Is Pedestrian Personal Injury Protection Useless?

Question

I was recently in an accident in New Jersey and I have Pedestrian Personal Injury Protection that states its coverage as $250,000 with a $250 deductible and 20% copay. My insurance claim representative told me that I have no coverage for my injuries and that I should use my outside health care provider. The problem is that I do not have an outside health care provider and after little searching I feel as though Pedestrian Personal Injury Protection should cover my injury (ambulance ride, X-rays, broken foot, loss of wages) but is it the "Pedestrian" in the coverage that means that I dont have a foot to stand on (ha ha ha get it)? Either way through searching I have found that it is mandatory for insurance companies in New Jersey to include PIP in their coverages. So should I start to put pressure on my claims representative or wait until after she has determined who is at fault? Thanks

Answer 1

Were you a pedestrian? I used to be an agent in NJ but it used to be that PIP included coverage for pedestrians automatically, it was not separate. Health insurance is secondary to auto insurance PIP so I doubt that health insurance will pay without a denial from the auto insurance anyway. How could you have no coverage for auto related injuries if you have PIP? I guess I don't understand that. You will still have to pay the first $250 plus 20% co payments up to a certain amount (used to be $5000) & the rest is covered 100% up to the $250,000). Your out of pocket expense should then be $1250 if your bills exceed $5250). Ask your agent to help you too, they can explain the coverage to you. Ask for a denial IN WRITING from your adjuster. If this cannot be provided, then ask to speak to the supervisor. If this gets you nowhere, tell them you will be making a complaint to the Department of Insurance. See if that helps you. With PIP coverage it does NOT matter who is at fault, that is the whole purpose of the coverage, to pay for medical bills, no matter who is at fault & have it done in a timely manner. So, plain & simple, your adjuster should not be delaying payments for your medical bills. Good luck to you & speedy recovery!!

Answer 2

You can put all the pressure you want to on the adjuster - but she still can't do anything until the investigation into coverage and liability is completed. You may want to talk to your adjuster again. See if she can explain to you in a very simple way - why the PIP does not apply at this time?

If she needs something like the police report - it's ok to get off your duff and go the police department and pick the report up and give it to the adjuster. Is there something else you can do to help the adjuster get what she needs to complete her investigation? No adjuster is going to be offended when an insured offers to help.

I'm not familiar with insurance in NJ. You may want to talk to your agent and see if they can explain things to you.

Answer 3

PIP mostly covers scientific expenditures. Depending on what your coverage covers, the estate within the auto might or is probably not blanketed. I feel that generally, auto coverage covers the estate of different men and women that you just broken (for instance, if he destroyed any individual's fence within the direction of the twist of fate) however does now not quilt your private estate harm. I might verify along with your coverage organization to look what variety of insurance policy you may have.