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Does PA First Party Or PIP Benefits Offer Benefits Other Than Medical Benefits?

Pursuant to Pennsylvania's Motor Vehicle Financial Responsibility Law (MVFRL), insured drivers/passengers' medical expenses related to car, truck and other automobile accidents are paid by first-party or PIP benefits coverage in their motor vehicle insurance policies. 

Related PA PIP Benefits Articles:

What most insured drivers/passengers do not know is that PIP benefits also include benefits other than medical benefits.  However, unlike medical benefits which are mandatory with a minimum of $5,000, other PIP benefits are not mandatory.

Section 1715 of the MVFRL provides:

(a)  General rule.--An insurer shall make available for purchase first party benefits as follows:

(1)  For medical benefits, up to at least $100,000.

(1.1)  For extraordinary medical benefits, from $100,000 to $1,100,000, which may be offered in increments of $100,000, as limited by subsection (d).

(2)  For income loss benefits, up to at least $2,500 per month up to a maximum benefit of at least $50,000.

(3)  For accidental death benefits, up to at least $25,000.

(4)  For funeral benefits, $2,500.

(5)  For combination of benefits enumerated in paragraphs (1), (2), (3) and (4) and subject to a limit on the accidental death benefit of up to $25,000 and a limit on the funeral benefit of $2,500, up to at least $177,500 of benefits in the aggregate or benefits payable up to three years from the date of the accident, whichever occurs first, provided that nothing contained in this subsection shall be construed to limit, reduce, modify or change the provisions of subsection (d).

The remainder of this article will discuss optional medical benefits and income loss benefits.

Medical Benefits

Though the minimum medical benefits drivers are required to have is $5,000, they may choose to purchase an amount higher than $5,000.

It is important to note the MVFRL also defines what types of medical treatments are covered.  Medical treatments and rehabilitative services must be reasonable and necessary.  These may include:

  • hospital stays,
  • dental procedures,
  • surgeries,
  • psychiatric services,
  • physical therapy, or
  • medications.

Income Benefits

Injured insureds who purchase income loss benefits may recover lost wages if they are not able to work after a motor vehicle accident.  However, there are limitations as to what injured insureds can recover under the law. 

The MVFRL defines what types of income benefits are covered:

  • Income loss benefits cover 80% of actual loss of gross income.
  • Reasonable expenses actually incurred for hiring a substitute to perform self-employment services thereby mitigating loss of gross income or for hiring special help thereby enabling a person to work and mitigate loss of gross income.
  • Income loss does not include loss of expected income for any period following the death of an individual or expenses incurred for services performed following a person's death.
  • Income loss shall not commence until five working days have been lost after the date of the accident.

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