After a car accident, the bills tend to show up long before anyone has decided who was at fault. The emergency room invoice, then the imaging center, then the first round of physical therapy, for example. Somewhere in there, a paycheck comes up short. Meanwhile, the question of who pays medical bills after a car accident is still sitting between the auto and health insurance companies.
Personal Injury Protection (almost always called PIP) is the part of an auto insurance policy built to cover that gap. It pays regardless of who caused the crash. Washington is a fault-based state rather than a no-fault state, which is where much of the confusion about PIP coverage in Washington state begins.
This guide walks through how PIP insurance works in practice: what it is, what it covers, how much it actually pays, what happens when it runs out, and how it fits alongside a claim against the at-fault driver.
What Is PIP, Exactly?
PIP is first-party coverage on an auto policy that pays for medical costs and certain other losses after an accident, regardless of fault. “First-party” means the claim goes to your own auto insurer, not the other driver’s.
That’s what separates PIP from nearly everything else in a car accident claim. There is no argument to win first. If the coverage is there, the benefits are available while fault is still being worked out. There is no need to get pre-authorization from the PIP insurer to receive treatment for injuries.
Washington law requires insurers to offer PIP. Under RCW 48.22.085, no new auto liability policy (and no renewal of an existing one) may be issued in this state unless PIP is offered as an optional coverage.
Under the same statute, a named insured can reject the coverage, and that rejection has to be written. We never recommend rejecting PIP coverage.
Here is the part worth knowing, and it tends to be good news: insurers have to be able to produce that written rejection. If a driver does not remember declining PIP and the insurance company cannot come up with a signed waiver, minimum PIP coverage is generally treated as being in force. So if you don’t know if you have PIP, check before assuming you do not.
PIP sits inside a broader framework of Washington insurance law, alongside health coverage, liability coverage, and underinsured motorist coverage, and the rules governing how those pieces interact are their own subject. For a more technical treatment of that framework, see Understanding Personal Injury Insurance Law for Today’s Health Care Provider.
Is Washington a No-Fault State?
No. Washington is a fault-based state (a tort state) which means the driver who caused the crash is ultimately responsible for the damages that follow.
Whether Washington state is a no-fault state is one of the most common questions after a crash, and it is easy to see why. PIP behaves like a no-fault benefit. It pays quickly regardless of fault. But it is a no-fault-style benefit layered on top of a fault-based system, not a substitute for that system.
The practical difference matters. In a true no-fault state, an injured person’s ability to bring a claim against the at-fault driver is limited by law. Washington does not work that way. PIP does not count against a later claim, and it does not stop someone from pursuing the at-fault driver’s liability insurer for the full scope of their losses – including categories PIP was never built to cover, like pain and suffering.
That distinction also shapes what Washington auto insurance laws require drivers to carry. Liability coverage is mandatory, and it pays other people for harm the policyholder causes. Washington auto insurance minimums are commonly written as 25/50/10 — $25,000 for bodily injury to one person, $50,000 total paid per accident regardless of how many people were injured, and $10,000 for property damage — and those are floors rather than recommendations. They are reached quickly in a serious collision.
PIP works in the other direction. It is optional, but it must be offered, and it pays the policyholder, household members, and passengers first, without waiting on a fault determination. Washington auto insurance requirements exist to make drivers protect other people; PIP is the coverage that protects you.
What Does PIP Cover?
PIP covers accident-related medical expenses first and foremost, but it is not limited to medical bills. Washington law defines four categories of PIP benefits, and each has its own limit.
Medical and Hospital Expenses
This is the core of the coverage and the reason most people encounter PIP at all. It pays reasonable and necessary medical expenses connected to the accident: emergency care, physician visits, diagnostic imaging, physical therapy, chiropractic care, prescriptions, and similar treatment. There is no deductible, no copay, and no limits on how many visits someone can have for a particular type of treatment on the way to the policy limit, which is why PIP so often becomes the first thing to actually pay a car accident medical bill. (RCW 48.22.095, RCW 48.22.100)
Income Continuation Benefits for Wage Loss
If injuries keep someone out of work, PIP can replace part of that lost income. Income continuation benefits are subject to both a weekly cap and a total cap. Wage loss has to be approved by a health care professional and documented (pay stubs, employer verification, and, for self-employed people, tax records). Where PIP income benefits overlap with other sources such as workers’ compensation or disability coverage, Washington law limits the combined weekly amount, so those benefits do not simply stack.
