A serious car accident can change your life in an instant. Beyond the physical pain and emotional distress, you may find yourself dealing with overwhelming medical bills. Emergency room visits, ambulance rides, surgery, physical therapy, and follow-up care can quickly add up to tens of thousands of dollars. If your injuries require long-term treatment or rehabilitation, the costs can become unbearable.
According to the National Safety Council, the average cost of a car accident injury in the U.S. is over $23,000—and that’s just for medical treatment. So, who pays for medical bills after a car accident in Pennsylvania? The answer depends on Pennsylvania’s no-fault insurance system, your coverage, and whether another driver was responsible for the crash.
In this blog, we break down how Pennsylvania’s no-fault system works, what Personal Injury Protection (PIP) covers, how medical bills are paid after car accident, what happens when medical bills exceed insurance limits, and when you may need legal assistance to recover compensation.
What Is the Impact of the No-Fault System in Pennsylvania?
Pennsylvania is a no-fault state when it comes to car accident injuries. This means that your own car insurance pays for your medical bills, regardless of who caused the accident.
Under this system, every Pennsylvania driver must have Personal Injury Protection (PIP) coverage as part of their auto insurance policy. PIP coverage ensures that medical bills are paid quickly without needing to prove fault or wait for a settlement from another driver’s insurance company.
How Does No-Fault Insurance Affect Your Ability to Sue?
While the no-fault system simplifies the payment of medical bills, it also limits your right to sue for damages unless you meet specific criteria. In Pennsylvania, drivers must choose between two types of auto insurance:
- Limited Tort Coverage – This restricts your ability to sue for pain and suffering unless your injuries are considered “serious” under Pennsylvania law (such as permanent disfigurement or loss of bodily function).
- Full Tort Coverage – This allows you to sue for all damages, including pain and suffering, regardless of the severity of your injuries.
If you only have limited tort coverage, your ability to recover compensation beyond PIP benefits may be significantly restricted.
Personal Injury Protection (PIP) Coverage: What It Covers and Limits
What Does PIP Insurance Cover?
PIP insurance helps pay for medical expenses and some related costs after a car accident. Pennsylvania’s minimum required PIP coverage is $5,000, but drivers can purchase higher limits.
PIP typically covers:
- Medical bills – Emergency room visits, hospital stays, surgery, doctor’s appointments, rehabilitation, and medications.
- Lost wages – PIP may cover part of your lost income if injuries prevent you from working.
- Funeral expenses – In fatal accidents, PIP can help cover burial costs.
However, PIP does not cover vehicle damage or pain and suffering. It is strictly meant to cover injury-related expenses.
What Happens When PIP Runs Out?
The minimum $5,000 in PIP coverage may not cover all medical expenses, especially if the accident was severe. Once your PIP benefits are exhausted, your remaining medical bills must be paid by:
- Your health insurance, if you have it.
- The at-fault driver’s liability insurance if they were responsible for the crash.
- A personal injury lawsuit, if necessary.
How Medical Bills Are Paid After a Car Accident in Pennsylvania
- Your Health Insurance
If you have private health insurance, it may cover medical expenses beyond your PIP limits. However:
- You may be responsible for co-pays, deductibles, and out-of-network charges.
- Some health insurance policies have subrogation rights, which may require repayment if you receive a settlement from an at-fault driver.
- Not all treatments may be covered, and specific procedures may require pre-approvals.
- The At-Fault Driver’s Insurance
If another driver was responsible for the accident and your injuries exceed PIP coverage, you can file a claim against their insurance policy. Pennsylvania requires drivers to carry at least $15,000 per person and $30,000 per accident in bodily injury liability coverage.
However, not all drivers carry enough insurance, and some may not have insurance at all. This is why uninsured/underinsured motorist (UM/UIM) coverage is an important option to consider.
- Filing a Personal Injury Lawsuit
If your medical bills are not fully covered by PIP, health insurance, or the at-fault driver’s insurance, you may need to file a personal injury lawsuit to recover compensation. A lawsuit may allow you to seek payment for:
- Medical expenses exceeding insurance limits
- Lost wages and future income loss
- Pain and suffering (if you have full tort coverage or meet Pennsylvania’s serious injury threshold)
It is important to act quickly because Pennsylvania has a two-year statute of limitations for personal injury claims. You may lose your right to seek compensation if you miss this deadline.
How Car Insurance Companies Determine Payment Amounts
Insurance companies do not automatically pay all medical bills submitted after a car accident. They review each claim carefully and use specific criteria to determine how much they will cover.
Factors That Affect Insurance Payments
- The limits of your PIP coverage – If you only have the minimum $5,000 coverage, you may be left with unpaid bills.
- The severity of your injuries – More serious injuries often require extensive documentation to justify medical expenses.
- Who was at fault – If another driver caused the accident, their insurance may be responsible for paying additional costs.
- The availability of other coverage – If you have uninsured/underinsured motorist coverage, it may help cover expenses if the at-fault driver lacks sufficient insurance.
Some insurance companies may dispute or deny claims if they believe the treatment was unnecessary or excessive. If this happens, seeking legal representation may be necessary to fight for your rights.
Medical Payments Coverage (MedPay) vs. PIP – What’s the Difference?
Some Pennsylvania drivers purchase Medical Payments Coverage (MedPay) as an additional safeguard. While similar to PIP, there are key differences:
| Feature | PIP Coverage | MedPay Coverage |
| Pays Medical Bills? | Yes | Yes |
| Covers Lost Wages? | Yes | No |
| Follows No-Fault Rules? | Yes | No |
| Limits Right to Sue? | Yes | No |
Unlike PIP, MedPay does not cover lost wages or other accident-related expenses; it only pays after other insurance sources have been used.
Speak with a Car Accident Medical Bills Lawyer Today
If you’ve been injured in a car accident in Pennsylvania, medical bills can add up fast. With PIP limits, health insurance rules, and insurance companies that don’t always play fair, it can be hard to figure out how medical bills are paid after car accident and what options you have. You shouldn’t have to struggle just to get the care you need.
At Pacin Levine, P.A., we help accident victims understand their rights, deal with insurance companies, and fight for the compensation they deserve. If you’re facing unpaid medical bills, denied claims, or other challenges after a crash, we are here to help.
Call 1-800-24-7-CRASH (2727) today for a free consultation. Let us handle the legal fight so you can focus on your recovery.
