Is Personal Injury Protection Worth It?
In my opinion, for most drivers the answer is yes. While Texas is fundamentally an “at-fault” state, meaning the person who caused the wreck is responsible for the damages, PIP is a unique “no-fault” addition that can serve as an immediate financial lifeline after an accident.
The “Texas Rule”: It’s Included Unless You Reject It
Many Texans are surprised to learn they already have PIP coverage. Under Texas Insurance Code §1952.152, insurance companies are legally mandated to offer a minimum of $2,500 of PIP coverage in every automobile liability policy issued in the state.
The Power of the “Signed Rejection”
You aren’t forced to keep PIP, but the law makes it difficult to accidentally lose it. To remove PIP from your policy, you must reject it in writing. A verbal “no thanks” over the phone to your agent isn’t enough.
I’ve personally handled cases where a client believed they didn’t have PIP protection. However, because the insurance carrier could not produce a “signed rejection” form, the law forced the insurer to provide the coverage anyway. If you’ve been in a crash, never take your insurer’s word for it. Ask to see the signed rejection.
Limits Matter: Is $2,500 Enough?
While $2,500 is the statutory minimum, in today’s world $2,500 likely won’t fully cover the ambulance ride and the initial ER triage. Many find that increasing their limits to $5,000 or $10,000 provides much better peace of mind for a very small increase in monthly premiums.
At-Fault Coverage
Like I mentioned earlier, PIP is “at-fault” coverage. That is, PIP will cover your medical bills up to your PIP limit even if you’re at fault for the accident. And if you’re not at fault, PIP is often paid out before the claim against the adverse driver is resolved and can provide a much-needed financial cushion in a time of need.
What Exactly Does PIP Cover?
Texas PIP is more robust than most people realize. It isn’t just for the driver. It covers you, your family members living in your household, and any passengers in your vehicle at the time of the crash. It even follows you if you’re injured as a pedestrian or a bicyclist in a collision.
The coverage generally falls into four main buckets:
1. 100% of “Reasonable and Necessary” Medical Expenses
This is the most common use for PIP. It covers:
- Ambulance and emergency room fees.
- Diagnostic testing (X-rays, MRIs, and CT scans).
- Surgery and hospital stays.
- Prescription medications.
- Ongoing physical therapy and rehabilitation.
2. 80% of Lost Wages
If your doctor tells you that you cannot return to work for three weeks due to a back injury or broken bone, PIP steps in. While liability claims only pay for lost wages at the very end of the case, PIP provides a check relatively quickly to help ease the financial pain.
3. Essential “Non-Wage” Services
What if you aren’t a traditional wage earner? If you’re a stay-at-home parent or caregiver and your injuries prevent you from performing household duties, PIP can pay for “substitute services.” This includes the cost of hiring help for:
- Childcare.
- House cleaning or laundry.
- Lawn maintenance.
4. Funeral Benefits
In the tragic event of a fatal collision, PIP provides a benefit to help families cover funeral and burial expenses without having to wait for a protracted legal battle over fault.
Why PIP Beats MedPay (The “Payback” Trap)
Many drivers see “Medical Payments” (MedPay) on their policy and assume it’s the same thing as PIP. It isn’t. In fact, MedPay can sometimes be a trap for the unwary.
The Subrogation Rule (No “Payback”)
In Texas, PIP benefits are generally non-subrogable. This is a fancy legal term that means your insurance company cannot ask you to pay them back. If you receive $5,000 from your PIP coverage to pay for surgery, and then later win a $50,000 settlement from the at-fault driver, you get to keep the full settlement. Your insurance company cannot “dip into” your settlement to recoup the $5,000 they paid you. MedPay, however, usually requires you to pay the insurer back out of your final settlement.
Comprehensive vs. Limited
As mentioned, MedPay only covers medical bills. It offers zero protection for your lost wages or the cost of hiring help around the house. For the small difference in cost, PIP is almost always the superior choice for Texas drivers.
Important Timeline: The Three-Year Window
A critical detail often missed is that PIP benefits are not infinite. Under the Texas Insurance Code, PIP covers expenses incurred within three years of the date of the accident. If you require a follow-up surgery four years after the crash, PIP will likely not cover it. This is why it is vital to have your attorney review your medical plan early to ensure your claims are filed within the statutory window.
The Bottom Line
Keeping your PIP coverage is an affordable way to provide you additional peace of mind. In my view, it’s a coverage option worth keeping for most Texas drivers.
Navigating insurance claims while recovering from a serious injury is overwhelming. Don’t leave your recovery to chance. Benham Injury Law serves North Texans who were injured in an accident.
Contact me today for a free consultation. I’ll review your policy, hunt down every available dollar of coverage, and ensure you receive the maximum compensation you deserve.
