By now if you have dutifully slogged through the first two chapters of Laurel Lawyer on Maryland Automobile Insurance, you know how Bodily Injury Liability Coverage and Uninsured Motorists Bodily Injury Coverage work. If you haven't you probably should in order to provide context for this discussion. Most people seek insurance coverage advice from Clark and Steinhorn after their car or truck crash when it is too late.
P.I.P. coverage or Personal Injury Protection is a unique benefit under Maryland insurance law as it is a true "no-fault" coverage. For the most part, accident victims only care about bodily injury coverage or uninsured motorist coverage when they are not at fault under Maryland's antiquated contributory negligence system. (For more on this go to:http://www.maryland-law.com/blog/of-brain-injuries-and-public-policy--thoughts-on-bj-s-wholesale-club--inc--v-rosen.cfm)
P.I.P. however is a benefit that exists without apportioning fault to the drivers. Quite simply if you are in a car and an accident occurs you can be entitled to have a limited amount of your medical bills or lost wages paid for by the insurance company applicable to the car. Not only that but if you are a driver who is the primary cause of an accident and you get hurt you can still use P.I.P.
P.I.P. also is a per person benefit so if you have 20 people in your vehicle each of the 20 can make a P.I.P. claim if injured! P.I.P. was once a mandatory coverage like bodily injury or uninsured motorist coverage but the insurance industry found it too expensive and lobbied to be able to get rid of it. The legislature in Maryland has long been in the thrall of the insurance industry and would not let them eliminate P.I.P. but came up with a craven compromise. Policyholders were allowed to "waive" P.I.P. and thereby reduce their premiums.
Sounds like a good idea right? Bring down the cost of auto insurance and make the insurers happy. Unfortunately, the cost of P.I.P. went up afterwards and the people who most needed P.I.P. couldn't afford it. The argument for P.I.P. waiver was "most people can use health insurance for their crash-related medical expenses" so they don't need P.I.P. Of course P.I.P. also is used for lost wages and the people who most needed cheaper auto insurance are the people with the least money and thus the least likely to have health insurance and the least likely to be able to afford to miss time from work.
In other words as usual the less wealthy were screwed by the disappearance of P.I.P.
With that unfortunate tale being told lets focus on what P.I.P. is. It is a no-fault benefit that pays medical expenses at their "reasonable cost" and lost wages at 85% of one's gross wage. A P.I.P claim must be made within a year of the accident although once made with the P.I.P. insurer one has up to three years after the crash to submit claims for lost wages and medical expenses.
Lets take an example. John has $5,000.00 in P.I.P. coverage and is in a crash in Laurel on Route 198 on Oct. 31, 2014. He goes to Laurel-Beltsville hospital where he is worked up for a broken right leg. His medical expenses are $4,000.00 and he misses eight weeks of work for a total of $6,000.00. What should John do?
Well he should notify his P.I.P. carrier as soon as practical about his prospective claim and under all circumstances no later than Oct. 31, 2015. Many insurance companies now have on-line P.I.P. processing although historically P.I.P. claims were three part forms with carbon paper. One form for John to give basic information abouit himself, the crash and his injuries and a form each for John's doctor and employer.
If John has health insurance he would probably prefer to be paid for his lost work time and get his doctor and hospital bills paid for by health insurance. Sometimes this can be a struggle. Health insurers often decline initial payment of accident-related medical expenses arguing that P.I.P. and liability should pay them. But John has hired a one of the best law firms In Laurel and they insist that the health insurer fulfill its insurance contract and pay the bills so John can use his P.I.P. for his lost wages and keep a roof over his family's head.
So John submits his $6,000.00 lost wage claim accompanied by the P.I.P form filled out by his employer and he gets??? 85% of his gross lost wages or 85% of $6,000.00 or $5,100.00 except of course John only has $5,000.00 in coverage so he gets that amount.
It is unfortunate that John loses out $100.00 but he is in much better shape than the average Maryland driver who has the state minimum P.I.P. of $2,500.00.
There are of course many permutations or scenarios for P.I.P. What happens when a pedestrian gets hit and doesn't own a car? The answer in its simplest form is that they can claim against the P.I.P. policy of the vehicle that hit them. If two drivers are at fault the pedestrian can claim against both their P.I.P. policies. This is a rare example where fault plays some small role in P.I.P.
The bottom-line make sure you have P.I.P. and the more the better even if you have health insurance and sick leave. And it always pays to contact a lawyer to help ensure you receive all the benefits you are entitled to. To contact the highly experienced lawyers of Clark and Steinhorn call us at (301)317-1001 or look us up the web at maryland-law.com. You will be glad you did.