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The New 2013 Personal Injury Protection Statute (PIP Series 3 of 3)

Posted by attorney Martin Macyszyn

Now, what’s changing in the Personal Injury Protection world come January and why you should care?

Previously, the only time an injured individual had to meet any type of threshold was when that injured person was suing either the adverse party or their own insurance company for Underinsured or Uninsured Motorist Coverage. That person, as mentioned above, had to prove in court that they sustained a permanent injury. Now, injured individuals will have to meet another threshold; they must treat within 14 days. This 14 day threshold applies only to Personal Injury Protection benefits. The new Statute states that an injured person must seek medical attention within 14 days of the injury to be eligible for Personal Injury Protection Benefits.

What kind of treatment do you have to seek initially? It can be personnel from the ambulance that arrives on scene, a medical doctor, a chiropractor, a dentist, or a hospital. However, remember, it has to be within the 14 days from the accident. If you wait one day extra, you are no longer eligible for the benefits. But do understand that you can still go after the person that caused the accident. The next change to the Statute is how much are you eligible for in PIP benefits.

Before, everyone that was injured in a car accident was eligible for $10,000 in Personal Injury Protection benefits. This is no more. Now, you the injured, are eligible for either $10,000 in PIP befits just as before or just $2,500. The way that is determined is based on your condition. In order to be eligible for $10,000 in PIP benefits, you must have what is called an “Emergency Medical Condition" or “EMC" for short. An EMC is a “Medical Condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention would reasonably be expected to result in any of the following: serious jeopardy to patient health, serious impairment of bodily function, or serious dysfunction of any bodily organ or part." Which injuries will fall in that category will certainly be debated by lawyers over the next few years.

For now, we at least know who is able to diagnose an injured as having an emergency medical condition. Only Medical Doctors, Doctor of Osteopathic, Physician Assistant, or an Advanced Registered Nurse Practitioner are able to diagnose an individual as having an Emergency Medical Condition. These professionals will be the gatekeepers into either the $10,000 door or the $2,500 one. Please note that one provider is specifically missing from that list; the chiropractor, the one that handles the most with automobile injuries.

The Statute can limit how much in benefits you are eligible for and in addition, limits how you use those benefits. No longer being covered under Personal Injury Protection benefits are massages and acupuncture. Therefore, a person that sustains whiplash as a result of an accident will no longer be able to get treated for tensed up muscles. Rather, the injured will be forced to pay out of pocked if that person does not meet the permanency threshold.

These are just a few of the changes coming in January.

If you have any questions, please feel free to contact the Law Offices of Lucas, Green & Magazine and ask for Attorney Martin Macyszyn. I will gladly speak to you and answer any questions you may have.

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