PIP Coverage - Some Things to Know

New Jersey is one of many states that have a Personal Injury Protection (PIP) system in place as part of your automobile insurance coverage. The purpose of PIP as part of comprehensive reform was to lower auto insurance premiums, although it has not necessarily worked out that way.

When you purchase a policy of auto insurance, you must choose whether your health insurance carrier (assuming that you have one) or your automobile carrier will be primarily responsible for your medical coverage if you are injured in a car accident.

Do not make this decision lightly.  There are pros and cons to both selections. If you choose your car carrier, you will be offered several levels of coverage from $15,000 per person per accident to $250,000. This coverage comes with a deductible of $250 and a co-pay of 20% on the first $5,000 of bills. This may be better or worse than your health insurance coverage.

While choosing your health insurance carrier as primary will reduce your PIP premium, the trade off is that your health insurance carrier may have a lien on any subsequent lawsuit that you bring against a third party for the injuries that you sustained if your health plan is a self-funded ERISA plan. That means that you would have to pay back your health insurance plan out of any settlement that you might receive. Generally, there is no re-payment obligation to your auto carrier.

Therefore, as the knight said to Indiana Jones in the last of the trilogy when Indiana had to choose the goblet - Choose Wisely!!

Parking lot pedestrian accidents and the related legal issues

I read today on NorthJersey.com about a grandma and her 2 year old granddaughter who were run over by an SUV in a Walmart parking lot. Besides wishing them a speedy recovery, there are some significant legal issues that they need to address:

  1. Who will pay for their medical bills?  Pedestrians involved in car accidents generally have the bills paid by their own car insurance company (PIP coverage) assuming they or a family member with whom they reside owns a vehicle. What happens if there is no household vehicle? NJ has the Unsatisfied Claim and Judgment Fund (UCJF) which can provide medical payments to uninsured pedestrians if they meet certain requirements. One such requirement is that the offending vehicle be registered in NJ.
  2. Can they sue the operator of the SUV for damages other than medical expenses?  Perhaps. NJ has a law that in some circumstances requires the injured party to suffer a serious injury before he/she can sue for pain and suffering. Serious injury is defined as death, dismemberment, loss of a fetus, significant scarring or disfigurement, displaced fracture, or a permanent injury. If either pedestrian is subject to this tort threshold and has not suffered such an injury, they will be precluded from suing.

There are many complicated legal issues involving pedestrian accidents. You should seek legal help to understand your rights.