After an accident, many people assume that the insurance policy that covers the at-fault driver will be responsible for covering medical expenses. However, this is not always the case, especially when the state uses a no-fault system. New Jersey is one such state that uses this system.
Rationale behind No Fault
Some states have developed no-fault insurance systems in which the insurance policy for each respective driver covers that driver’s medical expenses regardless of fault. The primary reason for this is to curb litigation. If the medical expense portion of the claim is handled in this manner, then there may be less incentive to pursue litigation. Another reason for the no-fault system is that it protects healthcare providers. Emergency rooms and doctors do not have to wait for insurance companies to battle out who should be responsible for the medical expenses.
No Fault Overview
In a no-fault state, each driver is legally required to purchase Personal Injury Protection coverage. This is the coverage that will pay for medical expenses in case of an accident. Each person must carry the minimum amount of insurance lawfully required, but they can increase the amount of coverage for an additional price. In order to determine if the PIP will cover a particular injury, there are a number of factors that are considered.
Vehicle Ownership
PIP covers injuries for the owner of the vehicle. This coverage follows the insured. For example, if someone owns a vehicle and was injured while in someone else’s vehicle or was a pedestrian, his or her own PIP coverage from automotive insurance would cover the medical expenses. Owning a vehicle means that the individual is the registered owner with DMV.
Residence
PIP coverage extends to the relatives of the owner. Therefore, if a person who is injured is not an owner of a vehicle with PIP, he or she can still be covered by the PIP coverage from someone else in the household so long as they are related by blood or marriage.
Vehicle Involved in an Accident
If the injured individual is not the owner of a vehicle and not in the same household as someone with PIP insurance, his or her medical bills will be covered by the insurance policy for the vehicle that he or she was in.
Pedestrian Injuries or Passengers in Uninsured Vehicles
If the injured victim was a pedestrian, a special state fund pays for his or her medical expenses related to the accident. This applies whether the driver stops or flees the scene of the accident. Likewise, this fund also provides medical coverage for passengers who were injured in vehicles that were not properly insured at the time of the accident.
Motorcycle Injuries
Most policies for motorcycle coverage do not include PIP. However, the injured individual should check with his or her policy to see if such coverage is available.
Other Insurance
In some cases, other insurance may pay for the medical expenses. For example, if the injured individual was working at the time of the accident, workers’ compensation may pay for the medical expenses. If the injured individual was working and covered by workers’ compensation at the time of the accident, workers’ compensation insurance takes precedence over the no-fault laws of New Jersey.
Some insurance policies state that the injured victim’s health insurance will be the primary insurance in the event of an automotive accident. However, this situation sometimes becomes complicated because the health insurance company will consider the injuries as being accident-related and will expect the automotive insurance to cover it.
Individuals who would like assistance in filing a claim for PIP may wish to contact a personal injury attorney in New Jersey.
