New Jersey no-fault car insurance provides personal injury protection benefits, commonly called PIP, for covered medical expenses regardless of who caused the crash. Depending on your coverage, PIP may also help replace lost income, pay for household services you cannot perform, and provide death and funeral benefits.

PIP does not pay for vehicle repairs or pain and suffering. Medical payments are also subject to coverage limits, deductibles, copayments, and other requirements. Understanding these rules can help you manage your bills and determine whether a separate car accident claim in New Jersey may cover additional losses.

Key Takeaways: What Does No-Fault Car Accident Insurance Cover in New Jersey?

• PIP pays covered, medically necessary treatment expenses regardless of who caused the accident.
• Your selected medical limit matters, but certain serious injuries and qualifying hospital treatment may receive coverage up to $250,000 despite a lower limit.
• Lost-income, essential-services, death, and funeral benefits depend on the applicable coverage.
• PIP does not cover vehicle damage or pain and suffering.
• The limited-right-to-sue option restricts pain-and-suffering claims. It does not prevent every claim for unpaid financial losses.

What Medical Expenses Does New Jersey PIP Cover?

New Jersey PIP medical-expense benefits can cover treatment for injuries caused by a covered automobile accident. Examples include:

• Emergency room care and ambulance transportation.
• Surgery, hospital stays, and follow-up care.
• Physical therapy, chiropractic treatment, and rehabilitation.
• Prescription medications, diagnostic imaging, and necessary medical equipment.

Treatment must be medically necessary and related to the accident. Payment is subject to your available benefits, applicable medical fee schedules, and policy requirements.

Some treatment may also require your provider to submit information for the insurer’s review or approval. These requirements generally do not apply to emergency care or treatment during the first 10 days after the accident, although treatment must still be medically necessary.

Which Insurance Policy Pays Your Medical Bills?

The responsible insurer depends on your insurance status and New Jersey’s coverage-priority rules. Your own automobile policy generally provides your PIP benefits if you are a named insured. A resident relative’s policy may apply if you are not named on your own policy.

Report the accident promptly and identify which insurer is responsible for your PIP claim. Give that claim information to your medical providers so they can submit bills to the appropriate carrier.

If you selected an eligible health insurer as your primary coverage for automobile injuries, that health plan generally pays first. Your automobile PIP coverage then provides secondary benefits under the applicable rules. Medicare and Medicaid cannot be selected for the health-care-primary option.

How Much PIP Medical Coverage Is Available?

Standard Policies commonly offer PIP medical limits of $15,000, $50,000, $75,000, $150,000, or $250,000. Basic Policies generally provide $15,000 in medical benefits. A Standard Policy does not automatically mean you have a higher PIP limit, so check your declarations page.

Certain injuries qualify for coverage up to $250,000 even when the selected limit is lower. These include permanent or significant brain injuries, spinal cord injuries, and disfigurement. The law also provides expanded coverage for medically necessary treatment of other permanent or significant injuries at a trauma center or acute care hospital immediately after the accident. For this category, expanded coverage continues until the treating physician determines that the patient is stable, no longer needs critical care, and can be transferred to another facility.

This exception does not apply to every injury described as serious. The injury and treatment must meet the legal requirements.

Your out-of-pocket costs also matter. Under the usual PIP structure, you pay your selected deductible plus a 20% copayment on covered medical expenses between that deductible and $5,000. For example, with a $250 deductible, the copayment on the remaining $4,750 is $950. Your combined share of those first $5,000 in covered expenses would be $1,200.

Does PIP Cover Lost Wages and Household Help?

New Jersey PIP can provide income-continuation and essential-services benefits when the applicable policy includes them. Standard Policy insureds can elect to exclude nonmedical PIP benefits, so review your coverage before assuming these payments are available.

The statutory income-continuation benefit pays qualifying lost income up to $100 per week, with a maximum of $5,200 per accident. Higher optional benefits may be available. Payments cannot exceed the qualifying income loss, and other benefits, such as temporary disability payments, may affect the amount payable.

Essential-services benefits help reimburse necessary and reasonable expenses for substitute services you normally perform but cannot perform because of your injuries. Examples include cleaning, laundry, and certain household chores. The statutory benefit is limited to $12 per day and $4,380 per accident, although higher optional coverage may be available.

To support these claims, keep medical documentation of your restrictions, earnings records, and receipts for covered substitute services. Your insurer may also request information from your employer to verify lost earnings.

Are Death and Funeral Benefits Included?

When nonmedical PIP benefits are included, coverage may provide death benefits based on the income-continuation and essential-services benefits remaining available under the policy.

The statutory funeral benefit pays reasonable funeral, burial, and cremation expenses up to $1,000. Higher optional benefits may be available.

These benefits are separate from any wrongful death claim against a party responsible for the crash.

What Does No-Fault Insurance Not Cover?

PIP does not pay for property damage to your vehicle. Vehicle repairs generally involve your collision coverage or a property damage claim against the responsible party.

Rental expenses require separate attention. Your own policy typically needs rental-reimbursement coverage to pay for a rental vehicle after a covered loss. You may also be able to seek reasonable rental expenses through the responsible party’s property damage insurer.

PIP also does not compensate you for pain, emotional distress, or reduced enjoyment of life. Those losses may be part of a separate claim against the responsible party, subject to New Jersey’s lawsuit rules.

