People buy insurance to protect themselves from possible losses in the future. Insurance policies are just in-case agreements between the policyholder and the insurer. Insurance is a fickle tool, and companies never like to pay out, like cover the cost of the medical treatment you need.
Most people acquire insurance policies because the out-of-pocket cost of most medical treatments is too expensive. They pay the insurance premium each month to protect them, just in case they need treatment at some point down the road.
In theory, insurance allows you to live without fearing bankruptcy from surprise medical costs since the insurance policy will cover any necessary health care treatment. In practice, however, health insurance companies are seldom willing to pay for the treatment you need and will attempt to withhold funds.
They will often attempt to justify it by disproving the severe injuries or trying to force lesser, cheaper medical options on you. They may also claim that the treatment you are quoting is not legitimate.
For example, some insurance policies will not cover treatments like massage therapy or adjustments by a chiropractor, often employed following a motor vehicle collision. Still, some policies might be willing to cover the cost if it genuinely relates to your injury.
One such insurance type that is more likely to cover medical massage therapy is PIP. In this article, we will focus on PIP insurance to help you determine if you can rely on your PIP to cover the costs of massage therapy after a car accident.
Let’s get started!
What is PIP Insurance?
Car insurance plans vary depending on the type of coverage you are looking to get. One such insurance policy is personal injury protection (PIP) insurance. PIP, also known as no-fault auto insurance, is a specialized plan to pay for your medical expenses to treat your injuries from an auto accident.
PIP is referred to as “no-fault insurance” because it offers coverage even if the accident resulted from the insured’s negligence. This way, both parties who were in the accident can get the medical treatment they need without breaking the bank by being hit with thousands in medical bills. However, what PIP insurance will cover might not be fully understood.
A PIP policy is meant to cover the expenses from your injuries:
- Medical Treatment: PIP insurance is expected to cover the costs of medical treatments you require to recover from your injuries. Everything from surgical costs to medication and nursing services falls under medical bills.
- Essential Services: PIP can also cover essential services you are unable to do as a result of your injuries, like caring for your lawn care, cleaning your house, and routine home maintenance costs.
- Lost Wages: When an injury related to a car accident prevents you from working, you are likely losing out on your wages. Some PIPs can help you recover the lost funds.
Unlike traditional car insurance, PIPs are comprehensive insurance policies to ensure you get all the treatment you need. However, like all insurance, there might yet be some restrictions regarding specific treatment options.
Some medical treatments are taken less seriously than others because an M.D. does not administer them or for the lack of pharmaceuticals are being prescribed.
When these treatment options come across an insurance company’s desk, they will look for any excuse to avoid covering them and leave you to be the pay.
PIP insurance is not available worldwide or even nationwide, as only 12 states require PIP insurance. They commonly are referred to as “no-fault states.”
Another eight states plus Washington D.C. make PIP an optional insurance policy, leaving 30 states where PIP insurance is not an option. As a result, PIPs will not always be able to cover the costs of even some of the more respected medical treatments.
No-fault States That Require PIP Insurance
- New Jersey
- New York
- North Dakota
In the states where PIP is optional, the state government either made it an optional add-on or something that could be waived away in writing by the policyholder.
States That Make PIP Coverage Optional
- New Hampshire
- South Dakota
- Washington D.C.
The primary distinguishing factor of a PIP is how it affects personal injury insurance claims and lawsuits. In states where PIP plans are not an option, victims of car accidents can recover money by filing personal injury claims against the at-fault driver.
In these claims, the at-fault driver’s insurance company is expected to give you a settlement that pays you a recovery for the costs of the injuries that PIP would cover. However, a PIP state means “no-fault;” both parties have their expenses managed by their insurance companies.
There are exceptions, of course, and it is still possible to file a lawsuit and get a claim number from your insurance over a car accident in a no-fault state.
However, the situation requires the injuries to have caused severe damage and injury to the body per the state’s statutes and medical expenses exceeding a certain amount.
Each state has laws that define both of these and can vary. For the most part, however, a no-fault state will have you relying on your insurance policy to recover your losses.
PIPs are restricted in what they can cover, as certain damages fall outside the scope of the policy.
Examples of what PIP auto insurance will not cover:
- Vehicle Damage: A PIP is not meant to cover the expenses of a damaged vehicle. You will need a separate auto insurance company policy to recover damages to your car.
