Both policy holders and medical providers may be able to file a PIP lawsuit if they were harmed by a denied claim.

What is PIP Insurance?

Personal Injury Protection (PIP) insurance is a part of automotive insurance that provides coverage for medical expenses. Fault does not matter when it comes to PIP insurance, instead, it aims to cover any medical expenses that may result from an auto accident.

Even if the covered driver is not injured in the accident, PIP insurance can cover expenses related to injuries sustained by passengers in the vehicle.

PIP can cover a variety of expenses related to a car accident injury, including:

• Medical expenses (medical treatment, surgery, dental treatment, optometric treatment, ambulance costs, nursing services, medical supplies, prescriptions, prosthetic devices, and more);
• Lost wages (if injuries cause a driver or passenger to be unable to work);
• Substitute services (cleaning expenses, etc. if injuries cause a driver or passenger to be unable to complete household tasks);
• Funeral expenses (if car accident injuries result in death).

Benefits from PIP insurance will typically vary from state to state. For example, PIP insurance in Florida reportedly provides 80 percent coverage of medical bills and 60 percent coverage of lost wages, for up to $10,000 of benefits. Benefits will also vary depending on individual plans and providers.

What is a PIP Lawsuit?

If you have filed a PIP claim that was not wrongfully denied, you may be able to take legal action through a PIP lawsuit. Typically PIP lawsuits are appropriate for policyholders who have attempted to appeal a decision and have exhausted all other administrative avenues.

PIP lawsuits could help policyholders secure the benefits they believe they are owed under their policy along with other potential benefits such as damages, court costs, and interest.

A PIP lawsuit may also be an option for healthcare providers who haven’t been paid by their patients’ PIP provider due to a denied or underpaid claim. Insurance companies may argue that they have paid a reasonable amount on the bill or make errors such as misapplying a deductible, resulting in underpaid or completely unpaid bills.

If medical providers feel like they are being taken advantage of by insurance providers because a claim is denied or underpaid, they may be able to take legal action.

For PIP lawsuits filed by healthcare providers, recovery could help secure payment for bills you believe should be covered. Experienced attorneys can also help review old files to make sure that providers have been completely paid on past bills.

The process can reportedly help recover compensation owed to medical providers and may even result in tens of thousands of dollars in “found” money as claims are correctly paid.

Even if you do not want to file a personal injury protection complaint, consulting with an experienced attorney can help you in the appeal and negotiation process. These qualified legal professionals are well versed in the requirements of PIP insurance claims and can help you assemble the documentation and support needed to successfully appeal a claim.

This article is not legal advice. It is presented
for informational purposes only.