PIP Medical Issues - Michael P. Maddux, P.A. Attorneys at Law

Your Doctor

You should return to each of your doctors as often as is necessary and should always tell them about your pain and complaints. If you see any additional doctors, please be sure that we are advised of their names and addresses.

Permanent Injury

It is important that we recognize the full extent of your injuries before we contemplate settling your case. In order to make a significant recovery, it is important that we are able to prove that you sustained a permanent injury. Therefore, it is important that you continually emphasize to your doctor the pain and difficulties that you are experiencing. Typically, it is only after a six (6) month period that your doctor will be in a position to conclude whether you have sustained a permanent injury.

Medical Bills

If there are other medical bills that have not been submitted, you should send these to your insurance company referencing the claim number and date of accident. You should advise us what bills you have sent in to your insurance.

Lost Wages

If you are going to make a claim for lost wages you should ask your doctor to complete a disability slip and send it to your insurance carrier. You also need to provide our office evidence of at least two (2) months proof of earnings for the period immediately preceding the accident. Please be aware that your PIP will pay both medical and lost wages up to the policy limits. If you are getting lost wages that means you are taking money that would otherwise be used to pay your providers.

Medical Bills/Your Insurance Company

If you were involved in an automobile accident, you probably have automobile insurance which is referred to as no-fault insurance or personal injury protection (PIP). Depending on the type of coverage you selected, your insurance company will pay for 80% or 100% of your medical expenses, up to the amount of insurance that you purchased. This is typically $10,000.00. You may also have a deductible that must be reached before your insurance company begins to pay these medical bills. Your insurance company will generally reimburse you for 60% of the lost wages you incur as a direct result of this accident out of your PIP. Any medical expenses or lost wages not reimbursed by your insurance company are a recoverable element of your claim from the other insurance company.

You should notify your doctor of the name of your automobile insurance company and, if you know it, the claim number. It is expected that you or your doctors will be sending the medical bills to your insurance company for payment under your PIP or med-pay policy. If you become aware of any bills which have not been submitted to your PIP Carrier for payment, please notify our office.

In order to encourage medical providers to continue rendering service for the partial PIP payments or after PIP runs out, we may be asked to issue letters of protection (LOP). An LOP is a promise to pay the provider their outstanding balance from your liability settlement in exchange for the provider’s promise to continue to treat your injury and not send your outstanding balance to collections. We will issue these contractual agreements when we feel it is in your best interest and generally after consulting you.

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