- Damage to Other Property: If you damage somebody else’s property during the collision, a PIP policy will not cover the compensation you owe to fix it. You will need a type of collision coverage to protect you.
- Expenses Beyond Limit: If the damages exceed the policy coverage limits of your PIP, it will not be able to compensate you for the losses. So this is where the exceptions mentioned before are applicable. States that allow you to pursue a claim against the other driver enable you to recover damages that exceed your PIP policy limit.
However, PIP insurance is meant to cover all essential treatments means there is still a fighting chance for specific non-traditional treatments to be covered. Whether a PIP covers massage therapy might depend on the circumstances surrounding your injuries.
What is Massage Therapy?
Massage therapy is a more common medical treatment avenue than most people realize. Victims of car accidents often seek manual therapy such as massage therapy for their neck and back injuries. Massage treatment is primarily used to address the damages caused by an accident that causes harm to your body.
These injuries are excruciating and can lead to severe consequences if not adequately addressed. Massage therapy is a treatment option where a trained physical therapist manipulates the soft tissue injuries where you sustained damage from the car accident.
This massage treatment has been used to alleviate pain and prevent long-term consequences of injuries. Massage therapy can even help with a whiplash injury, migraines, and sprains and improve your range of motion.
For the most part, massage therapy involves simply manipulating soft tissue through pressure. A massage therapist will apply pressure with their hands to the affected soft tissue to relieve tension.
In more severe cases, massage therapy might be performed alongside alternative modes of treatment such as electrodes or acupuncture. However, the most common massage therapy available to treat chronic pain is a pressure point massage.
More specifically, a massage therapy that is becoming more popular in the west to treat pain and promote wellness is ayurvedic massage. Ayurvedic massages are renowned for their use in pain management, making them a tool of choice for massage therapists treating victims of car accidents.
Massage therapy is standard in personal injury cases. Although, it can quickly generate a high cost, so there is some confusion about whether or not your PIP coverage will pay for the expense. Fortunately, given the right factors, it does not seem like all hope is lost.
Does PIP Insurance Cover Massage Therapy?
While PIP insurance is meant to cover the full range of your medical costs, there will be exceptions. Insurance companies often require proof that the treatment pursued is necessary for your physical recovery before they will consider paying for it.
This way, they avoid providing funds for unnecessary treatment. Meaning some specific therapies will be subject to additional scrutiny to ensure that you are not trying to pull the wool over their eyes.
Fortunately, this is not the most common issue when it comes to insurance companies since most medical facilities will not treat you beyond what is necessary for your recovery.
However, chiropractic treatments like massage therapy are an interesting exception in medical care because there are no restrictions on who can seek treatment or how often. This particular exemption makes insurance companies uneasy about paying for the treatment since the lack of limitations means a patient could treat indefinitely and more often than their wounds require.
This treatment could be abused in a state without PIP to try and max out the settlement sum. In states where PIP applies, continued chiropractic care could point to patients trying to get their insurance provider to pay for unnecessary treatment.
Likewise, massage therapy will also have extra scrutiny from the insurance adjusters. They do not want you to get massage therapy just because the insurance company will pay for it.
However, in reality, you did not need the massages to recover from the car accident you suffered. Insurance companies want to protect themselves financially from these types of situations.
This extra level of scrutiny and caution begs the question of whether PIP insurance will cover the costs of massage therapy at all. Like most things in life, the answer is a tentative “yes.” So long as you can prove that the massage treatment is necessary for your recovery.
You can typically accomplish this through the documented referrals your primary care physician made following the initial assessment or follow-up assessment of your injuries.
Your doctor is responsible for explaining and justifying what treatments are needed to recover from your injuries and will often refer you to a specific office or clinic. So your physician will alert you if chiropractic care or massage therapy is necessary.
You will want to prove that your doctor instructed you to have massage therapy sessions or that you went to a specific massage therapist recommended by your doctor. That info will make it more difficult for the PIP adjuster to refute your insurance claim.
There will be exceptions depending on the state you live in. Still, for the most part, your PIP insurance will likely cover the cost of your massage therapy when a doctor’s documented recommendation is behind it.
However, it helps if you still operate within the bounds of what is recommended by both the physician who referred it and the one administering the massage therapy. Going too far with massage therapy could invalidate your claim to PIP and leave you on the hook for paying the entire sum out of pocket.
How to File a PIP Claim After a Car Accident?
When you file a claim with the insurance adjuster for your auto accident injuries, you must take steps to properly process your accident claim. This is especially important if you are claiming massage therapy as part of your treatment plan.