When Can You Pursue a Claim Against the At-Fault Driver?

You may be able to recover unpaid medical expenses, lost income, and other eligible financial losses from the driver who caused the crash. You cannot recover the same loss twice, and rules governing expenses covered by PIP affect what you can seek from the other driver.

Pain-and-suffering claims follow a different rule. If the limitation-on-lawsuit option applies, you generally must establish one of these six injury categories:

• Death.
• Dismemberment.
• Significant disfigurement or significant scarring.
• A displaced fracture.
• Loss of a fetus.
• A permanent injury, other than scarring or disfigurement.

A permanent injury means a body part or organ has not healed to function normally and will not function normally with further medical treatment. Objective medical evidence must support the claim.

The law also requires a physician’s certification to support a claim under the threshold. It generally must be provided within 60 days after the defendant answers the complaint, although a court may grant an additional period of up to 60 days for good cause.

If the unlimited-right-to-sue option applies, you do not have to meet those injury categories to pursue pain-and-suffering damages. You still must prove that the other party was legally responsible and that the accident caused your injuries.

What Should You Say to the Insurance Company?

When speaking with an insurance adjuster, provide accurate information and avoid guessing about fault or your medical condition. Describe what you know, and say when you do not know an answer.

Your own PIP insurer and the other driver’s insurer have different roles. Your policy may require you to cooperate with reasonable requests for information, relevant medical records, earnings verification, and medical examinations.

Before providing a recorded statement or signing a broad medical authorization, consider getting legal guidance. Continue meeting your own insurer’s reasonable claim requirements so that avoidable delays or cooperation disputes do not interfere with your benefits.

Do not accept a settlement or sign a release without understanding which claims it resolves and whether your future losses have been considered.

What Can You Do if Your PIP Insurer Denies Treatment?

A PIP insurer may dispute whether treatment is medically necessary, related to the accident, or covered under the policy. It may request additional records or a medical examination before deciding whether to pay.

Ask for the reason for a denial in writing and share it with your treating provider. Your provider may be able to submit additional medical records explaining why the treatment is needed.

Depending on the dispute, you or your provider may challenge the decision through the insurer’s internal appeal process and, when appropriate, PIP arbitration. Required internal appeals may need to be completed before arbitration begins.

Keep copies of denial letters, treatment requests, bills, and appeal submissions. Prompt review can help you understand the available options and applicable deadlines.

How Do New Jersey’s 2026 Liability Limits Affect Your Claim?

For Standard Policies issued or renewed on or after January 1, 2026, New Jersey requires bodily-injury liability limits of at least $35,000 per person and $70,000 per accident.

These amounts concern the liability coverage available when an insured driver injures someone else. They do not increase your PIP medical limit or change the injury categories required for a pain-and-suffering claim.

Basic Policies follow different rules and do not automatically include bodily-injury liability coverage. The increased Standard Policy minimums therefore do not mean every driver has $35,000 available for an injury claim.

The responsible driver’s policy limits are one part of the coverage review. Other potentially applicable policies, including your own uninsured or underinsured motorist coverage, may also matter. No policy limit guarantees a payment.

Does Sharing Fault Affect Your PIP Benefits?

Ordinary crash fault does not reduce your PIP benefits by your percentage of responsibility. PIP pays covered benefits regardless of who caused the accident.

Fault does matter when you seek damages from another party. Under New Jersey’s modified comparative negligence system, you generally cannot recover if your negligence exceeds the combined negligence of the defendants from whom you seek recovery. If you are 50% or less responsible, your damages are reduced by your percentage of fault.

For example, if your recoverable damages are $100,000 and you are 20% responsible, the award would generally be reduced to $80,000.

Police reports, witness accounts, photographs, and other evidence can help establish what happened. An adjuster’s proposed fault percentage is not necessarily the final determination.

Frequently Asked Questions About New Jersey No-Fault Insurance

How Long Do You Have to Sue the At-Fault Driver?

Most New Jersey personal injury lawsuits must be filed within two years after the claim accrues, which is usually the accident date in an ordinary car accident case. Exceptions can affect that deadline, and claims involving public entities may require much earlier notice.

PIP claims and actions to recover unpaid benefits follow separate deadlines. Report the accident promptly and seek advice if benefits are delayed or denied.

Can You Change Your Personal Injury Protection Limits?

You can contact your insurer to request a change in your PIP limits, including before your renewal date. Confirm when the change takes effect. Increasing your coverage after an accident does not increase the benefits available for that past accident.

Does PIP Cover Passengers in Your Vehicle?

Passengers may receive PIP benefits for covered injuries, but your policy is not automatically responsible. A passenger’s own policy or a resident relative’s policy may apply first under New Jersey’s coverage-priority rules. PIP benefits cannot be stacked across multiple automobile policies for the same accident.

Need Legal Help? Brandon J. Broderick, Attorney at Law, Is Here for You

At Brandon J. Broderick, Attorney at Law, we believe everyone deserves top-tier legal representation, regardless of their financial situation or the complexity of their case. You do not have to navigate this difficult time alone. We are committed to supporting you through every phase of the legal process, providing compassionate guidance when you need it most.

Our dedicated team is available 24/7 to listen to your story, review the circumstances of your case, and pursue the full compensation available under the law. Take the next step toward protecting your health, finances, and legal rights. Contact us today for a free, no-obligation legal consultation.