If you’ve suffered injuries from a car accident in New Jersey, medical bills are inevitable. Expenses will pile up quickly, especially if you need specialists for your injuries. When someone else caused your injury, who pays for the medical bills after a car accident in New Jersey?
Personal Injury Protection (PIP) Covers Medical Bills — To an Extent
New Jersey Revised Statutes Title 39 provides for “personal injury protection coverage, regardless of fault” to all car accident victims. Specifically, the Statute provides for payment of medical expenses up to the policy limits. The maximum policy limit is $250,000 per person per accident.
PIP insurance covers medical expenses that apply, including treatments like in-patient and out-patient hospital visits, X-rays, MRIs, prescriptions, ambulances, and medical transportation (such as helicopter rides to the hospital). However, specific medical treatments — such as acupuncture — aren’t covered.
PIP insurance, however, does have a deductible. In New Jersey, the minimum deductible is $250. However, many drivers opt for a larger deductible — up to $2,500 — in exchange for a lower premium. Once the deductible is met, an 80/20 co-pay provision requires the insured to pay 20 percent of all medical expenses up to $5,000 while the PIP insurance picks up the remaining 80 percent of the costs. Any medical expenses above $5,000 are 100 percent picked up by the PIP insurance up to the policy limits.
Coverage Regardless of Fault
As the Statute indicates, coverage applies “regardless of fault” due to New Jersey’s no-fault system. In a no-fault system, each driver in an accident turns to their insurance company for compensation, regardless of who was at fault for the accident.
The minimum PIP coverage available in New Jersey is $15,000. While drivers can opt for this minimal coverage, they must know that $15,000 is the coverage cap. In other words, if you’re in an accident, and your medical bills from that accident total more than $15,000, you are responsible for the difference. Moreover, suppose a driver gets hurt in an accident and successfully pursues a personal injury claim against the other driver. In that case, the medical expenses over the PIP limit are repaid out of the settlement amount.
For this reason, many drivers opt for a PIP policy that covers the maximum allowance of $250,000, which provides better coverage in the event of an accident.
The Deemer Statute for Out-of-State Drivers
If you were in an accident in New Jersey and live out of state, the so-called “Deemer Statute” applies. This Statute applies to all out-of-state drivers who drive in New Jersey, and it requires these drivers to provide New Jersey PIP insurance to out-of-state drivers who are driving in the state and got hurt in an accident.
For example, suppose you are initially from Pennsylvania and driving in New Jersey when you get involved in an accident. In that case, you will be eligible for New Jersey PIP benefits if your insurance company conducts business in the state. The Deemer statute also applies to insurance companies that don’t conduct business in New Jersey but are legally affiliated with a company that does.
Can You Sue the Other Driver for Damages?
The short answer to whether you can sue the other driver for damages is, “It depends.”
In New Jersey, there is a limitation on lawsuit limits known as the verbal threshold. This law, first adopted in 1988, is formally known as New Jersey Statutes Annotated Section 39:6A-8. Suppose the driver opts for the verbal threshold. In that case, the injured party will not be able to seek financial compensation for pain and suffering unless their injuries fall under a particular set of guidelines, including:
- Death
- Dismemberment
- Loss of a fetus (for pregnant women)
- Significant disfigurement or scarring
- Permanent injury
- Displaced fractures
Drivers in New Jersey must choose between a verbal and a nonverbal threshold. Many choose the former to pay lower premiums. Still, it leaves car accident victims vulnerable because they cannot sue for pain and suffering without the injury meeting one of the above-mentioned guidelines.
Proving one of the guidelines will not be an issue when a catastrophic car crash occurs. But what do you do when you suffer soft tissue injuries or injuries that appear minor on the surface?
The answer, of course, is to prove that the seemingly minor injuries are, in fact, major ones and that they’ve caused “significant disfigurement or scarring” or “permanent injury.” Section 39:6A-8 defines a permanent injury as one that “has not healed to function normally and will not heal to function normally with further medical treatment.” As the injured party, you’ll have to prove this in court by providing objective evidence from medical professionals in the form of MRIs, X-rays, and similar proof, alongside a certification from an objective medical professional attesting to these injuries.
The Verbal Threshold and Out-of-State Drivers
The verbal threshold doesn’t apply to out-of-state residents with insurance from non-NJ licensed providers. It also excludes non-immediate family passengers and permitted drivers without required coverage.
Obviously, these are all very complicated concepts that require an experienced attorney to navigate. Trying to understand these various laws and requirements and negotiating on your own behalf while you’re trying to heal from your injuries can be both overwhelming and devastating. The consequences could include receiving less than you deserve or an outright dismissal of your claim. That’s why you’ll need our lawyers lawyers at Brach Eichler Injury Lawyers to help you.
Let Brach Eichler Injury Lawyers Handle Your Car Accident Injury Case
Complicated laws apply to car accident victim compensation in New Jersey, so you’ll need the help of the experienced car accident attorneys at Brach Eichler Injury Lawyers to fight for your rights. We offer free consultations for all prospective new clients, and there’s never a fee unless we win money for you. Contact us online or call us at (973) 364-8300 and let us help you get justice. Check out our recent case results to know why you should trust us.
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Written by: Brach Eichler Injury Lawyers Last Updated : January 9, 2025We are the trial attorneys with the experience and knowledge to get you the results you deserve. At Brach Eichler Injury Lawyers, we take time to get to know you, as well as your case. We are committed to excellence. It is important for our team to understand your fears, concerns and expectations. We are always available to answer any questions, and are willing to come to you if you are unable to come to us.
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