NJ PIP Coverage Pays Your Medical Bills After a Crash — Regardless of Fault
New Jersey is a no-fault state for auto insurance. That means after a crash, your own auto policy’s Personal Injury Protection (PIP) coverage pays your medical bills first — regardless of who caused the crash. Most NJ drivers carry PIP, but few understand how it actually works, what it covers, and what trade-offs come with it.
If you’ve been hurt in a NJ accident, call 908-692-7745 for a free consultation. PIP coverage decisions affect your medical treatment and recovery.
What PIP Covers
Standard NJ PIP covers:
- Medical expenses — emergency room, hospital, doctor visits, physical therapy, diagnostic imaging, prescriptions
- Lost wages — up to 60% of lost income, capped at the policy weekly limit (typically $100/week)
- Essential services — household services you can’t perform due to injury (up to $12/day, $4,380/year)
- Funeral expenses — up to $1,000 if fatal
- Death benefits — limited death benefit to surviving family
PIP Coverage Limits
NJ requires minimum PIP coverage of $15,000 per person per accident under N.J.S.A. 39:6A-4. Standard policies typically have $250,000 PIP limits. You can elect lower limits ($15K, $50K, $75K, $150K, $250K) at policy purchase.
If you elect lower PIP limits, you pay less premium — but you’re potentially exposed to substantial out-of-pocket medical costs if your injury is severe.
Who’s Covered by Your PIP
- You, the named insured
- Your spouse and resident relatives
- Anyone occupying your insured vehicle
- You as a pedestrian struck by a motor vehicle
- Your spouse or resident relatives as pedestrians struck by a motor vehicle
What PIP Does NOT Cover
- Pain and suffering (that’s the tort threshold question — see below)
- Vehicle damage (that’s collision coverage)
- Property damage to others (that’s liability coverage)
- Drug or alcohol-impaired driving (PIP can be denied if you caused the crash while impaired)
- Felony-flight scenarios
- Self-inflicted injuries
The Tort Threshold Trade-Off — “Limited” vs “Unlimited” Right to Sue
NJ gives you a choice when you buy auto insurance:
Limited tort (lower premium)
You give up most of your right to sue for pain and suffering. You can only sue for pain and suffering if your injury falls into one of 6 categories under N.J.S.A. 39:6A-8:
- Loss of a body part
- Significant disfigurement or scarring
- Displaced fractures
- Loss of a fetus
- Permanent injury (most litigated category)
- Death
Most NJ drivers carry limited tort. The premium savings is meaningful, but the trade-off is real.
Unlimited tort (higher premium)
You preserve full right to sue for pain and suffering for any injury. Costs more in premium but doesn’t restrict your recovery.
How PIP Coordinates With Health Insurance
PIP is “primary” — meaning your auto carrier pays first for accident-related medical bills, then health insurance picks up what PIP doesn’t. You can elect “health insurance primary” at policy purchase (lower premium, you use your health insurance first).
This is a significant decision. Health-insurance-primary lowers your premium but means your health plan’s deductible, copays, and provider restrictions apply to accident-related treatment.
PIP Decision Points — Common Issues
Pre-authorization and the PIP fee schedule
NJ PIP claims are subject to a state-mandated fee schedule. Some providers don’t accept PIP. Pre-authorization requirements apply for many services.
Independent medical examinations (IMEs)
The PIP carrier may require you to attend an IME by their chosen doctor. The IME findings can be used to deny or limit further treatment. Your lawyer’s involvement matters at the IME stage.
Cutoff of treatment
If the PIP carrier’s IME says you’ve reached maximum medical improvement, they may cut off further coverage. You can appeal through PIP arbitration.
PIP arbitration
NJ PIP disputes go through a specialized arbitration process. Your lawyer or the treating provider’s lawyer can file the arbitration.
What to Do After a NJ Auto Accident
- Get medical attention immediately — gaps in treatment hurt your claim
- Notify your auto carrier promptly — PIP coverage starts with notice
- Save all medical records, bills, and out-of-pocket expenses
- Get receipts for prescriptions and travel to medical appointments
- Don’t give a recorded statement to the other driver’s insurance carrier
- Contact a NJ personal injury lawyer
Frequently Asked Questions
Does NJ PIP cover passengers in my car?
Yes — your PIP covers anyone occupying your vehicle.
What if I don’t have auto insurance?
If you were a passenger or pedestrian, the at-fault driver’s PIP or the NJ Unsatisfied Claim and Judgment Fund may cover medical bills. If you were the driver, options are severely limited.
How long does PIP last?
PIP medical coverage continues until reaching the policy limit or until medical-necessity is no longer established. There’s no fixed time limit, but cutoffs are common as cases progress.
Can I sue for pain and suffering with limited tort?
Only if your injury falls into one of the six categories above. Permanent injury (the most common litigated category) requires medical proof that the injury is permanent and that it crosses NJ’s verbal-threshold standard.
Should I choose limited or unlimited tort?
This is a personal decision based on premium savings vs. preserved litigation rights. If you’re injured in a serious accident with limited tort, your recovery for pain and suffering may be substantially limited. The premium savings often doesn’t justify the trade-off for drivers with assets to protect.
Talk to a NJ Personal Injury Lawyer About Your PIP Claim
NJ PIP coordination is one of the most technical parts of an auto accident case. The decisions you make in the first 60 days — about treatment, about IMEs, about cutoff appeals — affect your medical care and your eventual recovery. Goldman Law Firm represents NJ accident victims through PIP, tort threshold, and liability claims. Free consultations.
Call 908-692-7745 or request a free consultation online.