Loss of Services Benefits
This is the benefit many people overlook. If an injury prevents someone from doing tasks they normally did themselves (childcare, housekeeping, yard work, driving family members around), PIP can pay for someone else to do them. A treating health care professional must approve this. It is a real benefit with a real limit, and it often goes unused because many don’t know to track it.
Funeral Expense Benefits
In the event of a fatal accident, PIP includes a funeral expense benefit. The amount is modest and fixed by statute, but it is available without regard to fault.
Washington law also sets two coverage tiers: a standard minimum level that applies by default, and a higher level available if requested in writing when the policy is purchased or renewed. For a more technical, provider-facing breakdown of how those tiers apply, Adler Giersch has covered the subject in Personal Injury Protection and Pedestrians.
Bottom line: for most people the question after a crash is simply who pays medical bills in a car accident, and in the early weeks the answer is usually PIP. Understanding what PIP medical coverage includes – and what sits alongside it – is often the difference between using the benefit fully and leaving part of it unclaimed
How Much Does PIP Actually Pay Out?
Washington law sets specific PIP benefit limits by category, and they differ depending on which tier of coverage a policy carries. The standard limits appear in RCW 48.22.095; the higher, opt-in limits appear in RCW 48.22.100. If you can afford it, higher PIP limits are almost always the better way to go considering the relatively low cost.
The figures below are the statutory benefit levels insurers are required to offer. An individual policy can differ, so treat these as the framework rather than as an answer about any particular claim.
| Benefit category | Standard tier (RCW 48.22.095) | Higher tier, by written request (RCW 48.22.100) |
| Medical and hospital | Up to $10,000 | Up to $35,000 |
| Income continuation | Up to $10,000, capped at $200 per week | Up to $35,000, capped at $700 per week |
| Loss of services | Up to $5,000, capped at $200 per week | Up to $14,600 |
| Funeral expense | Up to $2,000 | Up to $2,000 |
Two qualifications matter as much as the numbers. First, these are ceilings, not entitlements: PIP pays the actual amount of loss or expense incurred, so nobody receives a lump sum simply because a limit exists. Second, the medical benefit is tied to treatment received within a defined window after the accident, which is why gaps in care can cost someone coverage they were counting on.
To find out what your PIP medical expense limit actually is, pull the declarations page of your policy or call your agent directly.
Anyone who checks that page and finds the standard tier may also want to ask how much PIP insurance costs to increase coverage. Moving from the standard limits to the higher ones is generally a modest addition to the premium rather than a substantial one, though pricing varies by carrier and by the rest of the policy. The request has to be made in writing, and it has to happen before an accident.
How Do You File a PIP Claim?
Report the accident to your own insurance company promptly, even when the other driver was clearly at fault. PIP is your coverage, and the claim runs through your carrier.
The steps below are the practical version of how to claim PIP benefits without creating problems later.
Notify your insurer and ask to start a PIP claim. A general accident report is not the same as opening a PIP claim. Ask specifically for PIP claim forms. This is a separate process from any liability claim against the other driver, with a different adjuster and a different file.
If possible, have medical providers bill PIP directly. Give the PIP claim number to every provider at the point of care. Direct billing avoids the mess of paying out of pocket and chasing reimbursement, and it keeps claim records accurate.
Keep copies of everything. Bills, explanations of benefits, denial letters, emails, and notes from phone calls with the adjuster are examples. If a dispute comes up months later, accurate records settle it faster than memory does.
Document wage loss and loss of services as they happen. Track missed shifts as they occur and keep employer confirmation of lost time. Do the same for services someone else had to take over – housecleaning, childcare, lawn maintenance. Reconstructing eight months of expenses at the end of a claim is difficult and usually results in undercalculating. Make sure your healthcare providers are approving missed time from work or the need for help with household services.
