PIP Claims: When Your Best Friend Goes Bad

When you accept the optional Personal Injury Protection (PIP) coverage on your auto insurance policy, you might feel comforted knowing your new best friend, your insurance company, has got your back no matter what. Even if you are injured in an accident that is your own fault, your insurance company will pay your medical bills and cover your lost wages, without so much as wagging a finger at you. You could call it the insurance version of unconditional love. But sometimes, unexpectedly, the love stops coming.

Maryland insurance law requires providers of PIP coverage to pay reasonable and necessary medical expenses submitted by the insured, up to a predetermined limit. But you and your insurer may not always see eye-to-eye on just what is reasonable and necessary.  When that happens, usually your insurance company will require review by an independent medical practitioner, and they have a right to do that. What they don’t have a right to do is refuse to pay for arbitrary or capricious reasons, as the insurance regulations so eloquently put it.

If you feel your insurance company has acted in bad faith in denying payment under your PIP coverage, you have a right to file a civil complaint, and seek not only payment of the denied claims, but also reimbursement for legal expenses (up to one-third the amount of the actual damages claimed). Even if you have handled your claims on your own up until that point, this is the time to seek out the help of a new best friend: a Maryland personal injury attorney.

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