This is the first question on the mind of anyone who is injured in a car accident. In Massachusetts, there are multiple levels of insurance that may apply to different elements of your damages to get you back on your feet (financially and physically) as soon as possible. This is why you need an experienced personal injury attorney to help you navigate the insurance maze and ensure you are fully compensated as soon as possible. Below are some examples of insurance interactions.
Personal Injury Protection ("PIP")
PIP coverage pays for up to the first $2,000.00 or $8,000.00 in medical bills, lost wages, and other expenses. Typically, your own car insurance pays this initial portion of the claim, though the vehicle that struck you may pay instead if you were not in a motor vehicle at the time of the incident, such as for pedestrians and bicyclists. If you were riding a motorcycle at the time of the collision, you may not be covered by PIP.
Medical Payments ("MedPay")
MedPay coverage on your own personal insurance policy may pay for your medical bills once PIP is "unavailable" and before your health insurance will pay. There is an awkward interaction between PIP, Medical Payments, and Health Insurance coverage as explained in the Supreme Judicial Court's Golcin decisions and examined in this article I wrote for the Massachusetts Lawyers Journal titled Navigating the Golchin Gulch. An experienced personal injury attorney can help determine if MedPay coverage applies to you.
Once PIP is "exhausted," i.e. used-up, your health insurance will begin to pay your remaining medical bills. If you are responsible for any co-pays, these may be able to go back to the PIP insurer for payment if they have not reached the $8,000.00 ceiling. Note that your health insurer will be entitled to be repaid for the medical bills it pays for treatment related to your injuries from the collision. An experienced attorney can help you reduce the amount that needs to be repaid at the conclusion of the case.
Workers' Compensation ("Workers' Comp")
Workers' Comp insurance will step in and pay for your lost wages and medical expenses beyond PIP if you were covered at the time of the incident and you were injured while in the course of your employment. If the incident was the fault of your employer, this is likely your exclusive remedy. If, however, the incident was the fault of a third party (such as another car striking you while driving a delivery vehicle), then a bodily injury claim (below) likely still exists and you can recover from the third party's insurance. Note that you will need to repay your Workers' Comp insurer for any benefits you receive if you are successful in obtaining a recovery from the third party insurer. Repayment of a Workers' Comp lien is an administrative law process that needs the approved of a Department of Industrial Accidents judge. An experienced personal injury attorney will handle the filings and paperwork for you.
Bodily Injury ("BI")
A BI claim will pay for your past and future medical bills, lost wages, pain and suffering, and additional expenses incurred as a result of your injuries from the incident. This is a claim against the insurance of the driver who hit you. The amount you can recover is reduced by the amount of PIP benefits you have received and may be subject to liens from Health Insurance, Workers' Comp, and others. The amount you can recover is also subject to a reduction for comparative fault. Under Massachusetts law,G.L. c. 231, § 85, if you are more than 50% at fault for the collision, you are not entitled to any recovery for a bodily injury claim. If you are 50% or less at fault, your total recovery is reduced proportionately (so a $10,000 claim with a finding of 30% comparative fault means you only recover $7,000). An experienced personal injury will help ensure you are compensated for your injuries to the fullest extent possible under the law.
Underinsured/Uninsured Motorist Coverage ("UI")
Finally, UI coverage may apply to claims where the driver who hits you either has no bodily injury coverage or insufficient coverage to fully-compensate you for your injuries. This is insurance coverage on your own vehicle or a vehicle in your household that covers you. To determine your level of coverage, subtract the amount of available bodily injury coverage from your underinsured/uninsured limits. So, if the driver who hits you has $20,000 per person/per incident BI limits and you have $50,000 per person/per incident UI limits, then you will likely have $30,000 in additional coverage available. There are contract rules that govern how this coverage applies, and an experienced personal injury attorney will know how to determine if this coverage applies and how to recover it for you.
Please note that these insurance scenarios are examples that typify insurance interactions in Massachusetts. There are many variations on these outcomes depending on the facts of each particular incident, and hiring an experienced personal injury attorney is the best way to ensure that your case is handled correctly and that you are fully-compensated for your injuries and damages.
If you have been injured in a car accident in Massachusetts, call me today at 617-383-3542 for a free consultation to determine your rights.