Massachusetts PIP Benefits: What the $8,000 Limit Covers

By the FigureMyTax Editorial Team · How we calculate

Massachusetts personal injury protection pays, whoever caused the accident, at least $8,000 per person for reasonable medical expenses, lost wages limited to 75 percent of your average weekly wage, and replacement services.

What PIP covers

M.G.L. c. 90, 34A requires every motor vehicle liability policy to provide PIP for reasonable medical, surgical, x-ray and dental services, including prosthetic devices and necessary ambulance, hospital, professional nursing and funeral services; for loss of wages or salary, or loss of earning power for people not employed; and for ordinary and necessary services you would have performed for yourself or your household if not injured. It applies to injury in, entering, alighting from or struck as a pedestrian by the insured vehicle, without regard to negligence, up to a limit of at least $8,000 for one person.

The wage rule

Payments for lost wages are limited to amounts actually lost and to an amount that provides 75 percent of your average weekly wage for the year before the accident, together with any wage continuation program payments. A person not entitled to wage continuation gets an amount providing 75 percent of average weekly wage.

Exclusions

Insurers may exclude a person whose conduct contributed to the injury while operating a motor vehicle in Massachusetts while under the influence of alcohol or a narcotic drug, while committing a felony or avoiding lawful apprehension, or with intent to cause injury or damage.

How and when you are paid

Section 34M says PIP benefits are due as loss accrues on reasonable proof, the insurer must begin medical payments within ten days of a physician's notice of disability or give written reasons for not paying, and benefits unpaid more than 30 days support an action in contract with court costs and reasonable attorney's fees if you win. A claim must be presented as soon as practicable and in every case within two years of the accident.

Exempt from tort to that extent

PIP is granted in lieu of damages otherwise recoverable in tort. Owners, registrants, operators and occupants are exempt from tort liability for bodily injury damages to the extent you are, or without a deductible would be, entitled to PIP.

Using the calculator

A worked example: with $800 a week of lost wages for four weeks, PIP pays 75 percent, or $2,400, plus covered medical expenses, up to $8,000 in total. Run your own numbers in the Massachusetts no-fault calculator, then read the tort threshold and how health insurance and deductibles work. If the other driver has little insurance, see Massachusetts UM/UIM stacking.

This is general information, not legal advice, and the state comparisons above are illustrative, not an exhaustive survey. Confirm how Massachusetts's rules apply to your specific case with a licensed Massachusetts attorney.