My Texas PIP Benefits Are Exhausted – What Do I Do?

Drivers who are serious about protecting themselves and those who ride with them know that auto insurance is an essential component in any safety strategy. Without insurance, any driver who found himself in an accident – and millions do each year – could be faced with the prospect of covering the costs associated with that accident on his own. To prevent that, a variety of different insurance policy types have been developed over the years to enable vehicle owners to better distribute accident risks among the largest possible pool of people. One of those insurance types is something called Personal Injury Protection coverage, or PIP for short.

PIP coverage is commonly referred to as a form of first-party insurance coverage. That simply means that it is purchased by you to ensure that you are your passengers are protected. PIP covers costs related to lost wages and medical bills, making it a valuable thing to have when injuries occur. Unlike many other insurance coverage types, Personal Injury Protection typically provides quicker payouts in the aftermath of an accident but is also one of the more expensive types of coverage. Since it has relatively low coverage limits, however, it is common for Texas drivers to have their Texas PIP benefits be completely exhausted soon after a major accident. The question then becomes: what do you do next?

Texas Requirements

Under Texas law, every insurer is required to offer Personal Injury Protection coverage to its customers. The coverage requirement was considered by the legislature to be so important that insurance companies are required to obtain a customer’s written rejection of the additional coverage. Under the terms of the statutory language requiring the offering of this coverage, insurers must offer drivers a minimum of $2,500 of protection. In short, drivers in Texas are not required to carry this coverage, but insurers are required to offer it.

What it Covers

PIP insurance is always considered to be “no-fault” insurance protection. Even if you caused the accident, it still pays for medical costs related to injuries suffered by you or your passengers, as much as 80% of the wage loss suffered due to the accident, and funeral expenses if the worst happens. In many accidents, this coverage can make a real difference in an injured person’s ability to manage the financial harm caused by the crash, get time to seek proper medical attention, and recover from injuries. While insurers are mandated to offer at least $2,500 worth of PIP coverage to each insured driver, they can also offer higher limits to drivers who want to pay for it.

Exhausting Those Benefits

Obviously, many car accidents result in medical expenses and time away from work that create damages far in excess of the minimum $2,500 limit. And while the additional benefits can be helpful in ensuring that many accident victims avoid immediate financial peril, even a few thousand dollars won’t last very long when the injured person has to cover medical costs and his routine monthly bills – especially when the injuries cause time away from the job. The exhaustion of PIP benefits can create serious hardship for people who have not adequately planned ahead.

For many people, the natural reaction in the wake of this exhaustion of PIP benefits is to turn to their health insurance. After all, that is why you pay your health insurance premiums, right? Keep in mind, however, that health insurance coverage can involve the insurer’s right of subrogation – which means that you could be left repaying a substantial portion of those costs when all is said and done. In Texas, however, tort reform and various court cases have left residents with a variety of sometimes confusing possibilities that can make managing the aftermath of any accident a nightmare for injury victims.

Nor can you rely on a subsequent personal injury case to resolve the matter on your behalf. In fact, the 2003 changes to tort law made major overhauls to the way that juries are even allowed to review and evaluate medical expenses when they assess damages, as the Civil Practices and Remedies Code makes clear. As a result of tort reform in Texas, juries are only allowed to hear evidence related to any medical costs that were “actually paid or incurred.” And since insurance companies routinely pay at rates below the billed medical costs, your actual medical bills may never be considered by a jury.

One option that can work for those who can afford it is to ensure that you have the maximum coverage available in all areas on your main auto policy, as well as the maximum PIP coverage your insurer offers. That can often help to ensure that your true accident costs are covered to the fullest extent possible.

There are also government programs that may be able to assist you. For example, if you suffer an injury that leaves you disabled, you may be eligible for Medicare assistance. In cases where you are left with little income and few available assets, Medicaid may be an option.

Get the Help You Need

Each year in the United States, millions of auto accidents occur on the nation’s roads and highways. Nearly three million crash-related injuries are caused by those accidents. Many thousands of those injuries occur on Texas roads, leaving drivers and their passengers with no choice other than to cope with complicated laws, insurance policy provisions, and health care provider rules. While Personal Injury Protection coverage can be a tremendous boon, the exhaustion of those benefits can quickly leave injury victims confused about how to continue to get the care they need while somehow managing to make ends meet.

If you’ve suffered an automobile accident and you or a family member have been injured, don’t wait for your PIP benefits to run out before you begin to plan ahead. An experienced personal injury attorney can help you to negotiate all of the relevant legal issues related to your coverage and work with you to develop a strategy to ensure that your injuries don’t destroy your finances too.

Was this page helpful?

About the Author

LIVE CHAT