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Pennsylvania Car Accident Injury Law - Medical Benefits Claims

Under Pennsylvania law, car owners must carry medical coverage to pay for medical bills incurred in a car accident.  The minimum amount drivers must carry is $5,000.  Drivers can elect higher amounts up to $1,000,000. 

Pennsylvania is a no-fault state and that means, regardless of who caused the accident, an injured car accident victim would make a medical benefits claim under her/her own car insurance policy, up to the amount of medical benefit coverage purchased.

However, there are certain car accident situations where there can be more than once source of medical benefits.  Therefore, the injured car accident driver or passenger must make a medical benefits claim pursuant to the order of coverage, also known as “priority of coverage” under Pennsylvania law.  Section 1713(a) of the Pennsylvania Motor Financial Responsibility Act provides:

General rule.--Except as provided in section 1714 (relating to ineligible claimants), a person who suffers injury arising out of the maintenance or use of a motor vehicle shall recover first party benefits against applicable insurance coverage in the following order of priority:

(1) For a named insured, the policy on which he is the named insured.

(2) For an insured, the policy covering the insured.

(3) For the occupants of an insured motor vehicle, the policy on that motor vehicle.

(4) For a person who is not the occupant of a motor vehicle, the policy on any motor vehicle involved in the accident. For the purpose of this paragraph, a parked and unoccupied motor vehicle is not a motor vehicle involved in an accident unless it was parked so as to cause unreasonable risk of injury.

The first level of coverage under section 1713 is an auto policy in which the injured person is a “named insured,” i.e., an auto policy purchased by the injured person. 

The second level is an auto policy in which the injured person is “insured.”  This generally refers to an auto policy purchased by the injured person’s spouse, parent or relative residing in the same household.

The third level applies when the injured person does not own an auto policy and is not covered as an insured under any auto policy.  This third level is an auto policy covering the auto that the injured person was riding in when the accident occurred. 

Finally, the fourth level applies to injured persons who are pedestrians or bicyclists. This fourth level is any auto policy involved in the accident.  In some situations, more than one policy may apply and the first auto insurance policy to get billed will be responsible up to the applicable medical benefits amount.  That insurance company can then seek reimbursement form the other insurance company.

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Help After A Pennsylvania Car Accident

If you were in a car accident in Pennsylvania, you may be confused as to how or where to submit a medical benefits claim.  It is important that you speak to an experienced car accident lawyer who knows Pennsylvania car accident laws.  Feel free to call Daniel O’Brien for a free consultation at 877.944.8396

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