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PA Car Accident & Insurance Law - Who Is Eligible To Receive PIP Or Medical Benefits?

After car, truck or bus accidents in Pennsylvania cities such as Philadelphia, Bensalem or Norristown, injured drivers and passengers need medical attention.  Regardless of who caused the accidents, the injured drivers/passengers' own car insurance policies pay for the medical treatments related to the accidents.  Like New Jersey, Pennsylvania is a no-fault state, i.e., fault is not a factor in determining who pays medical expenses.  Therefore, even if injured drivers/passengers did not cause the car accidents, their own automobile insurance policies pay for medical expenses.

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There are situations where injured drivers/passengers do not have their own auto insurance policies.   They may be driving their spouses or parents' vehicles with their permission, or they may simply be passengers when the accidents happened.  Who pays for their medical expenses resulting from the accidents?  This PA car accident legal article will address who is eligible to receive PIP benefits in different situations.

In general, an "insured" under an automobile insurance policy is eligible to receive PIP benefits.  The question then becomes, what is an "insured?"

Title 75 Pa. C.S. Section 1702 defines an "insured" as any of the following:

(1) An individual identified by name as an insured in a policy of motor vehicle liability insurance.

(2) If residing in the household of the named insured:

(i) a spouse or other relative of the named insured; or

(ii) a minor in the custody of either the named insured or relative of the named insured.

Spouse/Relative Living In The Same Household

Pursuant to PA law, a spouse or other relative residing in the same household of the named insured on a car insurance policy is eligible to receive PIP benefits if he/she is injured in a car accident. For example, a wife driving her husband's car can receive PIP benefits even though she is not the named insured. 

Relatives such as parents or children who frequently visit the insured's home are not considered relatives who live in the same household.  Pennsylvania case law provides that the term "residence" is a matter of physical fact and not intention. 

For example, a mother who often visits her grown children, i.e., every weekend, and has her own home is not an "insured" pursuant to her children's car insurance policies because she does not live in their homes.  However, there are situations where someone may have 2 residences.  A common example involves a child with divorced parents.  The child may be covered as an "insured" under both of his parents' policies in different households. 

Help Determining PA Auto Insurance Coverage

Pennsylvania automobile insurance and accident laws are very complex.  If you were injured in a PA car accident, call Daniel J. O'Brien to schedule a FREE consultation.  You want to make sure that you recover all of the benefits available to you. 877.944.8396


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