, PA
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New PIP Law
Given the number of attorney and insurance commercials on television these days, you have probably heard of the terms “PIP” or “no fault” insurance. Both stand for personal injury protection insurance which is mandatory automobile insurance. PIP doesn’t cover motorcycles. PIP pays up to $10,000 for “reasonable” and “medically necessary” expenses resulting from an automobile accident. It will also pay up to $5,000 in death benefits. PIP also pays 60% of lost wages. However, the maximum benefit you can receive is $10,000. If you have purchased automobile insurance, PIP will pay for your medical expenses regardless of who caused the accident. It will also pay medical expenses for your family members who reside with you, for passengers in your car and for anyone struck by your car so long as those persons were not themselves in another car. PIP pays before the at fault driver’s automobile insurance bodily injury coverage.

Significant changes to the PIP statute may affect your rights. First, you must seek medical treatment for injuries resulting from the accident within fourteen days. Failure to do so results in a complete loss of PIP benefits. You can imagine what group was behind this change in the law and it is tough to justify why a person who has been paying premiums for years should lose those benefits simply because he or she was conservative in their treatment. The initial services must be provided by licensed physician, dentist chiropractor, a hospital or EMS personnel. 

Furthermore, to avoid a reduction in benefits, a physician, dentist, physician’s assistant or advanced registered nurse practitioner must determine that you had an “emergency medical condition.” Otherwise, benefits are reduced to $2,500. Please note that a chiropractor is not permitted to determine whether or not an emergency medical condition existed. Again, which lobbying group do you think had a hand in this change? Nevertheless, if your treatment is solely chiropractic you will suffer a reduction in benefits. You will also suffer a loss in benefits if your injuries do not constitute an emergency medical condition. Certain services are excluded altogether. No benefits are paid for massage therapy (even if ordered by a physician). The same is true for acupuncture – no benefits are paid. To ensure my clients receive maximum benefits, I make sure that a physician sees the clients (so that an emergency medical condition can be declared) even if the bulk of the treatment is chiropractic.

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