PIP Coverage for the Injured Pedestrian

We all know the inherent dangers of walking on the roads. We also know that there are affirmative steps that you can, and absolutely should, take to protect yourself. Walk on sidewalks where possible, observe crossing signals, cross only in marked crosswalks where feasible, wear bright clothing to stay visible, and most importantly, always remain alert. These steps will definitely mitigate the risk of an accident.

However – even when you have done everything as a pedestrian to protect yourself, sometimes a collision cannot be avoided.

The CDC reports that in 2010 alone, 4,280 pedestrians were fatally injured in pedestrian-vehicle collisions in the United States, and another 70,000 pedestrians were injured.[1] This averages out to one vehicle collision-related pedestrian death every 2 hours, and a pedestrian injury every 8 minutes.

Because the dangers are so prevalent, and the injuries potentially so catastrophic, most pedestrians injured from contact with a vehicle will require extensive and costly medical treatment. It is crucial then to identify the insurance available to pay for this treatment as early as possible.  Unfortunately, insurers are not always forthcoming with available coverage. One of the benefits of hiring a personal injury attorney is identifying the available sources of benefits.

Personal Injury Protection coverage (PIP) is coverage in an auto policy that will pay for reasonable and necessary medical expenses and income loss caused by a collision. The policy will specify who is covered via PIP and will define who is considered an insured under this portion of the policy. The amount of coverage will typically range between $10,000 and $35,000.

The insurer is required by law to offer PIP, but an insured may decline coverage by signing a written waiver (electronic waivers can be considered valid).  To be effective, this waiver must be in writing.  When an insurer asserts there is no PIP coverage, we always demand to see the written (or electronic) waiver.  If the insurer cannot produce a written or electronic waiver, then the insured has PIP coverage.[2]

Often, more than one policy of insurance will be available to potentially cover a pedestrian’s medical expenses and compensate for damages.  When more than one policy of insurance is available, there is an order in which to access benefits.  For example, in an auto claim, health insurance will usually refuse to pay until PIP has been exhausted.  Coverage is always a source of anxiety for a severely injured pedestrian with quickly mounting medical bills, particularly when that pedestrian has limited or no health coverage. When a pedestrian has been injured by a vehicle, we begin our claim analysis by seeing what available auto policies exist.

Most injured pedestrians do not realize that the place to start in the investigation is with the driver of the vehicle and examining their insurance policy. The PIP portion of a policy will identify who is covered as an insured and under what circumstances benefits are available.   We always request information from the driver’s insurance company, and specifically inquire as to whether PIP benefits are available.  Again, if the insurer asserts there is no PIP, we demand to see the written waiver. Most policies with PIP coverage will contain language similar to the following: We will provide medical benefits for bodily injury to each insured caused by a motor vehicle accident, all reasonable and necessary medical and hospital expenses.  Insured person means a pedestrian if struck by your car.

In fact, RCW 48.22.005 5(b) states that unless there is specific language to the contrary, an insured means, “a person who sustains bodily injury caused by accident while: (i) Occupying or using the insured automobile with the permission of the named insured; or (ii) a pedestrian accidentally struck by the insured automobile.”

Unfortunately, too many injured pedestrians do not know that insurance benefits providing coverage for their medical expenses are available under the driver’s auto insurance policy.  And too many insurance company adjusters will not divulge that this coverage is available unless coverage is asserted by the injured pedestrian.  If that driver’s PIP coverage is insufficient to cover all the medical costs, the pedestrian can then claim under their own insurance policy’s PIP coverage if applicable.  Health insurance is another source of coverage for the injured pedestrian.

Investigating all available coverage is important not only in assessing potential sources of monetary recovery for damages suffered by the injured pedestrian. It can also be crucial in ensuring that the injured pedestrian is able to receive all the reasonable and necessary medical care required to ensure maximum healing and recovery, as well as the recovery of lost wages when they are needed the most.



[1] See Department of Transportation (US), National Highway Traffic Safety Administration (NHTSA). Traffic Safety Facts 2010: Pedestrians. Washington (DC): NHTSA; 2012 [cited 2013 April 11].http://www.cdc.gov/motorvehiclesafety/pedestrian_safety/factsheet.html

[2] See Revised Code of Washington (RCW) 48.22.085.