PIP Regulations Affect Doctors, Insurance Companies, and Accident Victims

Citizens of New Jersey pay a high price ticket for their auto insurance coverage, and much of their premiums go to cover personal injury protection, or PIP coverage. Governor Chris Christie called this coverage a “pot of gold to abuse” last summer in response to doctors allegedly inflating their medical costs to make the most of patients’ PIP coverage.

That prompted a set of rules to prevent what some said was PIP fraud. The debate ruffled the feathers of doctors and drew many other groups into the discussion.

According to the NJ.com Statehouse Bureau, Jersey drivers paid an average of $1,101 for their insurance coverage in 2009. About 25% of these premiums went to PIP coverage. That insurance is designed to pay the medical costs associated with an auto accident regardless of who is at fault for the accident.

This pool of coverage is the “pot of gold” that Christie was referring to, suggesting that doctors and hospitals could charge what they wanted for medical services under the PIP system. Proposed rules would limit how much surgeons, anesthesiologists and other medical professionals could charge for pain management treatments and surgeries.

The medical providers spoke up in opposition to the rules and wrote lawmakers in an effort to change their support for the measure.

The insurance industry says it is concerned because it sees auto accident victims exhausting their PIP coverage. But doctors fear the strict rules would mean payment for services after a car accident would be lower than the standard rate.

Many of the initially proposed rule changes will not take effect, as the doctors’ voices were heard. However, price limits will be set on the cost of procedures at hospital-run outpatient surgery centers, something insurance carriers advocated for.

With the cost of New Jersey insurance so high, many drivers have reduced their premiums by cutting their medical coverage. While this does reduce the overall cost of coverage, it opens them up to problems if they are injured in an auto accident.

Fortunately, PIP coverage is not the only avenue for medical cost coverage after being hurt in an accident. If you weren’t at fault, you may also be entitled to bring a claim against the other driver for medical bills, lost wages from work and other damages.

How Davis, Saperstein & Salomon, P.C., Can Help

New Jersey insurance laws are complex. If you are hurt in an accident, you want to be able to focus on healing, not haggling with insurance companies about coverage and what they will or won’t pay for. At Davis, Saperstein & Salomon, P.C., we can help.

Our New Jersey personal injury attorneys are dedicated to helping serious car accident victims get the compensation and the medical treatment they are entitled to. Your injuries should be your concern; let us deal with the law. We don’t get paid unless you obtain a favorable settlement or verdict, so you can be confident we will aggressively pursue your claim. Contact our offices today to discuss the details of your case and how we might be able to help. Call (800) LAW-2000 or fill out the simple online contact form.