Personal Injury Protection (PIP) Coverage

In Washington, all auto insurance carriers are required to offer personal injury protection (PIP) coverage with any auto insurance policy. Although you are allowed to decline PIP coverage, your refusal does not become effective until the insurer obtains a document from you, in writing, stating that you do not want PIP coverage.

PIP covers your medical expenses and wage loss during your recovery. PIP is coverage you obtain through your own insurance policy—not the other driver’s policy. Most PIP policies cover up to $10,000 in medical expenses and $10,000 in lost wages, with some limitations. Some insurers also offer $35,000 PIP policies. Under most policies, there is a three year time limitation on PIP benefits. This means that medical treatment or wage loss occurring more than three years after the crash will not be covered.

PIP is a no-fault benefit, meaning that you are entitled to benefits under your PIP policy regardless of who caused the crash. Even if you caused the crash, you are generally entitled to collect benefits under your PIP policy.

Covered medical expenses include but may not be limited to:

• Doctor’s Bills
• Prescription Medication
• Hospital Bills
• Ambulance
• Physical Therapy (if prescribed by your doctor)
• Massage Therapy (if prescribed by your doctor)
• Imaging (e.g. as x-rays, MRI, CT)
• Medical Devices (e.g. knee scooter, crutches, wheelchair ramp to your home)

To collect PIP benefits, you should set up a PIP claim with your insurer and have your medical providers bill your insurer directly. PIP coverage is considered primary to your health insurance coverage, so your doctors will bill PIP for all accident-related treatment until you have used up all your PIP coverage. At that point, your health insurance would generally start paying. Unlike health insurance, there is no co-pay when treatment is paid through PIP—your PIP insurance pays the whole bill.

Although PIP policies include wage loss coverage, policies are often drafted so it is very difficult to recover much in the way of lost wages through PIP. For example, although a PIP policy may cover up to $10,000 in lost wages, the wage loss benefit may not kick in until 14 days after the crash, after the period when injured parties are most likely to miss work. In addition, PIP policies often limit benefits to $200 per week, which is significantly less than most people earn.

Under some circumstances you will be permitted to “stack” PIP policies. If you are a passenger in another person’s vehicle at the time of a crash, you are entitled to coverage under that person’s PIP policy. After you have exhausted (used up) all the benefits under the driver’s policy, your own PIP policy will kick in on top of that. Similarly, if you are hit by a car as a pedestrian, you are entitled to PIP coverage under the driver’s policy (primary) as well as under your own policy (secondary).

PIP is considered first-party insurance, meaning it results from an insurance agreement you have directly with the insurance company. Accordingly, most policies include language requiring you to cooperate with the insurance company in relation to the PIP claim. If you do not cooperate, the PIP carrier might cut off benefits.

The PIP insurance company also owes you a duty to handle your claim in good faith. If it fails to do so, you may be entitled to additional recovery against the insurance company for its bad faith, violation of the insurance fair conduct act (IFCA), violation of the consumer protection act, breach of contract, and other causes of action.