If you’ve been in a car accident in New York, you’ve probably heard the term PIP insurance thrown around. But what exactly does it cover? And why is it so important? Let’s break it down in clear, simple terms.

PIP stands for Personal Injury Protection. It’s part of New York’s no-fault insurance system, which means your own insurance pays for certain expenses after a car accident—no matter who caused it. This coverage is designed to help you get medical care and other financial support right away, without needing to wait for a lawsuit or settlement.

Understanding New York’s No-Fault Law

New York is one of several states that follow a no-fault insurance model. This means that after most car accidents, each driver turns to their own insurance for coverage.

That’s where PIP comes in. PIP is required for all drivers in New York and provides immediate financial help for medical bills and other losses. It ensures that injured drivers and passengers don’t have to wait for a liability investigation to get treatment.

Because of this, PIP insurance plays a vital role in the first days and weeks after a crash.

What Exactly Does PIP Insurance Cover?

PIP insurance covers a range of costs related to personal injury. In New York, the minimum required PIP coverageprovides up to $50,000 per person for the following expenses:

• Medical Expenses: This includes hospital visits, surgeries, doctor appointments, X-rays, MRIs, medications, and physical therapy. PIP pays for any necessary and reasonable medical treatment caused by the accident.
• Lost Wages: If your injuries prevent you from working, PIP will cover up to 80% of your lost earnings, up to a maximum of $2,000 per month for up to three years.
• Essential Services: If you can’t perform daily tasks like cooking or cleaning, PIP will reimburse the cost of hiring someone to do them.
• Funeral Expenses: If the accident is fatal, PIP also provides up to $2,000 for funeral and burial costs.
• Transportation Costs: PIP may cover the cost of traveling to and from medical appointments.

So, even if the other driver caused the crash, you don’t need to wait for their insurance company to pay for these essential services.

Who Is Covered Under PIP Insurance?

PIP doesn’t only protect the policyholder. It covers a wide range of people, including:

• The driver who purchased the policy
• Any passengers in the insured vehicle
• Pedestrians struck by the vehicle
• Bicycle riders hit by the car
• Other authorized drivers of the insured car

Additionally, if you’re injured as a pedestrian or bicyclist by another car, that driver’s PIP insurance may cover your injuries as well.

This broad protection ensures that nearly everyone involved in a car accident has access to immediate support.

Does PIP Cover Pain and Suffering?

One important limitation of PIP insurance is that it does not cover pain and suffering, emotional distress, or other non-economic damages. It only covers direct financial losses, such as medical bills and lost wages.

If your injuries are serious enough, however, you may still be able to sue the at-fault driver for additional compensation. This includes pain and suffering, disfigurement, or permanent disability. In New York, you must meet the serious injury threshold to file this type of lawsuit.

Understanding that PIP is not the final word in compensation is key to protecting your full rights.

What Is Not Covered by PIP Insurance?

While PIP is broad in scope, it does have limitations. Here’s what it typically does not cover:

• Vehicle damage: PIP doesn’t pay for repairs to your car. That’s handled by collision or property damage insurance.
• Other people’s property: If your accident damaged another vehicle, fence, or structure, PIP won’t cover it.
• Pain and suffering: As mentioned, emotional and mental trauma aren’t covered under PIP.
• Injuries beyond the coverage limit: Once you hit the $50,000 cap, PIP stops paying unless you have additional or optional no-fault coverage.

For full protection, it’s important to understand where PIP ends and where other policies begin.

Optional PIP and Additional Coverage

In New York, you have the option to buy Additional PIP (APIP) or Optional Basic Economic Loss (OBEL) coverage. These can increase your coverage beyond the standard $50,000 limit.

• APIP provides extra medical and wage loss benefits if your injuries exceed the base limit.
• OBEL allows you to apply an extra $25,000 toward medical expenses, lost income, or rehabilitation.

If you have serious injuries or a high-paying job, adding these coverages can be a smart move.

Filing a PIP Claim: Step-by-Step

Filing a PIP claim is fairly straightforward, but it’s crucial to act quickly. Here’s a step-by-step overview:

1. Report the accident to your insurance company immediately.
2. File a written PIP application (called an NF-2 form) within 30 days of the accident.
3. Provide documentation: Submit medical records, bills, and proof of lost wages.
4. Attend medical exams: The insurer may require an Independent Medical Exam (IME).
5. Follow up: Keep track of your claim and communicate with your adjuster.

Missing deadlines or incomplete forms can delay or reduce your benefits, so be sure to stay on top of everything.

What If the Insurance Company Denies My PIP Claim?

Insurance companies sometimes deny PIP claims, arguing that treatment was unnecessary, too expensive, or not related to the accident. If this happens, don’t panic.

You have the right to:

• Request an internal review
• Challenge the denial through arbitration
• Hire an attorney to dispute the claim

Having legal representation early on can make a huge difference if your claim faces pushback. A skilled attorney knows how to gather the necessary evidence and push back against unfair denials.

Can You Sue After Receiving PIP Benefits?

Yes, you can still sue the at-fault driver if your injuries qualify as serious under New York law. PIP is there for immediate relief. It doesn’t prevent you from taking further legal action to get full compensation.

The serious injury threshold includes:

• Significant disfigurement
• Bone fractures
• Permanent limitation of a body organ or member
• Substantial disability lasting at least 90 days

If your case meets this threshold, you can pursue damages beyond PIP—like emotional distress, loss of enjoyment of life, or long-term loss of income.

What Happens If I Was a Passenger or Pedestrian?

If you were a passenger in a car or a pedestrian hit by a car, you’re still eligible for PIP benefits. In most cases, the insurance policy of the vehicle that struck you will provide coverage.

If you own a car yourself, your own policy might apply first. However, if you’re not insured, you may qualify for benefits under the New York Motor Vehicle Accident Indemnification Corporation (MVAIC), which offers limited benefits for uninsured victims.

How Long Do PIP Benefits Last?

PIP benefits are not indefinite. Here’s how long they typically apply:

• Medical expenses: Covered as long as they are necessary and related to the accident.
• Lost wages: Paid up to 3 years after the accident, or until you reach the $50,000 limit.
• Essential services: Covered for up to one year.

Once you exhaust the coverage or hit the maximum timeline, you’ll need to rely on health insurance, disability insurance, or legal claims for further compensation.

How to Maximize Your PIP Benefits

To get the most out of your PIP insurance, be proactive:

• Keep all accident-related documents: Police reports, medical bills, pay stubs, and repair estimates.
• Follow your treatment plan: Attend every appointment and follow doctors’ instructions.
• Document your recovery: Write down how your injuries affect your daily life.
• Communicate clearly with your insurer: Stay professional and organized.

Most importantly, work with an experienced attorney who can help you avoid mistakes and get the full compensation you deserve.

Why Choose Mesadieu Law for PIP-Related Claims?

At Mesadieu Law Firm, we know how to handle PIP claims and fight back when insurers delay or deny coverage. We’ll help you understand your rights, meet every deadline, and push for every dollar you’re owed.

We also help injured clients file personal injury lawsuits when their damages go beyond what PIP covers. Whether you’re dealing with minor injuries or permanent disability, we stand by you every step of the way.

We treat our clients like family. That means regular updates, honest answers, and tough advocacy.

Call 844-3-RIGHT-BY-YOU (844) 374-4482.  Mesadieu Law. Right By You.