What Is PIP Insurance?

A girl sits on a couch with her broken leg propped up on a pillow, holding an ipad and waving to someone on a video call

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Personal injury protection (PIP) is an auto insurance coverage that pays for medical expenses, lost wages, and more for you and your passengers after an auto accident—regardless of who caused it.

Definition of Personal Injury Protection Insurance

Personal injury protection covers hospital bills and other medical expenses after you’re injured in an accident, whether or not it was your fault. It typically includes other benefits like lost wages, funeral expenses, essential services, death benefits, and more. All states with a no-fault insurance system require you to have personal injury protection as part of your car insurance policy. Some states with an at-fault system require drivers to carry personal injury protection, and it’s optional in a handful of other states. 

  • Alternate name: No-fault coverage
  • Acronym: PIP

How Does PIP Insurance Work?

Legislation introduced the no-fault system in the 1970s to make it faster and easier for accident victims to receive compensation, regardless of who was at fault for the accident. Under this system, financial losses like medical expenses are paid for by each party’s own insurance carrier, rather than having to wait for the insurers to agree who was at fault—and legally liable—for accident costs. 

States where PIP is required or optional have laws that allow policyholders to seek compensation from their own insurance company after an accident. In some of these states, known as no-fault states, you can only sue the other driver for additional medical expenses or pain and suffering if your injuries meet a state-specific tort threshold. Thresholds can either have verbal terms, like death or significant disfigurement, or monetary terms, such as minimum dollar amounts for medical bills.

For example, say you’re a Utah policyholder and you’re in a car accident. You have a PIP limit of $3,000, and your state has a tort threshold of $3,000. Your medical expenses from the accident total $2,500, so your insurer will cover your entire medical bill because it’s less than your PIP limit (as long as you’re eligible—see next section). But because your medical bill is below the tort threshold, you cannot sue the driver who hit you for pain and suffering.

States with “add-on” car insurance laws have no restrictions on lawsuits, unlike no-fault-based systems. But drivers get compensation from their own insurers as they would in no-fault states. In some of these states, PIP is still required, while in others, coverage is optional.

What Does PIP Insurance Cover?

Depending on your state, PIP may cover these items when you’re involved in an accident—even if you weren’t driving:

  • Medical bills for everyone on the policy (including when hit as a pedestrian, cyclist, or a passenger in another car).
  • Lost wages for you and your passengers if injuries cause you to miss work.
  • Cost of hiring temporary workers to handle your workload if you’re self-employed .
  • Essential services like lawn and child care and house cleaning.
  • Death benefits paid to your family in the event of your death.
  • Funeral, burial, or cremation expenses after a crash.
  • Disability and rehabilitation expenses.

Children living at home or away at school are automatically covered by a parent’s car insurance policy. Generally, your policy should list anyone over the age of 14 who lives in your house, even if they don’t have a license, though insurers may have different minimum age requirements. Anyone who drives your car regularly should also be on your policy. It’s not unusual for insurers to request this information when you obtain quotes or purchase a policy.


Your insurer may not pay out PIP benefits if the driver:

  • Intentionally caused the accident.
  • Was hurt while committing a felony.
  • Was injured while driving your insured car without your consent.
  • Was driving a vehicle they own but that was not listed on the insurance policy.

Additionally, passengers or relatives who live with you and own their own cars may not be covered by your PIP coverage. They may have to purchase PIP for themselves. 

Do I Need PIP Insurance?

Some states require PIP insurance as part of your car insurance policy, so if you live in one of them (see table), yes, you need PIP coverage. Three of those states (Kentucky, New Jersey, and Pennsylvania) are “choice no-fault” states, where you can reject the no-fault system and go with a traditional tort liability (fault-based) system if you prefer.

Here’s where PIP insurance is required and optional, as well as other important details.

