Personal Injury protection (PIP)

 

 

Massachusetts is what is known as a "no-fault" state with regard to car accident injury claims. This insures that everyone gets a basic level of help with their medical bills after an MA car accident regardless of who is at fault, this is known as "no fault".

  

 

PIP provides compensation for up to $8,000.00 for people injured in a motor vehicle accident for three types of out-of-pocket expenses:

 

 

1. Medical bills: PIP covers reasonable and necessary medical expenses incurred within two years of the automobile accident. Itemized medical bills subscribed and sworn to under the pains and penalty of perjury by the attending physician are admissible as evidence of the neccessity and reasonableness of the charges. M.G.L. Chap. 233, Sect.79G. Expert testimony is ordinarily not required to establish necessity of medical services. The Plaintiffs own testimony may be taken into consideration along with the medical bills and records. Scalia v. Liberty Mutual Insurance, 1995 Mass. App. Div.69, 1995 WL 296772.   NH Residence injured in Massachusetts who does not meet the $2,000 PIP threshold is deemed to have been injured by an uninsured tortfeasor and therefore could pursue an uninsured claim. Green Moutain Insurance Co. v. George, 138 N.H. 10, 634 A.2d 1011 (1993).  

 

2. Lost wages: PIP covers 75 percent of lost wages caused by injuries you sustain in the automobile accident. However, if you are eligible for a disability plan at work, you will receive only 75 percent of the difference, if any, between the disability plan and the amount you would otherwise be entitled to under PIP.


 

3. Replacement services: PIP pays for reasonable expenses to pay non-family members to perform services that the injured person would otherwise have performed for the benefit of himself and/or family members of his household.

 

 

PIP also covers pedestrians who are injured in an automobile accident.

 

  

Health Insurance and PIP Claims

 

 If you are injured in an automobile accident and you have health insurance, Massachusetts PIP (personal injury protection)  will pay up to $2,000.00 towards your medical bills. Any remaining medical bills must be submitted to your health insurer, in a timely fashion. You must also coordinate payment of your medical treatment between the health care provider (doctor) and health insurer.  Health insurance only impacts the payment of medical bills in Massachusetts. Massachusetts personal injury protection (PIP) remains available for the payment of lost wages and replacement services until the $8,000.00 in PIP coverage is exhausted. Most people have (Med Pay) in addition to PIP coverage. It is seen in multiples of $5,000. Med Pay coverage only applies to medical expenses and not to lost wages. Also, they must be incurred within 2  years of collision. It covers anyone occupying the insured motor vehicle with consent. It also covers the insured and any household member if occupying someone elsles automobile or if struck as a pedestrian.



PIP reimbursements

Whatever is received in PIP reduces the eventual personal injury recovery. The PIP carrier is entitled to reimbursement from the defendants insurance company. Therefore any settlement offers made by the defendants insurance have already taken into consideration the fact that it must make PIP reimbursement. The defendants insurance Co. only has a duty to pay up to its policy limits, whether it reimburses the PIP carrier or pays the injured party. Therefore, if the defendants insurance company pays the policy limits to the claimant, it is under no duty to reimburse the claimants insurance company for PIP.   


 

Compensation In Automobile Accidents

 

 Massachusetts personal injury protection is limited to $8,000.00 in coverage and does NOT cover compensation for pain and suffering. In order to obtain compensation for pain and suffering, you must show someone was at fault and meet other statutory requirements.

  

In order to pursue a claim for pain and suffering and other damages in a Massachusetts automobile case, your personal injury attorney must prove the following by a preponderance of the evidence (or in other words, after all the evidence is weighed, that the matter is more probably true than not):

  

  • Negligence: That the operator of an automobile failed to exercise reasonable care under the circumstances.

 

  •  Proximate causation:  That the defendant actions were the cause of your injury.

  

  • Damages: These injuries or damages must meet one of the following requirements in order to pursue an automobile personal injury claim for pain and suffering (usually in the amount of 3x's the total medical expenses): 

 

  • You must incur medical expenses in excess of Two Thousand ($2,000.00) Dollars; or
  • Sustain a fracture; or
  • Suffer a hearing impairment; or
  • Suffer from a sight impairment.

 

    Damages for which you may receive compensation in a personal injury claim include: lost wages, medical expenses, pain and suffering, scarring, loss of function, and emotional and mental distress. It is important to note that the $2,000 PIP threshold is so important, concerns arise as to whether the expenses are reasonable and neccessary. In order to prove necessity, the Plaintiff must show "that medical treatment rendered was a bona fide effort to alleviate and amerliorate the injury",  not that the treatment was an absolute necessity. Victum v. Martin, 367 Mass. 404, 407, 326 N.E.2d 12, 15 (1975); Pietroforte v. Yellow Cab of Somerville, Inc. 19 Mass. App.961,963, 473 N.E. 2d 1148, 1150 (1985).

  

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CONTACT AN EXPERT PERSONAL INJURY ATTORNEY


At the Law Offices of Michael R. St. Louis, we are fully prepared to handle your personal injury case. As a leading Boston personal injury law firm, we can provide you with the direction and legal counsel you need to win your case. Call our Law Offices today for your free consultation at 781-816-3950 or contact us online.

 

 
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