Massachusetts No Fault Rules

No-fault car insurance is a type of insurance structure in which the provider of insurance covers the cost of damages incurred in a crash by its own customer –regardless of who was at fault.

Boston traffic accident attorneys at Jeffrey Glassman Injury Lawyers know in many cases, it eliminates the need for a driver to pursue action against the other driver’s insurance company in order to be reimbursed for damages caused by the other driver. Motorists instead seek personal injury protection (PIP) benefits, which may include:

• Necessary, reasonable medical expenses
• Funeral expenses
• Lost wages/earnings
• Ordinary, necessary household services

The total amount of PIP benefits one can collect in Massachusetts is $8,000 for all expenses. However, if one has health insurance, PIP benefits will only cover up to $2,000 in medical bills. Massachusetts law pertaining to PIP benefits is spelled out in M.G.L.A. 90 § 34M.

The idea of no-fault insurance is to increase fairness in reimbursement, reduce the burden on the courts and keep car insurance rates reasonable. Still, 38 states remain under tort systems, while 12 states – including Massachusetts – adhere to the no-fault system in crash cases.

In order for an injured party to hold another driver and/or his insurance company liable for a crash is to meet several criteria:

• Injured person has incurred at least $2,000 in reasonable medical expenses AND/OR
• Injuries resulting from crash include serious and permanent disfigurement, bone fracture or substantial loss of hearing or sight.

Denial of PIP benefits by your own insurer may require the intervention of an experienced injury law firm. And if a person is seeking to pursue action outside the no-fault system, the involvement of an attorney is absolutely essential.

Auto insurance companies are notoriously aggressive negotiators, and agents are trained to reduce or eliminate liability and payouts wherever possible. Having a seasoned legal advocate negotiating on your behalf often has a huge impact on the outcome of a case.

For most people, the two most important thing PIP benefits cover is medical expenses and lost wages.

In order to qualify, these medical expenses have to be incurred within two years of the crash. Understand the insurer may require you to be examined by an “independent doctor” (someone the company chooses) in order to confirm continued treatment is necessary. Refusal to submit could be grounds for loss of benefits.

Wage losses, meanwhile, are paid at a rate of 75 percent of insured’s average weekly wage, based on what you earned one year prior to the accident. You aren’t taxed on this amount. If you use sick or vacation time to cover the expenses in the immediate aftermath, you may be entitled to a buy-back of the benefit. However, your PIP won’t reimburse you if your employer pays you regular wages or if you receive workers’ compensation benefits (which would occur if the crash happened in the course and scope of your employment). A lost wage benefit requires a doctor-supported diagnosis of temporary or permanent disability, either partial or total.

Funeral expenses are another important benefit for bereft families who have lost a loved one unexpectedly and have no way to cover those costs.

In some cases, PIP will cover ordinary and necessary household services. These would be things like cleaning the house or shoveling snow – things you would otherwise do yourself, but aren’t able to as a result of the injury.

Your insurance company may choose to deny PIP benefits if:

• You drove under the influence of alcohol or drugs
• You drove while committing a felony or trying to evade police
• You drove with the specific intent to harm yourself or others

If your claim has been denied, you should at least consult with an injury lawyer to determine if there are grounds to pursue the claim further.

It’s important to note that PIP benefits do not replace liability insurance. While PIP benefits serve as a cushion to all drivers, liability insurance covers damage to the other person’s vehicle if you cause a crash.

However, liability coverage only kicks in after injuries/expenses exceed the PIP limits. It’s important to point out your own liability insurance policy is not going to cover the costs associated with your injuries. It is solely intended to cover injuries suffered as a result of the insured’s negligence.

Liability coverage provides protection for claims made against the insured, where the use of an insured vehicle caused bodily injury or property damage to another. State law sets minimum liability insurance limits for each Massachusetts driver. Those are:

• $20,000 for any one person’s injuries in a crash
• $40,000 total for when more than one person is injured
• $5,000 in property damage for each accident

This is on top of the $8,000 in per-accident PIP benefits required.

Obviously, drivers and vehicle owners can pay to have a higher amount of coverage, and this is usually a smart move. All told, the cost of a serious accident can easily reach six figures. If an at-fault driver’s insurance coverage does not extend to cover the full cost of someone’s injuries or damages, that driver may personally be found responsible to cover the rest.

Contact Jeffrey Glassman Injury Lawyers today for a free and confidential consultation.