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Pennsylvania Car Accident Law - Priority Of Medical Coverage



Below is a question we received recently about medical expenses after a Pennsylvania car accident.

FAQ: I was injured in a car accident while in my friend’s car as a passenger. I submitted my medical bills to her car insurance company, but they said they don’t pay for them.  Is that true? If so, then who pays for my bills?

The answer to your question depends on a couple of things:

  1. Do you own a car and are insured for that car?
  2. If you do not own a car, do you live with anyone who owns a car?

Pursuant to PA auto accident law, when an insured driver is injured in a car accident, his own insurance company pays for his medical expenses regardless of fault.  When a driver buys car insurance, he has to buy Personal Injury Protection (PIP), which covers medical expenses when an injury arises out of the maintenance or use of a motor vehicle. This is PA’s no-fault system.  The law also provides a priority system to determine the source of PIP.  The coverage follows the insured and not the car.

Car Accident Settlements For Our Clients:

Scenario 1: You are injured in a car accident as a passenger in your friend’s car.  You own a car and are insured under that policy.

In this situation, because you are the named insured on your car, you would file a PIP claim with your own car insurance policy and not your friend’s policy. 

Scenario 2: You are injured in a car accident as a passenger in your friend’s car, but you do not own a car.  You live with your parents and drive their car.

In this situation, you would file a PIP claim with your parents’ car insurance company.  Though you are not the named insured, you are a relative residing in an “insured” home. 

Scenario 3: You are injured in a car accident as a passenger in your friend’s car.  However, you do not own a car, and you do not live with anyone who owns a car. 

In this situation, your medical expenses would be paid by your friend’s car insurance company under your friend’s PIP coverage.

Let’s assume you own a car and you submit your medical bills to your auto insurance company.  If you have the minimum PIP coverage of $5,000, that can be exhausted quickly if you have extensive injuries.  What happens after your PIP exhausts? Does that mean the other driver’s PIP is next in line to cover your medical bills? Unfortunately, the answer is no. 

Pennsylvania law prohibits stacking of PIP benefits.  Therefore, whenever the source of PIP coverage exhausts, then you have to use another form of insurance to pay for medical expenses.  This means if you have private health insurance, then you would use that to pay for medical treatments.  However, most health insurance companies will require your auto insurance company to issue an “exhaustion” letter before it will pay for your medical expenses, i.e., a letter stating that all PIP benefits have been exhausted. 

Most private health insurance policies have deductibles and co-pays.  Depending on the extent of injuries, they can add up fast.  If you pursue a PA car accident lawsuit, you may recover these expenses as part of your damages.

If you would like to discuss your car accident, feel free to call our office and schedule a FREE consultation.  877.944.8396

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