Insurance law is one of the most important fields of law. For example, the terms and condition of your car insurance policy dictate how much your insurance will cover in case of an accident.
New Jersey's personal injury protection (“PIP”) laws govern medical injury recovery in the case of a car accident. The attorneys at Kim & Feliz, LLC have experience helping victims with PIP claims.
Insurance Requirements in New Jersey
To legally drive on the roads of New Jersey, you must have at least a bare minimum of car insurance. This requirement is meant to ensure that damages are paid and victims are compensated, should you ever cause a car accident. The minimums in our state are:
- $15,000 in bodily injury and death coverage, per person
- $30,000 in bodily injury and death coverage, per accident
- $5,000 of coverage for property damage, per accident
Driving with less than these amounts of coverage means you can face a penalty if you cannot prove that you have adequate insurance. These penalties include:
- Fines of more than $300
- License suspension
- Surcharges on your insurance, when you do get it
In addition to these three kinds of insurance minimums, you also have to maintain personal injury protection, as well.
NJ Personal Injury Protection Insurance
PIP insurance covers the insured in the case of a motor vehicle accident. New Jersey is a “No-Fault” State which means your PIP carrier will cover eligible medical expenses regardless of who is at fault.
Because of this, while the minimum PIP policy requirement is $15,000, many drivers in the state recognize that healthcare costs in America are exorbitant and so elect to purchase a policy with a higher limit. A higher PIP option provides the finances to pay for medical care needed to recover from severe injuries. Many drivers offset the additional costs that come with these higher limitations by choosing higher deductibles, as well, or by using PIP as a secondary insurance provider, behind their health insurance. While you have to carry PIP coverage in order to drive legally in New Jersey, there is a lot of flexibility in the coverage that allows you to get the kind of coverage you feel you need to offset your worries about being in a car crash.
What PIP Covers in New Jersey
A crucial aspect of PIP coverage is the fact that it does not insure against all kinds of injuries or damages that you can suffer in an accident. Instead, it only covers the following:
- Medical expenses
- Lost wages
- Living expenses during your recovery
- Death benefits.
It is important to note that PIP coverage only disburses until it reaches the limit on your policy. If you have New Jersey's minimum policy amount of $15,000, but your medical expenses cost you $45,000, PIP will only pay for the first $15,000 in medical expenses.
Medical Expenses Covered by PIP in New Jersey
PIP coverage will pay for the cost of medically necessary treatment to causally related injuries arising from a motor vehicle accident. These services may include:
- Ambulance services
- X-Rays, MRIs, and CT scans
- Surgical costs
- Bills for hospital stays
- Follow up appointments at a doctor's office
- Rehabilitation and physical therapy sessions.
PIP's Coverage of Lost Wages
If your injuries in a car accident held you out of work and prevented you from earning an income while you recovered, PIP can also come in to fill in the gaps for you. However, the amount that your PIP coverage will pay for the wages you lost depends largely on the terms of your policy. For example, minimum PIP insurance policies of only $15,000 only pay around $100 per week in lost wage funds. The highest policies, on the other hand, can pay for more than $5,000 per week. Importantly, though, PIP will only never pay out more in lost wages than your normal income, before the crash. If you were making $780 per week at the time of the accident, even if you have the most valuable PIP policy that can go up to $5,000 per week in coverage for your lost income, you will still only receive $780.
Living Expenses During Your Recovery
PIP coverage also includes payments for basic tasks that you might not be able to do while you recover. If you have to pay someone else to perform daily activities like:
- House maintenance or lawn mowing
You can be reimbursed with PIP money up to $12 per day, or $4,380 for the term of your disability, whichever is less.
Death Benefits from PIP
If the accident was a fatal one, PIP will contribute up to $1,000 for funeral expenses. The exact amount, though, depends on the policy.
Additionally, if the victim was his or her family's income provider, PIP will issue death benefits to the victim's family. These are equal to the maximum benefits that would have been received by the victim, had they survived the crash. Death benefits are normally paid to the surviving spouse of the victim, though they can also be paid to any surviving children or the victim's estate if there is no surviving spouse.
