PIP Insurance: How Personal Injury Protection Works in No-Fault States

Last updated: 26 October 2026. This guide uses the Insurance Information Institute’s background on no-fault laws, the Florida, Michigan and New York no-fault statutes and regulator materials, state insurance department and DMV pages for Delaware, Maryland, Oregon and Texas, and Insurance Journal’s report on New York’s 2026 reforms. It is general information, not legal advice.

Short answer: PIP insurance, or personal injury protection, is car insurance that pays your own medical bills, a share of lost income and some other costs after a crash, whoever caused it. Twelve no-fault states and Puerto Rico require it. In those states you usually claim from your own insurer first and can sue the other driver only for more serious injuries.

Key takeaways

• PIP is first-party cover: your own insurer pays you, without anyone having to prove fault, up to the policy limit.
• The Insurance Information Institute counts 12 no-fault states plus Puerto Rico. Some other states, such as Delaware, Maryland and Oregon, also require or build in PIP but do not restrict lawsuits.
• Limits vary widely: $10,000 in Florida, $50,000 of basic economic loss in New York, and a choice of medical limits from unlimited down to an opt-out in Michigan.
• Deadlines are short. Florida pays medical benefits only if you get initial treatment within 14 days, and New York requires written notice within 30 days of the accident.

What is PIP insurance and what does it pay?

Personal injury protection is part of a car insurance policy that pays for injuries to you, and usually to members of your household and passengers in your car, after an accident. It is called first-party cover because you claim from your own insurer rather than from the other driver’s. Fault does not matter for the PIP claim itself.

What PIP pays depends on the state, but the typical list is:

• Medical expenses: reasonable and necessary treatment, often only a percentage of the bill, such as 80% in Florida.
• Lost income: part of your earnings while you cannot work, for example 60% in Florida and 80% up to $2,000 a month in New York.
• Replacement services: help with tasks you cannot do, such as housework or childcare. Michigan pays up to $20 a day for these for the first three years.
• Death and funeral benefits: fixed sums, such as $5,000 in Florida and a separate $2,000 death benefit in New York.

PIP does not pay for damage to your car, and in most no-fault states it does not pay for pain and suffering. Those losses go through property damage cover, collision cover or a liability claim against the other driver.

What is the difference between no-fault and tort states?

The Insurance Information Institute describes four systems. In a true no-fault state, PIP is compulsory and the right to sue for pain and suffering is restricted until an injury passes a threshold. In a choice no-fault state, drivers can pick between a no-fault policy with a lawsuit threshold and a traditional policy that keeps full rights to sue. In an add-on state, drivers get first-party benefits but there is no restriction on lawsuits. In a tort state, fault decides who pays and anyone hurt can sue the at-fault driver for all losses.

The idea behind no-fault was to take small injury claims out of the courts and pay people faster. The trade-off is the threshold: if your injury does not meet it, you cannot sue for non-economic losses such as pain and suffering, however clear the other driver’s fault. For how fault works where it does matter, see our guide to the car accident lawsuit process.

Which states require PIP?

According to the Insurance Information Institute, 12 states and Puerto Rico have no-fault laws: Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania and Utah. New Jersey, Pennsylvania and Kentucky are choice states, where drivers can reject the lawsuit threshold.

Florida lawmakers have debated replacing PIP in recent sessions, but no repeal has become law. The state’s highway safety department still requires every registered vehicle to carry at least $10,000 in PIP and $10,000 in property damage liability.

How did Michigan’s 2019 reform change PIP?

The 2019 reform (Public Act 21 of 2019) gave Michigan drivers a choice of PIP medical limits for policies issued or renewed after 1 July 2020. The Department of Insurance and Financial Services sets out the six PIP medical options. Unlimited remains the default if no choice is made. The lower options depend on having other cover: the $250,000 option with exclusions requires qualifying health insurance, the $50,000 option is for people enrolled in Medicaid, and the opt-out is only for people with Medicare Parts A and B.

Choosing a low limit saves money but shifts risk. A serious crash can exhaust $50,000 of medical cover quickly, and wage loss, replacement services and funeral benefits are separate from the medical limit. Michigan’s no-fault law pays work loss for up to three years, reduced by 15% because the benefit is not taxed, subject to a monthly cap.

When can you sue the other driver in a no-fault state?

