What Personal Injury Protection Covers (and What It Doesn’t)

If you’ve been injured in a car accident in New York, your first resort may be to your Personal Injury Protection (PIP) insurance. PIP is a key component of New York’s no-fault insurance system, designed to ensure that accident victims receive prompt medical treatment and financial support regardless of who was at fault. However, PIP coverage has its limits, and understanding what it does and does not cover is crucial for protecting your rights and financial well-being after an accident.

Learn about PIP coverage below, and if you or a loved one has been hurt in a car accident in Orange County or the Hudson Valley, contact Dupée & Monroe, P.C., to speak with an experienced and successful Goshen car accident lawyer.

What Personal Injury Protection Covers

Personal Injury Protection is intended to provide immediate financial assistance to individuals injured in auto accidents, covering a variety of essential expenses. One of its primary benefits is coverage for medical expenses, including hospital visits, doctor’s appointments, surgeries, rehabilitation, and prescription medications. This coverage ensures that accident victims receive necessary treatment without waiting for a liability determination.

PIP also covers lost wages if the injuries sustained in the accident prevent the victim from working. In New York, PIP typically reimburses 80% of lost earnings, up to a maximum of $2,000 per month, for up to three years following the accident. This can be a crucial lifeline for individuals whose injuries temporarily or permanently impact their ability to earn an income.

Another significant aspect of PIP coverage is reimbursement for essential services. If the injured person is unable to perform daily household tasks, such as cleaning, cooking, or childcare, PIP may cover the cost of hiring someone to assist with these duties. In New York, the standard benefit for essential services is up to $25 per day.

In the unfortunate event that an accident results in death, PIP provides a death benefit to the deceased’s surviving family members. This benefit includes a lump sum payment, which helps cover funeral and burial expenses, as well as additional financial support for dependents.

What Personal Injury Protection Does Not Cover

While PIP provides vital assistance, it does not cover all expenses related to an accident. One major limitation is that it does not compensate for pain and suffering or other non-economic damages. If you sustain serious injuries that result in long-term pain, emotional distress, or diminished quality of life, you will need to file a lawsuit against the at-fault party to seek additional compensation.

PIP also has limits on the total amount of coverage available. The standard minimum PIP coverage in New York is $50,000 per person. While this may be sufficient for minor to moderate injuries, severe injuries can quickly exceed this limit, leaving victims responsible for remaining medical bills and other costs. Additional supplemental insurance, such as bodily injury liability coverage or underinsured motorist coverage, may be necessary to fill these gaps.

Another key exclusion is property damage. PIP does not cover repairs or replacement of your vehicle or any other damaged property. Instead, property damage claims must be filed through your collision coverage or against the at-fault driver’s liability insurance.

Additionally, PIP coverage generally does not apply in situations involving intentional injuries, injuries sustained while committing a crime, or accidents that occur while driving under the influence of drugs or alcohol. If an insurer determines that an accident falls under one of these exclusions, they may deny PIP benefits altogether.

When to Seek Additional Compensation

If your medical expenses, lost wages, and other damages exceed the limits of your PIP coverage, you may be able to pursue additional compensation through a personal injury lawsuit. In New York, accident victims can step outside the no-fault system and file a claim against the at-fault driver if they suffer a “serious injury,” as defined by state law. Serious injuries include death, dismemberment, significant disfigurement, bone fracture, loss of a fetus, permanent loss or consequential limitation of a body organ or function, or any medically determined injury resulting in substantial disability for at least 90 days during the first 180 days after the crash.

Filing a lawsuit allows accident victims to seek damages for pain and suffering, emotional distress, and long-term disability, which are not covered by PIP. However, proving liability in a personal injury case requires thorough evidence, including medical records, accident reports, witness statements, and expert testimony. This evidence must be presented in a persuasive manner by someone skilled and knowledgeable about New York car accidents and personal injury law. An experienced personal injury attorney can help build a strong case and fight for the maximum compensation available, whether through a negotiated settlement or courtroom litigation,

How Dupée & Monroe, P.C. Can Help

Understanding the application and limitations of Personal Injury Protection after an accident can be difficult and confusing for the average accident victim, especially considering they are busy dealing with painful and stressful injuries at the time. At Dupée & Monroe, P.C., we have extensive experience representing accident victims in Orange County and the Hudson Valley. We can help you understand your PIP coverage, assist with serious injury claims, and explore additional legal avenues to secure the compensation you deserve.

If you or a loved one has been injured in a car accident in Goshen or surrounding areas, don’t settle for less than what you’re entitled to. Contact our firm today for a free consultation and let us help you move forward with confidence.