PIP Coverage Vs. Med Pay in Texas
Written by Greg on April 30, 2020
Personal Injury Protection or PIP coverage is one coverage that we recommend everyone carry on his or her auto insurance policy. While the minimum coverage is usually twenty-five hundred dollars ($2,500), we suggest that you carry at least $5-$10,000 in PIP coverage.
Where PIP comes in handy is when the health insurance coverage you have refuses to pay because it’s a car accident claim, and they say someone else should pay. In effect, the health insurance company often tells their insured’s–go collect from the negligent driver while that doesn’t help someone with a bill collector calling and harassing them for their medical bills.
Many car wreck claims can take months to resolve and even years sometimes. Leaving the medical bills unpaid does not sit that well with many people. That’s where PIP comes to the rescue.
Many primary care physicians also are reluctant to treat victims of car accidents simply because they expect a health insurance company to deny the claim pending the resolution of a car accident lawsuit. Med Pay is similar to PIP but more limited and costs only slightly less. We suggest PIP over Med Pay.
Texas auto insurance will vary in scope and substance from other states. The Texas insurance Commission has valuable resources for learning about car insurance coverage in Texas.
What PIP Covers in Texas
PIP insurance pays for your medical expenses, lost wages, and other expenses if you are injured in an automobile accident. PIP will also cover the same costs for your passengers if a car crash hurts them. In Texas, Personal Injury Protection coverage is required unless you sign a waiver declining the coverage.
Specific Coverage for PIP in Texas:
- Reasonable medical expenses
- Ambulance costs
- Physical therapy
- Funeral expenses
- Lost income because of the crash
- Replacement of family member services for an injury victim.
Personal Injury Protection coverage is very inexpensive and is a mechanism to get some of your medical expenses paid quickly. It has been our experience that many health insurers do not take medical claims given the overreaching by some medical providers and the constant battle over “who pays.” Nevertheless, Personal Injury Protection coverage is excellent coverage to have when you’re in a severe car accident.
Medical Pay Coverage
Medical Payments or Med Pay coverage.
Unlike PIP, Medical Payments (Med Pay) coverage is not mandatory in Texas. Your insurance company does not have to offer you Medical Payment coverage. Medical Payment coverage is more limited than PIP in Texas. The fundamental limitations of Med Pay are:
- Medical pay only pays expenses within one year of the crash
- there is no coverage for chiropractic treatment
- it only reimburses your health insurance deductibles and co-pays if you have health insurance
- It does not cover lost wages.
We recommend that you obtain PIP coverage instead of “medical pay coverage” because the Med Pay coverage asks that you pay them back should you recover from the third party who caused the accident.
In effect, Med Pay coverage simply pays the bills initially and then gets reimbursed out of any personal injury settlement. If you have to pay your insurer back, there’s not a lot of value in merely fronting the money for the medical bills. Personal-injury protection in Texas does not require you to pay back your medical expenses to the car insurance company.
Do you need a Lawyer to Collect PIP or Med Pay?
No, you probably don’t need an attorney to collect PIP or Med Pay coverage. You may, however, want to consider consulting with an attorney if your injuries are more substantial than a typical whiplash-type case. There can be issues such as subrogation, coordination of benefits, and whether or not your insurance carrier gets offset for PIP coverage paid when you are making an uninsured or UIM coverage claim.
Additionally, we have found that many insurance carriers are being obstructive and trying to claim undue offsets on many PIP applications. In such situations, you may need an attorney’s assistance.