PIP and No-fault versus Fault

What is no-fault?

No-fault coverage means that despite the fault of the accident (who caused it), you or the other driver, there is coverage provided for medical costs associated with the accident or occurrence through your own insurance policy for yourself and passengers. The other person's injuries are covered by their provider.

In state's without No-fault coverage this additional coverage can be added to your policy via Personal Injury Protection (PIP).  If you have a no-fault policy there is typically no need to go after the other person's insurance as your insurance covers your costs associated with the accident.

There are only 12 states with this type of coverage and Washington is NOT on that list. The states are: Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania and Utah.

In Washington state this PIP coverage is not mandatory so you may or may not have it in your policy.  When you signed up for the insurance policy you were presented with the option (the option is required in Washington state, meaning an insurance company must provide you with the opportunity to accept or decline PIP). Also, you must reject the PIP in writing.

PIP covers your medicals and lost wages resulting from an accident or occurrence, but there are exclusions.  You must read your policy to find those exclusions.

For more information regariding PIP visit the Washington State Insurance Commissioner's Website - click here.

How Much Does PIP Cover?

It provides the following minimum benefits:

  • Up to $10,000 for reasonable and necessary medical expenses for each person injured in an auto accident. This is available for up to three years from the date of the accident.
  • Up to $2,000 for funeral expenses.
  • Up to $200 per week ($10,000 total) for income replacement coverage. This is limited to one year after someone's been disabled for 14 consecutive days after the accident.
  • Up to $200 per week ($5,000 total) for loss of services (payment to non-family members for work you can't do).

You can buy more coverage. Check with your insurance company or agent.

Who does PIP cover?

  • Person named on the policy
  • Household residents related by blood, marriage or adoption
  • Step or foster children
  • Any non-family passengers and pedestrians involved in an accident

What is fault?

Fault in terms of insurance coverage and auto accidents means that the costs associated with recovery (trying to make one whole again) are determined by the percentage of fault assigned to each driver.

In Washington we are a Fault state, meaning that even if you are 99% not at fault (liable) you will be responsible for the 1%. Of course that is simply deducted from your 99% recovery from the other (liable) driver.

So when there is an auto accident in Washington state the at-fault driver's insurance is responsible but your PIP would cover you while the case were pending.  This means if you have PIP, your medicals and lost wages would be covered up to the minimums already discussed.  PIP kind of acts like a loan from your insurance provider while your case is pending.

Once you reach a settlement or are awarded damages by a jury, you would have to pay your insurance company back the PIP it provided on your behalf, otherwise this would be what is called "double dipping" (meaning you received monies from your insurance company and the at-fault party).  The amount you pay back can be reduced subject to negotiations by your attorney and what is called the Mahler rule.

If you have questions about your auto injury and claim, contact us today for a complimentary evaluation and consultation.  We are your Seattle Personal Injury Pros (some of the Best Seattle Personal Injury Lawyers in the State).

Contact us or Call today (425) 522-4200. 

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