New Jersey PIP Coverage Limits: Medical Bills After a Car Accident

Do the PIP deductible and co-pay reduce your limit?

No. In Birmingham v. Travelers (2023), the Appellate Division held that the insurer owes the full limit, and your deductible and co-pay are paid on top of it.

The insurer had counted a $250 deductible and a $950 co-pay against a $15,000 limit. The court said no, so that limit can cover about $16,200 of bills before it runs out.

How do the deductible and 20% co-pay work?

You pay the deductible first, then 20% of bills between the deductible and $5,000. Above $5,000 the insurance company pays everything up to your limit.

What are the PIP limits in New Jersey?

On the Standard Policy you choose a medical limit of $15,000, $50,000, $75,000, $150,000 or $250,000. DOBI says most drivers pick $250,000.

Do not assume you have $250,000: the limit that counts is on your declarations page on the crash date.

Do I need personal injury cover on car insurance in NJ?

Yes, every Standard and Basic Policy includes PIP. Our explainer on whether New Jersey is a no-fault state shows how it fits with fault. See which coverages are mandatory in New Jersey.

Does a $15,000 limit still pay for serious injuries?

Yes, up to $250,000 for permanent or significant brain injury, spinal cord injury or disfigurement. It also covers trauma center or acute care treatment of other permanent or significant injuries right after the crash, until the patient is stable.

Those payments use up the lower limit you chose first. The Basic Policy has a $15,000 PIP limit with the same rule. See how the Basic Policy compares with a Standard Policy after a crash.³

Who pays a hospital bill after a car accident in NJ?

Your own PIP pays it first, after your deductible and co-pay, unless you chose your health plan as primary.

What is PIP primary?

It is the default: auto PIP pays before your health plan. Our guide on whether PIP or health insurance pays first explains the other choice.

Does a provider balance mean PIP has run out?

No. A provider balance does not prove your PIP has run out. DOBI's medical fee schedule sets how much PIP pays for each listed service, including home care, ambulance and medical equipment, so check which of three numbers someone is quoting.

Our guide to medical records for a New Jersey injury claim lists what else to keep.⁴

Does PIP pay lost wages and household help?

Only if you kept the Extra PIP Package, which DOBI says most consumers choose but you can decline. A medical-only selection pays treatment from hospitals, doctors and other providers, and needed medical equipment, up to your medical limit, nothing else.

Extra PIP Package only:

• Lost wages (income continuation), less any Temporary Disability Benefits, up to the amount you select
• Household help (essential services), such as cleaning, mowing the lawn, shoveling snow or laundry
• Death benefit: uncollected wage and household help benefits, paid to family or estate
• Funeral expenses, up to the limit you select

See our guide to lost wages after a New Jersey car accident.⁵

What happens when medical bills go over your PIP limit?

You can claim bills above your limit, and bills PIP does not cover, from the driver who caused the crash. The limitation on lawsuit option does not block this, as our verbal threshold rulings review shows.

How future treatment costs split between PIP and that claim after the 2026 Murray v. Punina ruling is in our guide to bills PIP and health insurance leave unpaid. Other PIP rulings, on arbitration, rideshare policies and fee schedule disputes, are in our review of New Jersey PIP appeals decisions.

• If you were partly to blame: what happens when you are partly at fault.
• If the at-fault driver was uninsured: uninsured and underinsured motorist claims.
• For every other step: the New Jersey car accident help guide.⁶

Will PIP take money back from my settlement?

Bills PIP paid or can still pay are kept out of your claim against the at-fault driver.

That is the rule against double recovery. Your claim against that driver covers bills above your PIP limit or outside PIP, plus pain and suffering where your lawsuit option allows it.

In Liberty Mutual v. Penske (2019), a PIP reimbursement dispute between companies, including fault, had to go to arbitration. It did not involve an injured person's settlement.

Our sources set no single rule on whether an insurer can claim part of your own settlement, so ask before you sign. See signs you may need an accident lawyer. Under the court rule, a lawyer's contingent fee is worked out before any medical lien is deducted.⁷

What can you do if PIP denies a bill or treatment?

Ask for the written reason, then use the insurer's internal appeal and, if needed, binding PIP arbitration. Liability and UIM denials, and DOBI complaints, are in what to do when a claim is denied.

1. Find your declarations page: note your PIP limit, deductible and whether you have the Extra PIP Package.
2. Give every provider your PIP claim number so they bill the PIP insurer (or your health plan, if primary).
3. Your doctor requests approval through decision point review and precertification, on the Uniform Attending Provider Treatment Plan Form.
4. If a bill is denied, get the reason in writing and ask your provider to file the insurer's internal appeal.
5. If that fails, the dispute can go to binding PIP arbitration, explained in our PIP denial and arbitration guide.
6. Get your New Jersey car accident report for any claim against the other driver. PIP arbitration does not handle that claim.⁸