In New Jersey, employers are required to maintain workers compensation insurance for their employees. If you are injured while in the scope of your employment, then you are entitled to three things: medical benefits, temporary benefits, and a permanency award.
Your employer’s workers compensation insurance will provide medical aide to you with their authorized treating doctors. The insurance company should ensure that you are being treated with authorized doctors for injuries that you sustained while working. You should not be responsible for any medical bills arising out of medical care you received for injuries that you sustained while in the scope of employment. If you are in the unfortunate situation where your employer’s insurance refuses to either provide you with authorized medical care or refuses to pay the medical bills, a lawyer can file a motion with the Worker’s Compensation Court to compel those medical benefits.
Now suppose you are treating with the workers compensation doctor, and the doctor recommends that you discontinue working for a period of 6 weeks because of your injuries. In this type of situation, you are entitled to temporary benefits, which means your employer still has to pay you 70% of your paycheck during the time that an authorized treating doctor has put you out of work.
Finally, a permanency award is the monetary award you receive as compensation for the functional loss of a specific body part. This award is determined once you reach maximum medical improvement, or MMI, which means that your injury will not be improved by any more treatment. After physically examining you, an independent medical expert would then provide a percentage of your disability, which determines the amount of your award.
One of the initial decisions you will have to make when enrolling in a car insurance policy is selecting health care primary or personal injury protection, known as PIP. When you are injured in a car accident, the issue arises as to who will take care of your medical treatment and cover your medical expenses. Many people will choose the healthcare primary option because of the smaller price tag. However, you must tread carefully. Addressing the possible repercussions of this option is imperative to understand how it can impact you later on if you are injured in a motor vehicle accident.
If you select PIP as your primary, then typically your PIP will cover medical expenses incurred up to the PIP limit. PIP coverage can include medical expenses of up to $250,000 but you may elect to purchase less coverage in the amounts of $15,000, $50,000, $75,000, or $150,000. However, purchasing less than the $250,000 limit, you may end up not having enough insurance to get all the medical treatment you need or to pay for all your medical bills.
Electing your health care insurance as your primary is an option that you have and is cheaper than electing PIP as your primary. However, it is crucial to be cognizant that your health insurance plan may refuse to provide coverage for a car accident. Also, your health insurance plan may also refuse to pay certain bills because of your deductible and fee schedules. Another important factor to take into consideration is if you decide to sue the driver who caused the accident, and you are awarded compensation for your injuries and damages, your health insurance carrier can assert a lien on the case. For example, if your health insurance paid $50,000 in medical expenses and you are awarded $100,000 in your lawsuit, the health insurance can come back and put a lien on the case and get reimbursed the $50,000 it paid, leaving you only with $50,000.
These are all very important factors to take into consideration when making the decision of selecting your health insurance or PIP as primary.
Imagine getting into a car accident that was not your fault and getting severely and permanently injured. Now imagine suing the person who caused the accident, only to discover that the person has a mere $15,000 in liability coverage. Is that $15,000 really going to compensate you for your injuries, pain and suffering, wage loss, and property damage? Or worse, imagine that person committed a hit and run, nowhere to be found. Who is going to pay you for your injuries and damages? That is where Uninsured Motorist and Underinsured Motorist coverage steps in and saves the day. Yes, you should always elect the UM/UIM coverage option.
Uninsured Motorist Coverage pays you for your property damage or bodily injury if you are in a car accident caused by an uninsured motorist. For example, suppose a driver rear ends your vehicle and then takes off. Your car has damage and you suffer injuries. Who is going to pay for that when the person at fault is gone? Your uninsured motorist coverage will take care of that for you.
Underinsured Motorist Coverage pays you for property damage or bodily injury if you are in a car accident caused by someone who, although is insured, does not have enough liability coverage to pay you for your property damage or injuries. For example, supposed you have $100,000 in Underinsured Motorist Coverage and you are involved in a car accident caused by someone who has $15,000 in liability coverage. If your injuries and property damage cost $100,000, you will only be able to get $15,000 from the other driver. So where can you get the $85,000 for the rest of your damages? Your Underinsured Motorist Coverage takes care of that for you.
As you can see, while the UM/UIM election is optional, it really is something that everyone should choose, because these types of situations happen often and it is always better to make sure that your bases are covered. You never can anticipate what may happen and it is always better to be prepared.