How Personal Injury Protection (PIP) Works In Texas

March 14, 2010

Substantially less than half the automobile drivers in Mansfield, Dallas, Fort Worth, Arlington, Grand Praire, Weatherford, or any other place in the State of Texas carry Personal Injury Protection (PIP) benefits on their automobile insurance policy. Dollar for dollar it is one of the more expense insurance benefits a person can purchase.
PIP covers losses for medical bills and lost wages that are incurred for incidents arising out of the use of a covered automobile. This requirement is set out in the Texas Insurance Code, Section 1952.151. It is required to be offered on all automobile insurance policies issued in the state of Texas. This requirement is found in Section, 1952.152.
This purpose of this article is to help the reader understand Texas Insurance Code, Section 1952.155 and to tell the reader that the law in this section is enforced by holdings in the Texas Supreme Court. It states some of the Texas law dealing with PIP. The title of this section is, "Benefits payable without regard to fault or collateral Source; Effect on Subrogation."
The section starts out:
(a) The benefits under coverage required by this subchapter are payable without regard to:
(1) the fault or nonfault of the named insured or recipient in causing or contributing to the accident; and
(2) any collateral source of medical, hospital, or wage continuation benefits.
Ok, what does (1) and (2) mean? One means that PIP benefits are payable no matter who is at fault in causing the loss. So regardless of who caused the injury, you or some other person, PIP will pay benefits. Number two means that the PIP benefits are payable even if you already had a medical benefits plan pay your bills or a hospital benefits plan already paid the bill. And it pays lost wages even if you had some other disability or other type of wage loss plan pay the lost wages. Both these essentially mean that a person could legally get a "double recovery" This is the only place in Texas law where this is a possibility.
Next, this section says:
(b) Except as provided by Subsection (c), an insurer paying benefits under coverage required by this subchapter does not have a right of subrogation or claim against any other person or insurer to recover any benefits by reason of the alleged fault of the other person causing or contributing to the accident.
This part (b) means that if you receive PIP benefits and it is determined that some other person was at fault for causing the injury or loss, then your the insurance company cannot attempt to recover from the other person or his insurance company any monies that have been paid to you.
The last section says:
(c) An insurer paying benefits pursuant to this subchapter, including a county mutual insurance company, shall have a right of subrogation and a claim against a person causing or contributing to the accident if, on the date of the loss, financial responsibility as required by Chapter 601, Transportation Code, has not been established for a motor vehicle involved in the accident and operated by that person.
So this section (c) is an exception to (b) in that if another person causes the accident, and the other person does not have the liability insurance required under Texas law, then the insurance company providing the PIP benefits can pursue the at fault person for the monies paid on the PIP claim.