PIP Coverage in Massachusetts: How It Affects Your Personal Injury Claim
Massachusetts is one of a handful of no-fault auto insurance states, and PIP (Personal Injury Protection) is at the center of how car accident claims work here. Every auto insurance policy in the state must include PIP coverage, and it directly affects how your medical bills are paid, when you can sue the at-fault driver, and the overall value of your personal injury claim.
Understanding PIP is essential because it interacts with your health insurance, the tort threshold, and the at-fault driver’s liability coverage in ways that can be confusing.
What PIP Covers
PIP provides $8,000 in no-fault benefits under M.G.L. c. 90, Sections 34A and 34M. “No-fault” means your own insurance pays these benefits regardless of who caused the collision. You do not need to prove the other driver was at fault to receive PIP.
PIP covers three categories, all within the $8,000 total limit:
- Medical expenses: Reasonable and necessary medical treatment related to the collision, including emergency room visits, hospital stays, surgery, physical therapy, chiropractic care, prescriptions, diagnostic imaging, and necessary ambulance and funeral expenses.
- Lost wages: 75% of your average weekly wage for income lost due to injuries from the collision.
- Replacement services: Reasonable payments to others for necessary services you would have performed for yourself or your household (such as housekeeping or childcare) had you not been injured.
PIP does not cover:
- Pain and suffering
- Property damage to your vehicle
- 100% of lost wages (only 75%)
- Medical expenses that are not reasonable and necessary
Who Is Covered by PIP?
Your PIP coverage extends to:
- You (the named insured)
- Household members listed on your policy
- Passengers in your insured vehicle at the time of the collision
- Pedestrians struck by your insured vehicle
If you are injured as a pedestrian or cyclist, the PIP coverage on the vehicle that struck you applies to your medical expenses and lost wages.
How PIP Works with Health Insurance
This is where most confusion arises. PIP and health insurance interact in a specific way:
First $2,000 in medical expenses: PIP is the primary payer. Your auto insurance pays these bills first, before your health insurance.
After $2,000: If you have health insurance, your health insurance becomes the primary payer for additional medical expenses. PIP becomes secondary and pays the balance (co-pays, deductibles, and amounts your health insurance does not cover) up to the remaining $6,000.
If you have no health insurance: PIP covers the full $8,000 in medical expenses as the sole payer.
This coordination matters because it stretches the PIP dollars further. For someone with good health insurance, PIP may cover the first $2,000 in bills plus co-pays and deductibles on subsequent treatment, effectively covering far more than $8,000 in total medical care.
The Tort Threshold: When You Can Sue Beyond PIP
PIP pays your initial medical expenses, but the question most people ask is whether they can pursue a claim against the at-fault driver for the full extent of their injuries, including pain and suffering.
The answer depends on the tort threshold under M.G.L. c. 231, Section 6D. You can step outside the no-fault system and sue the at-fault driver only if:
- Your reasonable and necessary medical expenses exceed $2,000, or
- Your injuries include death, a fracture, loss of a body member, permanent and serious disfigurement, or qualifying loss of sight or hearing
If you meet the tort threshold, you can pursue a full personal injury claim against the at-fault driver for all damages: medical expenses (past and future), lost wages, pain and suffering, emotional distress, and loss of enjoyment of life. The value of these claims ranges from thousands to millions of dollars depending on the severity of the injuries.
If you do not meet the tort threshold, your recovery is limited to PIP benefits and any property damage claim.
PIP and the July 2025 Insurance Changes
When Massachusetts increased its minimum auto insurance requirements effective July 1, 2025, several minimums changed significantly. However, the PIP limit remained unchanged at $8,000.
The changes that did take effect:
| Coverage | Previous Minimum | New Minimum (July 2025) |
|---|---|---|
| Bodily Injury (per person) | $20,000 | $25,000 |
| Bodily Injury (per accident) | $40,000 | $50,000 |
| Property Damage | $5,000 | $30,000 |
| Uninsured/Underinsured Motorist | $20,000/$40,000 | $25,000/$50,000 |
| PIP | $8,000 | $8,000 (unchanged) |
What Happens When PIP Runs Out?
Once your $8,000 in PIP is exhausted, your health insurance takes over as the primary payer for ongoing medical treatment. You should continue following your treatment plan, because all medical expenses beyond PIP become part of your personal injury claim against the at-fault driver.
