What is a No-Fault State?

If you are in an accident and live in one of the 12 no-fault states, such as Massachusetts, paying for your medical expenses, lost earnings, and being able to bring a claim against the responsible motorist differs from those states that are at-fault or tort liability states.  Being in a no-fault state generally means that you are at least initially responsible for paying your own medical expenses and other economic losses resulting from the accident regardless of who is at fault for the collision.  And, if you wish to bring an injury claim against the responsible driver, you must first meet certain threshold requirements.

The majority of states require motorists to carry minimum auto liability coverage. In Massachusetts, this is $20,000/$40,000/$5,000.  This means that your insurer will pay out a maximum of $20,000 to any one claimant if you are deemed liable for the accident, and up to $40,000 for multiple claimants with no one person receiving more than $20,000.  The $5,000 is for property damage coverage.  You are of course able to purchase far higher coverage levels.  AND YOU SHOULD!

What is PIP Coverage?

No-fault state motorists also are required to purchase personal injury protection coverage or PIP, or, to opt out – be careful, some companies inform you that they are saving you money and don’t tell you that it’s because they are urging you to opt out of the best coverage – no fault PIP coverage.  In any motor vehicle accident in Massachusetts, your PIP coverage is $8,000.  Your PIP coverage is available to any passengers in your vehicle, a pedestrian injured by your car, and anyone who was driving your vehicle with your consent.  The $8000 is applicable to:

  • Medical bills from the accident
  • Up to 75% of your lost income
  • Replacement services needed to assist you in household chores if needed

There are some differences in whether PIP covers certain medical expenses if you have separate private medical insurance.  If so, your medical bills will be paid by your PIP carrier only up to $2000. The remainder must be submitted to your private health insurer.  Also, PIP coverage does not compensate you for pain and suffering.

At times, your insurer will decline to pay for certain medical expenses if it feels the care or expense was unreasonable or not related to the injuries you sustained in the accident.  Do not hesitate to contact a car accident attorney who can advise you or handle your PIP claim and subsequent third-party claim against the liable party or parties. 

What is the Threshold for a Third-Party Claim?

In a no-fault state, you must meet certain requirements or a threshold before you can bring a claim against another party or entity who caused your accident.  In Massachusetts, the threshold is:

  • You must have incurred a minimum of $2000 in medical expenses
  • Or you suffered a broken bone, sustained a substantial loss of hearing or vision, have a permanent and serious disfigurement, loss of a body member, or death

It is fairly routine to meet at least the threshold for medical expenses.  If you were taken by ambulance to a hospital and given diagnostic tests, your bill will usually surpass the $2,000 threshold before you even receive any other care. 

Once you meet the requirements for a third-party claim, retain a car accident attorney to handle your claim.  Few car accident injury claims handled by claimants without legal representation result in satisfactory settlements. 

Damages in a Third-Party Claim

Once you are able to pursue a claim against a responsible party for your accident, you are entitled to recover certain damages:

  • Past and future medical expenses
  • Past and future income loss
  • Pain and suffering
  • Emotional distress
  • Diminished quality of life
  • Permanent disfigurement or disability
  • Separate claim for spousal loss of consortium

Be aware that any medical expenses paid by your private health care insurer are subject to a lien by that insurer on any compensation recovered through settlement or a jury verdict. In some cases, your car accident attorney can reduce the lien amount or even have it waived. 

Retain a Car Accident Attorney from Burns and Jain 

It is not uncommon for issues to arise in PIP coverage as well as for liability and damages. Have your claim handled by a successful and highly experienced car accident attorney from Burns and Jain. In the overwhelming majority of cases, claimants recover far more when represented by counsel than those who handle their own claims, even accounting for legal fees. Call us at (617) 227-7423 for a free consultation about your PIP or accident injury claim. 

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