What is PIP Insurance in Washington State?
Personal injury protection (PIP) is coverage you can add to your existing insurance policy. This optional coverage will help pay for costs such as:
- Lost wages;
- Medical and hospital expenses; and
- Funeral expenses.
Some states require drivers to carry personal injury protection coverage, but Washington is not one of them. Under RCW 48.22.100, drivers in Washington are not required to obtain PIP coverage.
However, in Washington, every auto insurance policy must include an option to purchase personal insurance protection (PIP) coverage.
Customers that decide to purchase PIP coverage receive minimum personal injury protections established by statute. PIP insurance requires an insurance company to pay policyholders up to the specified amount in benefits following an accident.
PIP insurance does not cover all injuries, though. For coverage to attach, several requirements must be satisfied. Certain injuries are excluded from coverage altogether.
What is PIP Coverage in Auto Insurance?
Insurers offer PIP coverage as a means to help injured drivers cover the cost of medical expenses. The best thing about a PIP policy is that fault does not factor into a person’s ability to collect on it. Whether you or the other driver caused the accident, your insurer must pay out if you file a claim under your personal injury protection policy.
If you have a PIP policy, it is important that you understand how it works, when to file a PIP claim, and what type of damages you can collect under PIP coverage.
Who a PIP Policy Covers
PIP policies work in much the same way as Washington auto insurance policies. In addition to covering the insured individual, a PIP policy also covers
- household members related by blood, marriage, or adoption,
- foster and step-children,
- and any non-family passengers or pedestrians involved in the accident.
In essence, it covers all of the same individuals that would be covered under a typical auto insurance policy, except for the driver and passengers of the other vehicle.
PIP Coverage Limits
Every state’s minimum PIP coverage is different. PIP coverage in Washington must provide the following minimum benefits:
- $10,000 in medical and hospital benefits;
- $2,000 in funeral expense benefits;
- $10,000 of income continuation benefits; and
- $5,000 in loss of service benefits.
Insurance companies must increase the benefit amount at the request of the policyholder. In this case, the insurer must provide:
- $35,000 in medical and hospital benefits;
- $35,000 of income continuation benefits; and
- $14,600 in loss of service benefits.
Do You Really Need PIP Insurance?
No. Under Washington insurance law, PIP coverage is not mandatory. So, in a legal sense, you do not need PIP insurance.
However, PIP insurance developed out of a concern for fairness. As such, several policy-focused features of PIP insurance are worth keeping in mind before opting out of the optional coverage.
- Quick compensation without filing a lawsuit
PIP insurance benefits the policyholder by requiring insurance companies to provide coverage. This mandatory coverage provides compensation following an accident without resorting to litigation.
- Compensation is independent of the fault of either party
PIP insurance does not require establishing the fault of either party. The benefit payments also are not based on the policyholder’s fault. PIP coverage is not limited or denied even if the holder was entirely responsible for the accident.
- PIP insurance avoids tort law rules
PIP insurance is a matter of contract law, rather than tort law.
Avoiding tort law is particularly beneficial in states with comparative and contributory negligence systems.
This is because, in comparative and contributory negligence systems, your recovery may be reduced or barred entirely if you were at fault.
Washington is a “pure comparative negligence” jurisdiction.
Pure comparative negligence rules will not bar your claim if you were more at fault than the other driver. However, your award amount will be reduced by your degree of responsibility.
- Policyholders control how to spend the benefits
Insurance providers generally have little discretion to limit or deny benefit payments for hospital or medical services. The insurer may limit or deny coverage only if the services are unreasonable, unnecessary, unrelated to the injury, or incurred more than three years after the accident.
How Does PIP Insurance Work?
The Injury Must Arise Out of an Automobile Accident
PIP compensation is available for injuries sustained during an automobile accident. An “automobile” is a passenger car that carries no more than ten passengers.
The Accident Must Occur While the Car is in “Use”
PIP insurance covers only injuries that arise out of “use” of a vehicle. Whether the injury arises out of the proper use depends on several considerations:
- Causation or a physical connection exists between the injury and the use of the vehicle.
- The person was in close geographic proximity to the vehicle at the time of the injury. Though the person need not be touching the car.
- The injury must occur while the motor vehicle is beingoperated as a motor vehicle.
Exclusions: Injuries Not Entitled to PIP Coverage
Insurers are not required to extend PIP coverage in seven instances. The exclusion applies to:
- Intentional injuries;
- Injuries incurred during street racing;
- Injuries due to war or from toxic materials; or
- Injuries that occur while using the car to commit a felony.
Mandatory Personal Injury Protection
For any other type of injury, the insurance provider must distribute the benefits under PIP insurance coverage to qualified policyholders.
Filing a Personal Injury Protection Claim in Washington
PIP Covers Costs Incurred Within Three Years of the Accident
For instance, a PIP policy only covers costs sustained within three years of the incident in which you were injured, regardless of when you file. For this reason, you want to file as soon after the accident as possible, even if you are not sure whether or not the other party’s insurance company will pay for your damages.
Expenses must be Related to the Injury, Reasonable, and Necessary
Additionally, you will need to demonstrate that your expenses are related to your injuries from the accident, and that they are reasonable and necessary. Proving the “reasonable and necessary” part may be the most difficult, as it will require a doctor’s note with reasoning for each recommended procedure and treatment.
Contact Our Lawyers
If you have PIP coverage and want to file a claim under your policy, or if you just want to learn more about personal injury protection insurance and whether or not it is right for you, contact the Yakima personal injury lawyers at Kapuza Lighty, PLLC, today