This was written to help explain personal injury protection benefits, also known as No-Fault or PIP benefits, for Utah automobile insurance policies.
The purpose of this article is to help Utah residents understand what it is they are buying when they purchase automobile insurance. When a Utah automobile driver buys automobile insurance, at bare minimum, she or he must purchase two components, commonly known as liability coverage and Person Injury Protection (also known as No-Fault coverage). This article focuses on the Personal Injury Protection coverage. I should note that Personal Injury Protection is not available for semi-trucks or motorcycles.
In Utah, Personal Injury Protection coverage, usually referred to as PIP, is a required component of automobile insurance. This coverage covers the driver and any passengers in a vehicle, when an accident occurs. At minimum, PIP provides to each injured passenger the following benefits:
1. Up to $3,000.00 toward necessary medical bills, resulting from injuries sustained in an automobile accident, generally paid directly to the medical providers, or sometimes reimbursed to you;
2. Up to 85% of your wages lost, because you are unable to work due to injuries sustained in an automobile accident, but only up to a maximum of $250.00 per week.;
3. Up to $20 per day to reimburse you, if you need to pay out money to someone to help you do your normal daily activities, but are unable to do so, as a result of injuries sustained in the automobile accident.
4. If there is a death involved in the automobile accident, the PIP also will pay $1,500 towards funeral expenses and a $3,000.00 survivor benefit to the decedent’s heir.
These benefits are also called “No-Fault” benefits, as your insurance company must pay these benefits, up to the limits, regardless of who caused the accident.
These benefits are not very large, but they do help when you are injured and begin to incur medical bills, and may not be able to work for a while. What many insurance agents fail to tell their clients is that some of these coverages can be increased, and the resulting increase in premium cost is usually very small. There are some insurance companies that offer up to $100,000.00 towards medical bills, rather than $3,000.00. I purchase the maximum offered under my insurance policy for the medical bill coverage, which is $10,000.00 per person. I recommend everyone increase the medical payment coverage on your policy to at least $5,000.00, especially if you lack health insurance.
As with any insurance benefit, there are other limitations involved. Under the payment for medical bill, PIP will not usually pay 100% of any given medical bill. PIP insurance companies are only required to pay an amount listed in the Utah payment schedule. This payment schedule is created every other year, using the average that medical providers bill for any given medical procedure, then reduced by 25%. The injured person is then responsible to the medical providers for the difference. Another general rule regarding PIP medical benefit payments is that they must be for medical bills incurred within three years from the accident date (and of course, must be directly related or caused by the automobile accident). The lost wage benefit will pay lost wages, up to the maximum weekly benefit amount, for up to 52 weeks.
Your PIP insurance carrier has 30 days to pay any given benefit after having received adequate proof of the claim. If the PIP carrier does not pay within the 30 days, you, as the insured person being entitled to the benefits, are allowed to file a law suit against your insurance company. If you win your suit, you are entitled to interest on the amount owed of 1 ½ percent per month after the amount became past due, and attorney’s fees if you use an attorney to recover the money.
This is only a general overview of PIP benefits. There are too many other details involved to include in this article. This article is not meant as legal advice for your specific situation, and does not create an attorney – client relationship.