Understanding PIP in Massachusetts: Coverage and Deductible Risks

Winter driving in Massachusetts comes with challenges: shorter days, icy roads, and heavier holiday travel. With accidents more likely during this season, it’s the perfect time to review your auto insurance policy: especially your Personal Injury Protection (PIP) coverage.

 

Many drivers misunderstand how PIP works, or assume a deductible always saves money. In reality, the wrong deductible choice could leave you more financially exposed after a crash. Let’s break it down.

 

What Is PIP Under Massachusetts Law?

Massachusetts law requires PIP coverage under G.L. c. 90, §§ 34A and 34M. Key points:

• Coverage Amount: $8,000 minimum per person, per accident.
• Applies Regardless of Fault: Even if you caused the accident, PIP applies (with exceptions for DUI, intentional harm, or certain felonies).
• Who’s Covered: The insured driver, household members, passengers, and in some cases, pedestrians.

What PIP Covers

• Medical expenses: Hospital, surgery, X-rays, dental, prosthetics, ambulance, and nursing.
• Lost wages: Up to 75% of your average weekly wage.
• Replacement services: Household tasks you can’t perform due to injury.
• Funeral expenses.
• Two-year limit: Expenses must be incurred within two years of the accident.

Health Insurance Coordination Rule

If you have private health insurance, PIP pays the first $2,000 of medical bills. After that, your health insurance pays (subject to its deductibles/co-pays). PIP may then cover remaining amounts up to the $8,000 cap.

If you don’t have health insurance, PIP pays up to $8,000 directly.

 

Deductibles: Options and Risks

You can choose deductibles ranging from $100 to $8,000. But here’s the risk:

• Deductibles are subtracted from what PIP would otherwise pay.
• Higher deductibles mean more out-of-pocket costs after an accident.
• Premium savings are often minimal compared to the protection you give up.
• Lower PIP coverage also means reduced tort protection, leaving you more financially vulnerable.

Timing and Rights Under the PIP Statute

Insurers must pay benefits once they receive proof (medical bills and records). Payments are due within 30 days. If insurers delay or deny without reason, you (or your medical providers) can sue to enforce benefits.

Common Misconceptions About PIP

• “Fault matters.” False — PIP applies regardless of fault.
• “It covers everything.” False — PIP is capped at $8,000.
• “Deductibles always save money.” False — they often reduce protection more than they reduce premiums.

To Choose PIP Options Wisely, check if your policy has a deductible; consider how your health insurance works with PIP; weigh the risk of higher out-of-pocket costs against small premium savings; revisit your coverage before the winter driving season.

Understanding PIP coverage now can help you avoid costly surprises after an accident. At Ravosa Law Offices, P.C., we can review your policy and coverage, step in if an insurer delays or denies payment and guide you through your rights under Massachusetts law. Call today to review your coverage or get help after an accident, or contact us online.