Motor Vehicle Accidents
PIP No Fault Benefits
If you are injured in a motor vehicle accident your medical expenses may be covered by Personal Injury Protection, No-Fault Benefits that you purchase through your own car insurance. The most common policy provides for $250,000 toward medical benefits for motor vehicle accident injury treatment. Most policies have a deductible of $250 and a 20% co-pay on the first $5,000 of all medical expenses.
The car insurance policy you purchased may be considered your primary insurance coverage even if your car was not involved in the accident. If you are in someone else’s vehicle at the time of an accident, you may be eligible for benefits from the insurance policy of the car you were traveling in or or from an insurance policy issued to a relative in your household. If no other sources of personal injury protection benefits are available, you may be entitled to receive medical treatment coverage from PLIGA, the Public Liability Insurance Guaranty Association.
To obtain benefits, you must promptly submit an application to the appropriate insurance company or companies. There are strict time lines that apply to the application process, and you should not delay in securing all your rights under the your PIP policies. Once your claim has been received, the insurance company should provide you with a claim number which must be used to obtain medical treatment for your injuries. Even after you have been assigned a claim number, there are still additional administrative requirements that you must follow to receive your benefits. Certain procedures must be pre-authorized by the insurance company in order for you to maximize the amount of benefits available to you. Failure to pre-certify certain procedures could result in additional financial obligations to you beyond the standard co-pay and deductible.
In addition to your auto insurance, your health insurance may be considered a secondary source of insurance to help pay for your treatment as a result of your accident. I encourage my clients to provide their health insurance information to medical care providers in addition to the PIP claim information. Health insurance may cover some co-pay and deductible amounts.
If you are involved in a motor vehicle accident in New Jersey, your right to be compensated for pain and suffering may be limited by what is known as the “verbal threshold.” This is also known as the “Limitation on Lawsuit” option. You should check the declaration page of your automobile insurance policy to see how you are effected by the “verbal threshold.”
The verbal threshold may limit your ability to be compensated for pain and suffering to six specific types of injuries:
- Significant disfigurement or significant scarring
- Displaced fractures
- Loss of fetus
- Permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement
Certification of Permanency
New Jersey law requires that in any case to which the verbal threshold applies, you are required to provide a Certification of Permanency signed by a treating physician to establish a good-faith basis that the “verbal threshold” has been met. This certification must be filed with the Court within a limited period of time. Failure to file this important document in a timely manner could result in a complete denial of any claim for damages in a verbal threshold motor vehicle accident claim.
Uninsured & Underinsured Motorist Claims
Uninsured and underinsured benefits may be available to you if you are injured in a car accident with a driver who has no insurance or has less insurance coverage than your own underinsured motorist policy.
Benefits are available to someone injured under their own motor vehicle liability insurance policy. Benefits may also be available under the policy of the owner of any vehicle in which you were traveling at the time of the motor vehicle accident.
To determine if underinsured benefits may apply, you must compare the amount of insurance coverage are available to the person causing the accident with the amount of underinsured motorist liability coverage you have purchased. A review of the declaration page of your own policy as well as the policy of any other vehicle that you are occupying at the time of the accident, can identify the amount of coverage that may be available to you. In addition, it may be possible to receive benefits under any other policy where you are either the named insured, or the resident relative of a named insured.
Uninsured and underinsured coverage in New Jersey is a very important benefit for most people. I strongly encourage my clients to increase the amount of coverage available under these two policy benefits so that they are properly protected in the event of an accident with an uninsured or underinsured driver.
What Kind of Insurance Should I Buy?
Most policies carry with it a property damage limit of liability. Given the increasing price of cars, I encourage my clients to purchase an increased amount of liability for property damage coverage. This is a rather small increase in premium for the additional coverage and benefit which you can receive.
The average car rental expense coverage allowable by most insurance policies is fixed at an amount which may not fully reimburse you for the expense of renting a vehicle comparable to yours. On a long-term rental, which may be required based upon a significant loss of use of your vehicle, that may not be sufficient to allow you to replace your vehicle on a temporary basis with a comparable rental car. I recommend increasing the amount of rental car reimbursement coverage to $100 per day.
I encourage my clients to purchase a significant amount of liability coverage to protect them and their families. I believe that low dollar limit liability policies are not enough to protect most people in the event of a serious accident. In making the determination to increase to more significant limits of liability, I encourage you to ask your insurance agent what the cost difference is to increase your limit to the higher dollar amount. You may find that the cost factor is rather insignificant in light of the additional benefits which could be obtained in purchasing a $250,000 or $500,000 or even a $1,000,000 policy. Without knowing the difference in price, it would be impossible for you to make the educated choice to protect you and your family.
Uninsured and Underinsured Motorist
You should purchase an amount of uninsured and underinsured liability coverage which matches the amount of your own liability policy. This “matching” benefit provides you and your family with some of the most cost-effective insurance products available. It protects you and your family members from the possibility that somebody who causes an accident does not have significant enough liability insurance to satisfy all of the damages which have been claimed.
Your automobile insurance policy can provide you with coverage for lost wages in the event you are unable to work as a result of a motor vehicle accident claim. Most standard policies only provide for $100 worth of weekly wage continuation for a maximum of 52 weeks. In my opinion, this is an insufficient benefit for most motor vehicle accident claimants. It would be more appropriate to choose one of the 16 optional levels of benefit made available to New Jersey drivers to provide better protection. The appropriate selection would be a weekly benefit which matches your current income level for an unlimited benefit period.
If you have any questions or concerns about your benefits and how they relate to your motor vehicle accident claim, you are welcome to contact my office for a free consultation either via our online intake form, or by calling us at 856-751-7676.
The Law Offices of Adam M. Kotlar serves Camden County, Gloucester County, Burlington County, Bucks County as well as the cities of Haddonfield, Huntingdon Valley, Feasterville, Pennsauken, Cherry Hill, Southampton & Levittown in New Jersey & Pennsylvania.