PIP Benefits Do Not Limit Medical Expense Recovery

Submitted by New Jersey Personal Injury Lawyer, Jeffrey Hark.

The Law Division of the Superior Court of Cumberland County, New Jersey has recently ruled medical expenses exceeding Personal Injury Protection (“PIP”) coverage benefits are not limited and are recoverable in a law suit.  In Angel Viruet, Jr. v. Fernando Maoine, the plaintiff was involved in a vehicle accident.  At the time, plaintiff was insured by GEICO and selected PIP medical coverage benefits of $15,000.00.  Normally PIP coverage is offered in the amount of $250,000.00, but plaintiff elected a lower policy to reduce his premium.  Plaintiff’s medical bills he sustained from the accident amounted to $56,321.93, well above his PIP coverage.  Plaintiff sued the defendant to recover the medical expenses he incurred beyond the $15,000.00 limit.

The defendant attempted to prevent the plaintiff from presenting the excess medical damages to the jury by arguing that the medical bills exceeding the $15,000.00 PIP medical coverage limit are subject to the New Jersey Medical Fee Schedule.  The Medical Fee Schedule would significantly reduce the amount the plaintiff would be able to present to the jury.  The Court in this case disagreed by ruling the Medical Fee Schedule only applies to the medical expenses actually covered by PIP.  Those expenses incurred by the plaintiff beyond PIP coverage are not subject to the Medical Fee Schedule.

In summary, the plaintiff would be able to present to the jury the full amount of medical expenses he or she is contractually obligated to pay to the health care provider.  Those medical expenses as a result of an accident that exceed PIP coverage are not subject to restrictions and are not barred from evidence to be presented to the jury.