Christopher Collins 
After a car accident in Massachusetts, you are thrown into a world of forms, insurance calls, and legal terms. One of the first is personal injury protection (PIP) — the no-fault coverage that pays your medical bills and certain lost wages regardless of who caused the crash.
If you want to learn how to handle the matter after the accident, you’ve come to the right place. In this article, we’ll break down the subject in plain English and discuss what PIP covers, how much it pays, and when a Massachusetts car accident lawyer may help.
What Is Personal Injury Protection in Massachusetts?
Personal injury protection coverage is a mandatory part of every auto insurance policy in Massachusetts. The main goal of this insurance coverage is to compensate for some of the immediate monetary losses in case of a collision.
Usually, the main costs that PIP covers are medical expenses and lost wages. It takes some stress off your shoulders during the first days and weeks after the crash while the insurance company investigates the details of the crash and negotiates the final outcome.
PIP is often described as mandatory no-fault coverage, since you can receive it no matter who caused the accident. Besides, it covers more than just the driver and ensures that every person injured in the collision can access up to $8,000 in payouts.
How Does PIP Fit into Massachusetts No-Fault Car Insurance?
PIP is the main component of the no-fault auto insurance coverage mandated by the Massachusetts General Laws (Part 1, Title XIV, Ch. 90, Sec. 34M). According to the law, an injured person uses a layer of their own insurance regardless of their contribution to the accident to cover initial medical expenses and lost wages. This speeds up treatment, reduces stress, and limits small injury claims. However, it does not mean that a victim can’t file and pursue a liability claim aimed at maximum compensation for their losses.
Who Is Covered Under Massachusetts PIP?
According to the insurance law, PIP coverage includes anyone in the vehicle, household members, and even pedestrians and cyclists injured in an accident. You don’t have to be the driver to access the benefits; the coverage applies even if the policyholder was a passenger or other party at the moment the accident occurred.
What Does Massachusetts PIP Coverage Include?
Most car accidents in Massachusetts leave the victims and their families with medical treatment bills and other expenses, and the PIP coverage can compensate for all or part of those costs. To give you a better understanding, our experts compiled an overview of the possible damages and whether personal injury protection covers them:
|
Type of Expenses |
Example |
Paid by PIP |
| Medical expenses | Doctor appointments, prescriptions, and rehabilitation | Yes |
| Lost wages | Time off work due to the injuries sustained in the incident | Yes |
| Replacement services | Childcare, housekeeping | Yes |
| Property damage | Car repairs or any other property losses | No |
Medical Expenses Paid by PIP
PIP in Massachusetts can cover reasonable and necessary medical care, even if you are the one to cause the crash. While the primary coverage limit is $8,000, your health insurance will take over the expenses after the first $2,000.
On average, you can expect the insurance to pay for the following:
Lost Wages and Replacement Services Under PIP Benefits
In many cases, after a car accident, the injured person can’t fulfill their day-to-day activities, including but not limited to doing chores and going to work. That is why PIP coverage pays up to 75% of the victim’s average weekly wage. In addition, you can use this part of the insurance to pay for other people carrying out your daily tasks, such as meal preparation, childcare, yard work, etc.
PIP Limits, Deductibles, and Health Insurance in Massachusetts
The PIP coverage is capped at $8,000 in Massachusetts. That is the maximum amount you can receive in case of an accident per person. However, the coverage you actually receive often depends on the type of deductible you choose. An insurance provider can set different deductible ranges for clients to choose from. They may start at $0 and go up to $8,000.
A deductible is the amount that you pay out of your pocket. In most cases, it affects the monthly premium you will pay. The higher the deductible, the lower the premium.
|
Deductible |
Pros |
Cons |
| $0 | PIP coverage benefits | Higher premiums |
| $2,000 | Lower premium | You have to pay out of your pocket |
| $8,000 | The lowest premium | No real PIP use |
How Does PIP Work with Your Health Insurance?
In most post-accident scenarios, when PIP steps in, it covers the portion of your medical expenses that do not exceed $2,000. After that, your health insurance takes over. However, in case your health plan does not cover a service or is insufficient, personal injury protection will step back in until your bills reach the $8,000 limit. Victims who do not have valid private health insurance can rely on the PIP cap and personal expenses.
Can a PIP Deductible Be Risky?
Yes. A high deductible means that you can save some costs on your monthly premium payments. However, should an accident happen, this approach may leave you without the early coverage that you need. Moreover, health insurers can count the deductible as a ‘phantom’ PIP payment when calculating the final settlement, which can reduce the compensation that an injured party counts on.
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When Can You Step Outside PIP and File a Personal Injury Claim?
Massachusetts is a no-fault state, which means that you are bound to use your PIP coverage first, no matter whether you are the at-fault party or the victim. However, you can file a personal injury claim against the liable party. To do that, you need to meet certain legal thresholds, which mostly revolve around the overall amount of your medical expenses and the severity of your injuries.
Massachusetts No-Fault Thresholds After a Car Accident
The primary reason to move on from PIP to a personal injury claim is the extent of financial expenses. Serious traumas imply costly treatments, and a victim has the right to file a lawsuit once the reasonable medical costs go over $2,000. If you meet the medical bill and/or severe injury threshold, you may want to contact a personal injury lawyer.
Examples of Cases That Go Beyond PIP Benefits
A broken leg may not qualify for a personal injury case, but a fractured wrist that needs reconstruction and lengthy rehabilitation will. The same goes for severe scarring and any long-term disability. PIP does not cover long-term injuries, primarily because they exceed the policy’s limits, but a timely injury claim will help you recover the sustained damages in full.
How to File a Massachusetts PIP Claim After a Car Accident?
After you’ve received medical treatment and reported the collision to the police, you need to notify your health insurance provider. However, you must be careful about what to say to the insurance after an accident. The best course of action is to stick to the facts. When the insurer sends you the PIP claim form, fill it out and send it back to the provider. If you’re unsure, just contact our law firm for a free consultation.
Documents You Need for a Strong PIP Claim
A solid claim is based on strong evidence. That is why you will have to gather and provide the insurance company with as much documented proof as possible. Collect the following documentation to support your PIP claim:
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Police accident report
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Medical records and bills
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Proof of lost wages
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Receipts for replacement services
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Photos of injuries and vehicle damage
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Correspondence with the insurance company
How Can a Massachusetts Personal Injury Lawyer Help Maximize PIP and Get a Larger Compensation?
Even though claiming PIP coverage is your legal right, there may be some tricks and challenges to overcome before you can actually receive what is yours. That is why it is never a bad decision to introduce a skillful attorney to the case from the beginning.
A trained lawyer will help you complete the forms and gather necessary documents to prevent rejections or delays. They will keep track of critical deadlines, including the Massachusetts statute of limitations, and help you transition from a PIP request to a personal injury claim if your case qualifies.
Coordinating Personal Injury Protection Benefits with a Personal Injury Case
Attorneys monitor every dollar PIP pays because it affects the final settlement in a personal injury case. They help manage liens, negotiate medical bills, and make sure you don’t repay more than required. By coordinating PIP with the overall case strategy, a lawyer increases your net recovery and ensures you keep as much of your settlement as possible.