You would typically file this claim with the other driver’s insurance company in an at-fault state. However, in a no-fault state where PIPs are applicable, you would submit the claim to your insurance company for them to review. You will need to submit copies of all your medical bills to be compensated, including those from massage therapy.
Submitting the medical costs to the insurance company is something a car accident lawyer will handle for you.
Once your PIP policy approves the compensation sum, you can continue your life without worrying about the medical costs you had from the accident.
However, there are requirements you must meet to file your claim successfully. Specifically, you will have to be sure to file within the statute of limitations for your injury.
This statute varies depending on the state or jurisdiction where the accident occurred. Failing to file a claim within the required timeframe will cause you to forfeit your right to sue for the claim altogether.
PIP claims are little more than submitting paperwork to the insurance company. Your insurance company should keep you apprised of the details.
So you might think hiring an attorney is unnecessary in no-fault states like Florida, and you would only contact an attorney if you met the state’s requirements to file a lawsuit against the other driver.
However, concerning PIP, that is not the case for several reasons. You will want to hire a car accident lawyer to get you the best results.
PIP Attorneys in No-fault States
A personal injury attorney can help your PIP insurance claim by:
- Personal injury attorneys can fight a denied PIP claim to get the insurance company to approve it.
- PIP Lawyers can negotiate down the medical liens you owe to health providers at the end of your PIP claim.
With this information, you now have the knowledge you need to understand the basics of how PIP insurance claims handle massage therapy. However, there is always more to consider regarding lawsuits, so you should always consider hiring an attorney for PIP claims since it will affect you financially.
Personal Injury Protection and Massage Therapy
Personal injury policies are prevalent for many and are required for the citizens of no-fault states. They should allow them to recoup the financial losses from their motor vehicle accidents.
However, they are far from foolproof or fair, as extreme injuries can make it impossible for a PIP policy to compensate you for your lost funds. When treating with massage therapy, a PIP is more likely to cover it if it is vital for recovering from your injuries.
Your insurance company cannot easily refute the recommendations of your primary care physician, an M.D. So your odds of having an issue getting compensated for the cost of massage therapy are slimmer as long as you treat them honestly. However, in cases where you need to pursue a lawsuit against the other driver, you will have to concern yourself with other financial aspects.
If you are in a legal battle in a no-fault state, you already have to cope with some of the financial complications that come with car accidents. These complications only worsen when you are trying to balance the cost of living with the fees from your medical treatment since your PIP insurance fails to cover everything.
Auto accident cases like these are what Express Legal Funding can offer our pre-settlement funding service. It’s a risk-free lawsuit cash advance on your claim. So you can get access to the settlement money you need now to pay for essential costs or purchase new items you need.
All you are giving up is the right to a small portion of your potential settlement or trial award, and that is assuming you will settle or win your case.
So if your lawsuit goes south and you end up recovering no money at the end of your case, you get to keep the lawsuit funding cash we advanced to you. That is what makes it non-recourse and risk-free. So, you can still win even if you lose in court by going ahead and getting your money from the legal funding company early.
So, if you want to learn more about how we can help you, call us anytime. If you plan to file a lawsuit in addition to the claim you filed with PIP and hired an attorney, you qualify to apply for legal funding.
Get in touch with our industry experts for a free consultation to see if lawsuit funding is the right choice for you!
About the Author
Aaron R. Winston is the Strategy Director of Express Legal Funding. As "The Legal Funding Expert," Aaron has more than ten years of experience in the consumer finance industry. Most of which was as a consultant to a top financial advisory firm, managing 400+ million USD in client wealth.
As Strategy Director of Express Legal Funding, he has devoted thousands of hours to advocating for the consumer. Aaron's "it factor" is that he is a tireless and inventive thought leader who has made great strides by conveying his legal knowledge and diverse expertise to the public. More clients and lawyers understand the facts about pre-settlement funding because of Aaron's legal and financial service SEO mastery.
Aaron has a scholarly approach to business. In early 2022, Aaron Winston gained the Search Engine Optimization and the Google Ads LinkedIn skills assessment badges. He placed in the top 5% of those who took the SEO skills test assessment.
Aaron's work has been granted copyright protection by the United States Copyright Office. He has gained positive notoriety via interviews and case studies, which are a byproduct of his successes. Aaron R. Winston was featured in a smith.ai interview (2021) and company growth case study (2022).