PIP Coverage Can Impact Your Right to Sue in New Jersey
One of the bigger decisions that you will have to make when you decide which PIP policy to select is whether to take the full tort option or the limited tort option. Which one you choose will determine your legal rights, should you ever be hurt in a car accident that was caused by another driver.
Full Tort PIP Insurance
If you choose full tort PIP insurance, you will retain your unlimited right to sue someone after they cause an accident and hurt you or damage your car. In cases where you were the victim in a car crash and have full tort PIP coverage, you can file a lawsuit against the negligent driver and recover damages for additional compensation that is not covered by your policy, such as:
- Pain and suffering
- Loss of reputation
- Loss of enjoyment of life
- Loss of consortium with your family
However, there is a cost to retaining the right to recover for all of your damages sustained in the car crash: Your PIP insurance premium will be higher than if you choose the other coverage option, limited tort.
Limited Tort PIP Insurance
Limited tort PIP insurance is a cheaper option than full tort coverage, but you sign away your right to pursue noneconomic damages in a lawsuit stemming from a car accident. Therefore, if you get hurt in a car crash in New Jersey and the other driver was at fault, if you chose limited tort PIP coverage, you will only be allowed to recover for your:
- Past and future medical expenses
- Lost income and earning capacity
- Property damage
You will not be able to pursue compensation for the pain and suffering that you have been put through, by the other driver's negligence, and will not be able to recover the mental and emotional difficulty that the crash has put your family through. These are not insignificant amounts, in many car accident cases. In many of the worst car crashes, pain and suffering compensation accounts for the bulk of the recovery amount.
However, there are exceptions to this rule. If you have limited tort, you can still recover noneconomic damages in the following circumstances:
- You suffered a significant disfigurement
- You lost a body part
- You suffered a displaced fracture
- The injuries were fatal
- You lost a fetus in the crash
- The injuries you have suffered are permanently debilitating
In these instances, you will be able to pursue compensation for your pain and suffering, as well as for your family's loss of consortium.
New Jersey PIP Coverage and Your Health Insurance
PIP insurance pays for your medical expenses after you're injured in a car accident – something that usually falls within the realm of your health insurance. Therefore, if you get hurt in a car accident in New Jersey, an important issue that gets raised is whether your PIP coverage or your health insurance will pay for your medical bills.
When you select a PIP policy in New Jersey, one of the decisions you will have to make is whether your PIP insurance or your health insurance will be your primary source of coverage in a car accident, and which will be your secondary source. Whichever insurance is your primary source will have to be exhausted, before your secondary source will contribute anything for your medical expenses.
This decision can be difficult, and will likely involve lots of factors, including:
- Deductibles on both policies
- Lifetime limits on each insurance policy
- The amount you save on PIP premium by designating your health insurance primary
In some cases, it can be wise to consult with a personal injury attorney to decide which one is the best option for your unique situation.
Filing PIP Claims in Fort Lee NJ
Initiating the PIP claim process as soon as possible after a car crash is essential, as you can lose coverage if you delay. For example, if you get treated at a hospital, bills should be sent to your insurance company putting them on notice that you are utilizing PIP coverage.
Dragging your feet with the paperwork can have disastrous effects. If you delay notifying your PIP provider for an extended amount of time, they may try and disclaim your coverage.
PIP Personal Injury Attorneys in Fort Lee, New Jersey
Insurance issues like these can make your eyes glaze over. Worse, policies are often meant to be misunderstood in ways that make it seem like you do not have coverage when you really do. Plowing through the legalese and jargon of an insurance policy can be an uphill battle even for the most sophisticated and educated among us.
Having a personal injury lawyer from the law office of Kim & Feliz, LLC can make a huge difference. If you are considering what kind of PIP coverage to buy, whether it is wise to change your insurance now that life's circumstances have changed, or want to know if your PIP insurance will cover the injuries you have suffered in a car accident, having legal help to turn to is critical. Reach out to Kim & Feliz, LLC by contacting us online or at (201) 585-2250 so we can help you understand your rights and plan the best course of action.