Texas auto insurance policies are required to include Personal Injury Protection (“PIP”) coverage unless the policy owner specifically rejected that coverage in writing when the policy was purchased.   (See Texas Insurance Code §1952).  The benefits are paid without regard to whose fault the accident was and even when the party has a collateral source to pay the expenses.

Personal Injury Protection Benefits

The PIP benefits are paid for:

  1. Necessary medical, dental, hospital, professional nursing or funeral services;
  2. Replacement of income lost as a result of the accident; or
  3. Reimbursement for expenses incurred for services ordinarily performed by the injured person.

The benefits are to be paid no later than the 30th day after the insurer receives satisfactory proof of a claim.  The insurer may require proof as to the expense mandating the payment of the PIP benefits.  If the insurer fails to timely pay the PIP benefits, the person entitled to the benefits is entitled to recover reasonable attorney’s fees, a penalty of 12% and interest.

The insurer shall exclude benefits in the insured’s conduct contributed through an intentional act which caused the injuries, while in the act of committing a felony or seeking to elude lawful apprehension by a law enforcement official.

Conclusion

Depending on the circumstances of your accident, you may be entitled to other types of benefits (i.e. workers’ compensation, short term disability, etc.).  Not all claims are straight forward.  Have an experienced attorney on your side.

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