Texas Personal Injury Protection

• QUICK TIPS ABOUT WHO CAN COLLECT PERSONAL INJURY BENEFITS

1. Personal Injury Protection is an optional coverage that costs extra money beyond a standard liability-only policy. 2. Call the agent who sold the policy, or the insurance carrier to verify whether you have PIP. 3. Named insureds (people named on the policy) are always covered by Personal Injury Protection – regardless of what car they are in at the time of the wreck. 4. Family members who are not named on the policy are generally covered people, so long as they are not in a car owned by a family member that is not listed on the policy as a covered auto. 5. Injured people riding in cars listed on the policy are generally covered by Personal Injury Protection for that car. 6. The borrowed car scenario can lead to several layers of Personal Injury Protection coverage for the same injured person. The borrowed car scenarios can become confusing, but can also trigger coverage of more than one Personal Injury Protection policy. Personal Injury Protection is not required under Texas law but is an optional coverage you can purchase in addition to the required liability policy which we all must carry. The policy language for Personal Injury Protection coverage is written so that it covers certain people and certain cars. The easiest way to determine if you are covered by Personal Injury Protection as a named insured, or if your car is covered as a covered auto, is to call the agent who sold you the policy and ask them if you are covered. Calling the insurance company and making the claim is also a good way to find out if you are covered. Determining if you are covered is usually an easy task, but can become complicated under certain circumstances. Generally, there are covered people and covered cars which are identified by name or make, model and year on the declaration sheet – which is the documents you received from the insurance company showing who, and what vehicles, are covered on the policy. Covered people always include the named insured and generally include the family members of the named insured. The named insured is the person who bought the policy and any other people who are identified by name in your insurance papers. Family members are generally defined to include those people related to the named insured by blood and living under the same roof as the named insured. This means that family members who are not named on the insurance policy may also be covered. Remember the policy defines a family member as anyone related to the named insured by blood, marriage, or adoption and living with the named insured at the time of the wreck. Be sure to read the terms of your policy. Many policies cover family members, but some do not. Covered cars are identified in the insurance papers by make, model and year. Anyone riding in a covered auto is covered by the Personal Injury Protection policy, regardless of whether they are a named insured or related to a named insured. Being hurt in, on, getting into or out of a covered auto qualifies that person for benefits of the Personal Injury Protection coverage. It does not matter if the injured person is not named in the policy as long as they are occupants of the vehicle that is covered. It is possible then to be covered by Personal Injury Protection because you are the person named as a covered person in your auto policy, but you may also be covered by a friend’s policy on their car if you get into their car and ride as a passenger. This scenario leads to two layers of Personal Injury Protection coverage, and both policies will pay if you become injured in a wreck. This is what we call the “borrowed car scenario” and we are always on the lookout to see if we can collect multiple polices as a result of covered people riding in other covered cars which they don’t own. The borrowed car scenario can become complicated, especially if there are family members who are not named in the policy riding in borrowed cars. If you are unsure about whether Personal Injury coverage applies to you, then please call our office and we will review the coverage with you. Below is a set of hypothetical scenarios which illustrate Personal Injury Protection coverage: Let’s pretend Mary buys Personal Injury Protection from State Farm on her Ford. She lives with her children Harry, who is 17, and Jane who is 9. Harry drives a Chevy, but it is covered by a separate liability only policy without any Personal Injury Protection which is from Allstate. They live next to the Hendersons who own a van covered by Farmers with a Personal Injury Protection policy. When anyone is in the Ford they are covered because the Ford is a covered auto. Mary, Harry and even Harry’s friend Bill are all covered when they are in the Ford. Personal Injury Protection coverage on the car covers everyone in the car. What if Mary, Harry, and Jane get into the Henderson’s van and ride with them to the movies? Everyone in the van is covered by the Henderson’s Farmer’s policy on the van because the van is a covered auto so all occupants are covered. Mary is also covered under the State Farm Personal Injury Protection policy because she is named as an insured in that policy. Harry and Jane are covered under the State Farm policy because they are family members of Mary. Remember that family members are related to the named person by blood, marriage, or adoption, and live in the same house as the named person. Under this scenario Mary, Harry and Jane are covered by both Farmers and State Farm. Of course, the Hendersons are only covered by Farmers, because they are not named in the State Farm policy and are not family members of Mary. Typically, the Farmers insurance on the van must be used first, then the State Farm policy will begin to cover once the Farmers policy on the van is all used up. Our hypotheticals are all easy to understand so far. Unfortunately, the policy contains exclusions for family members who are not specifically named in the insurance policy. The exclusion limits coverage in instances where a family member is driving a car that is not listed on the named insured policy but is owned by a family member. This is a little confusing and is illustrated by the following scenario. What if Mary rides in her son Harry’s Chevy? The Chevy is insured by Allstate, but without Personal Injury Protection. There is not any Personal Injury Protection coverage on the car, so Harry is not covered by Allstate. Mary is still covered by State Farm because she is the named insured on that policy. The question is whether Harry is covered by State Farm because he is a family member of Mary’s. The rule is that all family members are covered, but if a family member is not a named insured, then they are not covered when driving a vehicle owned by a family member when that vehicle is not listed as a covered auto. Confused? You should be. This is confusing, but it makes sense when you think about it. Let’s change the hypothetical. Mary has ten children, and all are over the age of 16 and all drive cars. Mary buys an auto policy with Personal Injury Protection, but only lists herself as an insured and her car as a covered auto. All her kids live with her and are related to her by blood, so they are all covered people. It’s not fair to the insurance company to be forced to cover ten additional drivers in ten additional cars without listing them and paying insurance premiums for them. She did not pay premium dollars for them, so they should not be covered when they are in their cars which have not been disclosed to Mary’s insurance carrier. Simply put, if your family member is riding in a car owned by a friend, look for covered people and covered cars. If you need help, please call us at 903-892-4440. Consultations are free