The health insurance company may assert a subrogation or reimbursement claim against your settlement, meaning they may seek to recover the amounts they paid for your collision-related treatment. Your attorney will negotiate the subrogation claim to maximize the amount you keep from your settlement.
PIP and IMEs
Your auto insurance company has the right to require you to attend an Independent Medical Examination (IME) to evaluate whether your ongoing treatment is reasonable and necessary. If the IME doctor concludes that your treatment is no longer needed, the insurer can terminate your PIP benefits.
If your PIP benefits are cut off based on an IME, you have options:
- Your health insurance will cover continued treatment
- You can dispute the IME finding through the insurance company’s appeals process
- Your personal injury attorney can challenge the IME at settlement or trial
Insurance companies sometimes use IMEs as a tool to cut off PIP benefits prematurely, particularly in soft tissue cases. Having an attorney involved early can help prevent or challenge this tactic.
PIP for Pedestrians and Cyclists
If you are injured as a pedestrian or cyclist in Massachusetts, PIP coverage from the vehicle that struck you applies to your medical expenses and lost wages. If the at-fault driver cannot be identified (hit-and-run), your own auto insurance PIP coverage applies if you have a policy.
Pedestrians and cyclists who do not own a car and do not have auto insurance may still be covered under a household member’s policy or the policy of the vehicle that struck them.
Frequently Asked Questions
What does PIP cover in Massachusetts?
PIP (Personal Injury Protection) in Massachusetts covers up to $8,000 in reasonable and necessary medical expenses and 75% of lost wages, regardless of who caused the collision. It applies to the policyholder, household members, passengers in the vehicle, and pedestrians struck by the vehicle. PIP does not cover pain and suffering.
Does PIP pay before or after health insurance?
PIP pays first, before your health insurance. It is the primary payer for the first $2,000 of medical expenses. After the first $2,000, if you have health insurance that covers the treatment, your health insurance becomes primary and PIP becomes secondary. If you do not have health insurance, PIP covers the full $8,000.
Can I sue the other driver if PIP covers my medical bills?
Yes, but only if your case meets the tort threshold. Under M.G.L. c. 231, Section 6D, your reasonable and necessary medical expenses must exceed $2,000, or your injuries must include death, a fracture, loss of a body member, permanent and serious disfigurement, or qualifying loss of sight or hearing. If you meet the threshold, you can sue the at-fault driver for all damages including pain and suffering.
What happens if my medical bills exceed the $8,000 PIP limit?
Once you exhaust your $8,000 PIP coverage, your health insurance takes over for ongoing medical treatment. You can also recover all medical expenses beyond PIP from the at-fault driver through a personal injury claim, provided your case meets the tort threshold.
Does PIP cover passengers in my car?
Yes. PIP covers passengers in the insured vehicle regardless of fault. Passengers can also file a claim against the at-fault driver’s insurance for injuries beyond what PIP covers.
About the Author
Christopher Murphy, Esq. is the Managing Partner of Scalli Murphy Law with offices in Everett and Danvers, Massachusetts. Attorney Murphy has represented personal injury victims across Massachusetts since 1999 and has been recognized as a Massachusetts Super Lawyer in Personal Injury. He has helped thousands of clients and families recover compensation after car accidents, premises liability incidents, wrongful death cases, and other personal injury claims.
Contact Scalli Murphy Law
Understanding how PIP works and when you can pursue a claim beyond your no-fault benefits is essential to maximizing your recovery. Scalli Murphy Law has decades of experience navigating the Massachusetts no-fault system and fighting for full compensation for accident victims.
Call 617-387-7000 or 1-833-933-HURT for a free consultation. There is no fee unless we recover for you.
Everett Office: 537 Broadway, Everett, MA 02149
Danvers Office: 1 Webb Street, Danvers, MA 01923
Related Resources:
- Average Car Accident Settlement in Massachusetts (2026)
- What to Do After a Car Accident in Massachusetts
- Massachusetts Auto Insurance Minimums Increase (July 2025)
- Uninsured vs. Underinsured Motorist Coverage
This article provides general information about Massachusetts law and is not legal advice. Every case is different. For advice about your specific situation, contact Scalli Murphy Law, P.C. at 617-387-7000 for a free consultation.