Personal Injury Protection (PIP) is a coverage which is required by Texas law to be offered when a person purchases automobile coverage. One of the questions regarding this coverage is, why is it paid. This issue was partially addressed in the 2020, Texas Supreme Court opinion styled, Farmers Texas County Mutual Insurance Company v. Rodney Beasley.
In this case the Court had to decide whether a plaintiff had standing to file a lawsuit against his PIP insurer after the insurer paid the incurred medical expenses pursuant to the PIP policy, but the amount paid was the negotiated rate between the plaintiff’s health care provider and the insurer — not the medical providers’ list rate. This Court concluded that plaintiff could not show harm and thus, the case should be dismissed.
Here, Beasley was injured in a car accident. Beasley sought medical treatment and incurred expenses with a list rate of $2,662.54. Beasley’s health insurer, Blue Cross Blue Shield (BCBS) has a negotiated rate with the medical providers and paid $1,068.90, and no attempt was made against Beasley by the medical providers to recover any further monies.