One more thing worth asking for: the PIP ledger. Every PIP claim generates a running record of what has been billed, what has been paid, and how much of each benefit limit remains, and insurers will provide it on request. Reviewing the PIP ledger periodically rather than at the end catches the two most common problems – bills that were never submitted to PIP at all, and reductions applied without a clear explanation. It is also the fastest way to see how close the medical benefit is to running out.
What Happens When PIP Runs Out?
PIP benefits are capped, and treatment for a more serious injury can run past those caps well before recovery is finished. When that happens, the coverage is described as exhausted.
Exhausting PIP does not mean a claim has gone wrong. It usually means the injury was significant enough to require sustained care, which is exactly the situation the limits were never sized to handle.
Once PIP is exhausted, the unpaid medical bills and remaining lost income typically become part of the claim against the at-fault driver’s liability coverage. Health insurance often comes into the picture as the next layer of coverage, which introduces coordination questions between carriers – and, later, questions about what has to be repaid out of any settlement.
It’s important to note that PIP payments and limits can be disputed (readers who want more information on the topic can find it here).
Common PIP Questions and Misconceptions
Will using PIP raise my insurance rates? No. PIP is a no-fault benefit, and using it is not a statement about who caused the crash. It is coverage that was paid for, and using it is the point of having it.
Doesn’t the at-fault driver’s insurance pay my medical bills instead? Potentially, but not right away. Not until treatment for injuries is complete within the 3-year time limit allowed under the “statute of limitations.”A liability claim has to work through fault, treatment, and valuation, which can take months or longer. Providers expect payment in the meantime. That timing gap is precisely why PIP exists.
Can I use PIP and still pursue a claim against the other driver? Yes. They are separate claims, and you don’t give up your right to file a claim or sue another driver if you use PIP. Whether PIP has to be repaid out of a later settlement depends on the circumstances of the case, and it is not automatic in every situation.
What if I’m not sure whether I have PIP? Check the declarations page of your policy, or ask your insurer directly. If the insurer says PIP was declined, ask them to produce the written rejection – they are required to keep proof of it.
My insurer or insurance agent has advised me not to purchase PIP. What should I do? Keep PIP on your auto policy if at all possible. Consider getting more than just the minimum coverage. You’ll pay less out of pocket in the long term, unlike health insurance.
My auto insurer has offered PIP coverage that is less than the $10,000.00 minimum for Washington State. What should I do? PIP policies covering less than $10,000.00 come with their own price. They may cost less in premiums, but the fine print may result in your guest passengers, your spouse, or your children being excluded from much needed coverage in the event of an accident.
How Adler Giersch Helps After a PIP Claim Gets Complicated
Adler Giersch has spent more than 43 years advocating for injured people across Washington. Much of that work involves untangling exactly the situation described above: PIP benefits that have been reduced, denied, or exhausted, and the coordination between PIP, health insurance, and a liability claim that follows.
The firm works case by case rather than at volume. That boutique approach is deliberate, and it shapes how each claim is handled from the first conversation forward – more on that in How We Work.
Adler Giersch maintains long-standing relationships with chiropractors, physical therapists, and other treating providers throughout the state. Those providers see PIP disputes from the inside, often before the injured person realizes there is a problem, and that perspective is useful when a claim starts to stall.
Anyone looking for a personal injury protection attorney or a Washington state car accident lawyer is welcome to request a free consultation, whether PIP has run out, been denied, or simply raised questions worth answering. Adler Giersch serves clients from offices in Seattle, Everett, Issaquah, and Kent.
Insurance language can be confusing even at the best of times. After a car accident – with appointments to keep, injuries to recover from, work to miss, and mail arriving from carriers you didn’t know were involved – it can be even harder still.
Understanding how PIP works now can help prevent surprise bills later. Knowing what the policy covers, what the limits are, and what to document from the outset puts you in a better position than finding out after the fact.
If PIP has been denied or exhausted, or if a second set of eyes on the policy would help, Adler Giersch is available to talk it through. There is no cost to request a consultation.
