIP coverage?
A: Yes. PIP coverage has no network restrictions, meaning you can see any specialist you need, even if they are outside your health insurance network.
Q: Do I need a referral to see a specialist under PIP coverage?
A: No. PIP coverage does not require a referral. As long as the care is reasonable and necessary, it is covered.
Q: How does PIP coverage affect my settlement amount?
A: Under Washington State law, health insurance companies organized under federal law are not required to share in the cost of your attorney. PIP coverage, however, is subject to state law and must share in those costs, which means more money stays in your pocket after a settlement.
Q: How much extra does PIP coverage cost?
A: PIP coverage only costs a little bit more per month on your auto insurance policy, making it a highly cost-effective form of protection.
Q: How do I add PIP coverage to my auto insurance?
A: Call your insurance agent or insurance company directly and ask to add personal injury protection, or PIP coverage, to your existing policy.
Conclusion
No out-of-pocket expenses, no network restrictions, no referral requirement, and you get to keep more of the money you recover from the person who caused the accident. No matter what kind of health insurance you have, PIP coverage is a smart and necessary addition to your auto insurance policy.
Check your auto insurance right now. Call your agent or your insurance company and make sure you have personal injury protection, or PIP coverage. If you do not have it, get it. It only costs a little bit more each month, and you will be glad you did if you are ever injured in an accident.
If you have any questions regarding auto insurance coverage, personal injury claims, or anything else, do not hesitate to reach out. We would love to hear from you.
