CUSHNER & BLOOM, P.C.

BROOKLINE, MA  02446

Tel. (617) 608-0019

 
e-mail: cbpc@ix.netcom.com

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AUTOMOBILE ACCIDENTS IN MASSACHUSETTS

IF YOU BEEN INJURED IN A MOTOR VEHICLE ACCIDENT, CALL ME............

 
 

Who will pay my medical bills?

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THE FOLLOWING IS A GENERAL OVERVIEW OF ONLY PORTIONS OF THE APPLICABLE  LAW.  IT IS NOT INTENDED TO BE COMPLETE NOR IS INTENDED TO CONSTITUTE LEGAL ADVICE.  EVERY CASE IS DIFFERENT!!! ALWAYS CONSULT WITH AN ATTORNEY TO KNOW YOUR RIGHTS.

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PERSONAL INJURY PROTECTION

Under Massachusetts law, generally, most automobiles (with a few exceptions) carry "Personal Injury Protection" provisions in their auto insurance policies.  This part of the auto insurance provides for payment to:

• the named insured;
• members of the insider's household; and
• any authorized operator or passenger of the insured's motor vehicle, including a guest occupant and any pedestrian struck by the insider's  motor vehicle

unless any of these persons would otherwise be covered under worker's compensation insurance for the same accident.

Generally, the Personal Injury Protection (PIP) will provide payments of all reasonable expenses incurred within two years from the date of accident for necessary medical, surgical, x-ray, and dental services, including prosthetic devices and necessary ambulance, hospital, professional nursing and funeral services as a result of bodily injury, sickness or disease, including death at any time resulting therefrom, caused by an auto accident or while entering into or alighting from, or being struck as a pedestrian by, the insured's motor vehicle.  This provision applies regardless of fault.

This provision applies regardless of fault.  The limits of this type of insurance (for lost  wage benefits and medical coverage) is usually (but not always) $8000 per covered person.

The auto insurance company may refuse to pay a PIP benefits if such person's conduct contributed to his or her injury in any of the following ways while operating a motor vehicle in the Commonwealth of Massachusetts (1) while under the influence of alcohol or a narcotic drug; (2) while committing a felony or seeking to avoid lawful apprehension or arrest by a police  officer;  (3) with the specific intent of causing injury or damage to himself.  The auto insurance company may also refuse to pay PIP benefits for other reasons.                                                                                                                                                                                                             

IF THE INJURED PERSON HAS THEIR OWN HEALTH INSURANCE

If the injured person has their own private health insurance, is a member of an HMO, or is covered by another insurance policy or agreement of any group, organization, partnership or corporation to pay for or reimburse the cost of medical, hospital, dental or other health care services, usually, PIP will provide for payment of no more than $2000 of expenses incurred within 2 years from the date of accident for medical, surgical, x-ray and dental services, including prosthetic devices and necessary ambulance, hospital, professional nursing and funeral services.  If an injured person has their own health insurance or is a member of an HMO, it may become quite legally complex as to whom is responsible for paying for the medical bills between $2000 and $8000.  For example, in the recent case of Dominguez v. Liberty Mutual Ins. Co., 429 Mass. 112 (1999), the Massachusetts Supreme Judicial Court held that the auto insurer did not have to pay the injured person's medical bills in excess of $2000 where the injured person had the appropriate health care available to him through his health plan but he decided to go outside of the plan for medical care.
   

WHAT IF MY MEDICAL BILLS EXCEED THE PIP COVERAGE?
(CONTACT US!)

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We recommend that all persons injured
in automobile accidents seek
representation by a competent attorney.