Who pays your medical bills in an Automobile Collision?
- Dan T. Matrafajlo
- Mon May 2020
- Car Accidents,Insurance,
In the State of New Jersey, a motorist involved in an automobile accident is responsible for his/her own medical bills, regardless of fault. In other words, an innocent party who is driving along and gets hit by another car, through no fault of their own, is responsible for his/her own medical bills, which includes the cost of care, co-pays, and deductibles.
The medical coverage selection in an automobile policy is commonly referred to as “Personal Injury Protection” coverage (“PIP” for short).
In the State of New Jersey, the “standard” automobile insurance policy comes with $250,000 in PIP coverage, a $250.00 deductible, and co-insurance or co-pays of 20% of the first $5,000.00 in medical bills, or $1,000.00. Under the standard policy, after the first $5,000.00 in medical bills, the automobile insurance carrier is responsible for 100% of the remaining bills. So, under the standard policy, the total out-of-pocket medical expenses you may be responsible for is $1,250.00.
You are free to choose to get less PIP coverage than is offered under the “standard” policy. Given that we are all responsible for our own medical bills, the type of automobile insurance coverage we select is very important. If you are not sure what you selected for medical coverage review the “Declaration Pages” of your insurance policy which will neatly outline your coverage selection.
There are many PIP coverage options available in New Jersey. You can go from the $250,000 offered under the standard policy to amounts including $150,000, $75,000, $50,000, all the way down to a “basic policy” that provides only $15,000 in medical benefits. For certain drivers with limited incomes, there is a “special policy” that provides only “emergency personal injury protection coverage” up to $250,000 for emergency treatment immediately following an automobile accident.
Although we have the option of selecting personal protection coverage of less than $250,000.00, I strongly recommend a minimum of $250,000.00 in PIP coverage. The difference in cost between a “standard policy” and the lower levels of PIP coverage is minimal, and the benefits of $250k in medical coverage far exceed the slight difference in costs.
HEALTH INSURANCE PRIMARY – DON’T DO IT
We recommend that clients NEVER select a PIP option that places health insurance as the primary source for your medical payments after a collision. Regardless on the type of health insurance you may have, after an automobile accident your health insurance will never provide the same scope of coverage as $250k in PIP coverage.
Time and time again, we have seen clients and potential clients learn to their horror that their workplace health insurance will not permit them to see the kinds of doctors they need to address car accident-related injuries. Even the best health insurance policies can have restrictive networks, and their co-pays and deductibles continue until you hit annual limits that can far exceed PIP limits. The cost savings is not worth the trouble. I advise my clients to use his/her health insurance as secondary insurance to potentially cover co-pays, deductibles, and/or excessive coverage.
If you have been involved in a car or trucking accident, give Dan T. Matrafajlo a call to discuss your medical coverage options, including reporting and/or pre-certification requirements. As always, Dan T. Matrafajlo or associates of Beninato and Matrafajlo Attorneys at Law provides free office, video, and/or telephonic consultations.