Depending on the state, economic losses above your PIP benefits may be recoverable from the at-fault driver, but suing for pain and suffering requires passing the threshold. Thresholds come in two kinds. A verbal threshold describes the injury, such as death, fracture or permanent loss of use. A monetary threshold lets you sue once your medical costs pass a fixed dollar figure.

New York changed its rules in 2026. As Insurance Journal reported, the state budget repealed the “90/180” category of serious injury, which had covered injuries that stopped someone from carrying out their usual daily activities for 90 of the first 180 days. Law firm commentary says the change applies to actions started on or after 26 May 2026. The same package bars recovery of non-economic damages in motor vehicle cases by a claimant who is more at fault than the defendants combined, although no-fault benefits are still paid. Michigan already bars tort damages for a party more than 50% at fault under section 3135 of its insurance code.

If you think your case clears the threshold, our guides to when to sue or settle after a car accident and what injury lawyers charge explain the next steps.

What is the difference between PIP and MedPay?

Medical payments cover, usually called MedPay, also pays accident medical bills regardless of fault, but it is narrower. The Texas Office of Public Insurance Counsel explains that Texas PIP pays medical and funeral costs incurred within three years plus 80% of lost wages, or household services for someone not working, while MedPay “does not pay lost wages” and can carry tighter limits. Texas insurers do not have to offer MedPay at all. Where both are available, PIP is the broader cover and MedPay works as a top-up for medical bills.

How do you make a PIP claim, and what are the deadlines?

Tell your insurer about the accident as soon as possible, even if you feel fine. Then get medical care quickly, keep every bill, and send proof of lost earnings from your employer. Specific state rules include:

• Florida: under section 627.736 of the Florida Statutes, medical benefits are paid only if you receive initial services within 14 days of the accident, and the full $10,000 is available only if a qualifying provider finds an emergency medical condition; otherwise medical benefits are capped at $2,500. Benefits are overdue if not paid within 30 days of written notice of the loss.
• New York: the Department of Financial Services’ no-fault forms say the application must reach the insurer within 30 days of the accident if earlier notice was not in writing, medical bills within 45 days of treatment, and lost earnings claims within 90 days.
• Michigan: under section 500.3145, a lawsuit for PIP benefits must be started within one year of the accident unless written notice of the injury was given to the insurer within that year or the insurer has already paid benefits.

Insurers can reduce or refuse PIP bills they consider unreasonable or not medically necessary, and Florida requires them to give an itemised explanation of any reduction or denial. If a claim is cut or denied, ask for the reasons in writing; our guide to options after an insurance claim is denied explains how to challenge it. Separate time limits apply to injury lawsuits against the other driver, which our New York personal injury statute of limitations page covers for that state.

Frequently asked questions

Is PIP insurance worth it if I have health insurance?

In no-fault states you usually have no choice, because PIP is compulsory. Where it is optional, it can still help, since health insurance does not replace lost wages or pay for household help, and PIP often covers passengers too.

Does PIP cover passengers?

Usually yes. Most PIP policies cover the policyholder, household family members and passengers in the insured car. Texas PIP, for example, covers the policyholder, family members, permitted drivers and passengers. Check your policy for the exact rule in your state.

Does PIP pay for pain and suffering?

No. PIP pays economic losses such as medical bills and lost income. To recover pain and suffering in a no-fault state, you normally have to sue the at-fault driver and show that your injury meets the state’s threshold.

Will my premium go up if I make a PIP claim?

It can. Rating rules differ by state and by insurer, so ask your insurer or your state insurance department how a PIP claim will be treated before deciding whether to claim.

What happens when PIP runs out?

You can turn to your health insurance, MedPay if you have it and, depending on the state, a liability claim against the at-fault driver for economic losses beyond PIP. In no-fault states, a claim for pain and suffering still requires passing the threshold.

Is Florida still a no-fault state in 2026?

Yes. Repeal bills have been debated, but none has become law, and Florida still requires $10,000 of PIP on every registered vehicle. The 14-day treatment rule and the $2,500 limit for non-emergency conditions still apply.

This article is general information about US auto insurance law and is not legal or insurance advice. PIP rules, limits and deadlines differ by state and by policy and can change with new legislation, so read your policy and speak to your insurer, your state insurance department or a qualified lawyer about your situation.