State PIP Required? PIP Minimum Insurance System Tort Threshold
Arkansas Optional $5,000 Add-on No
Delaware Yes $15,000 Add-on No
Florida Yes $10,000 No-fault Verbal
Hawaii Yes $10,000 No-fault $5,000 or verbal
Kansas Yes $9,000 No-fault $2,000 or verbal
Kentucky Yes $10,000 Choice no-fault $1,000 or verbal
Maryland Yes $2,500 Add-on No
Massachusetts Yes $8,000 No-fault $2,000 or verbal
Michigan Yes $250,000; may be lower if you have Medicaid or Medicare No-fault Verbal
Minnesota Yes $40,000 No-fault $4,000 or verbal
New Jersey Yes $15,000 Choice no-fault Verbal
New York Yes $50,000 No-fault Verbal
North Dakota Yes $30,000 No-fault $2,500
Oregon Yes $15,000 Add-on No
Pennsylvania Yes, called “medical benefits” $5,000 Choice no-fault Verbal
Texas Optional, but automatically included in policies unless you reject it in writing $2,500 Add-on No
Utah Yes $3,000 No-fault $3,000
Virginia Optional N/A Add-on No
Washington Optional, but automatically included in policies unless you reject it in writing N/A Add-on No
Washington, D.C. Optional N/A Add-on No

Medical Payments vs. PIP Insurance

Medical Payments Insurance PIP Insurance
Available in at-fault states and states with add-on systems Available in states with no-fault or add-on systems
Almost always optional May be required or optional
Covers medical and funeral expenses Covers medical expenses, essential services, and more

You’ll find PIP insurance offered in no-fault states or at-fault states with an add-on system. Some of these states may also offer medical payments insurance, which may be able to supplement your PIP coverage after it’s exhausted. All other states only offer medical payments coverage. 

When available, medical payments coverage is nearly always optional. PIP, however, can be obligatory or optional, depending on your state’s laws. 

Both coverages help pay medical expenses for you and your passengers after a car accident, regardless of who caused it, but PIP has additional coverages. For instance, it can cover up to 80% of lost wages and household services like child and lawn care if you can’t fulfill those responsibilities because of injuries.

Key Takeaways

  • Fifteen states require drivers to have personal injury protection (PIP) insurance. PIP is optional in another four states and Washington, D.C., though in some states insurers will include it in your policy unless you reject the coverage in writing. 
  • In no-fault states, your insurer pays the benefits included under your PIP for people insured under the policy and your passengers up to your policy’s limits after an accident. You can also only sue for severe injuries or pain and suffering if you meet certain conditions. 
  • If you have PIP in a state with an add-on insurance system, your insurer also pays you and your passengers’ expenses up to the limit, but there aren’t any restrictions on lawsuits. 
  • Both PIP and medical payments coverage pay health care expenses, but PIP may also have other coverages. You can have both types of insurance if your state or insurer offers it, in which case your medical payments may act as secondary coverage.

Article Sources

  1. Insurance Information Institute. "Background on: No-Fault Auto Insurance." Accessed April 20, 2021. 

  2. Insurance Information Institute. "Background on: No-Fault Auto Insurance," see "The Beginning of the No-Fault System." Accessed April 20, 2021. 

  3. Insurance Information Institute. "Background on: No-Fault Auto Insurance," see "The Different Auto Insurance Systems." Accessed April 20, 2021. 

  4. Utah State Legislature. "31A-22-309.  Limitations, Exclusions, and Conditions to Personal Injury Protection." Accessed April 20, 2021.

  5. Direct Auto Insurance. "Do I Have to Include Everyone on My Car Insurance Policy?" Accessed April 20, 2021. 

  6. Florida Office of Insurance Regulation. "Notification of Personal Injury Protection Benefits," see p. 2. Accessed April 20, 2021. 

  7. The Hartford. "Medical Payments Coverage – Auto Insurance." Accessed April 20, 2021. 

  8. Texas Office of Public Insurance Counsel. "Understanding PIP vs Med-Pay." Accessed April 20, 2021.