An Overview of "No Fault" Insurance Benefits

The term “no fault” benefits is often used to refer to specific insurance coverage in connection with an accident or injury claim. Generally, no fault benefits are available from an insurance policy to cover specific losses or bills, depending on the type of accident case. These benefits are called “no fault” benefits because they are available to cover the losses or bills no matter whose fault the accident was. So, there is no need to determine liability or fault. Let’s take a look at some of the most common no fault benefits in specific cases:

Motor Vehicle Accidents

Massachusetts is one of several states that follows a no fault car insurance system. In Massachusetts, your auto insurance policy must carry Personal Injury Protection (PIP) coverage. PIP benefits are available from your own auto insurance policy to cover a certain amount of your medical bills if you are injured in a car accident. PIP benefits are also available to reimburse you for 75% of lost wages if you are injured in a car accident and miss time and lose wages due to the injuries you suffered in the accident. PIP benefits will also cover some specific out-of-pocket expenses or replacement services. The PIP benefits are referred to as no fault benefits because they are payable regardless of who was at fault for causing the car crash.

Another type of no fault benefits available in an auto insurance policy is Med Pay. Med Pay is short for Medical Payment Coverage. This type of insurance coverage is optional, which means you are not legally required to purchase it. If you do purchase Med Pay your auto insurance company will cover medical bills up to a certain amount over and above what PIP pays. This insurance coverage is also considered no fault because it is available regardless of who was at fault for causing the accident.

In contrast, if you want to be compensated for any medical bills or lost wages over and above what PIP paid and/or pain and suffering, then you must file and pursue a bodily injury claim against the other driver’s auto insurance company or a personal injury lawsuit against the negligent driver. In this bodily injury claim or lawsuit, you must prove that the other driver was negligent and at fault for causing the accident and your injuries.

Work Accidents / Workers’ Compensation

Employees in Massachusetts are covered by workers’ compensation insurance for injuries they suffer in a work related accident. Two important benefits available to an injured worker are Disability Benefits and Medical Benefits. Disability Benefits are payments to the injured worker whose work injury prevents them from working and earing wages. The Disability Benefits are weekly payments to the injured worker to cover a specific percentage of his or her average weekly wage depending on the extent of the injury and disability.

Medical Benefits from a workers’ compensation policy are available to cover the reasonable and necessary cost and expense of medical treatment related to the work injury. If you are injured on the job, the workers’ compensation insurance policy carried by your employer will pay the medical bills for your treatment. This is true even if the injury doesn’t render you unable to work. If you are hurt on the job and still able to work, but need medical treatment, the workers’ compensation insurance policy will still cover the medical bills.

These workers’ compensation benefits are also called “no fault” benefits. This is because it doesn’t matter whose fault the work accident was, the injured worker is still entitled to workers’ compensation. So, even if the employee was negligent and caused the accident that resulted in his own injuries, he is still entitled to workers’ compensation.

Slip & Fall Accidents (Med Pay)

Generally, if you are injured on someone else’s property (i.e., a slip and fall accident) and are seeking compensation for your damages and losses, then you must prove or establish that the property owner or person/entity in control of the property was negligent. Sometimes, there are no fault insurance benefits available from property insurance policies to cover medical bills. They are referred to as Med Pay.

The term “Med Pay” refers to Medical Payments Coverage. Med Pay is optional insurance coverage that is sometimes purchased by property owners to cover a specific amount of medical bills for anyone injured on their property. Med Pay is available for an injured party no matter whose fault the accident was. That’s why it is referred to as no fault insurance.

If you want to seek compensation for additional medical bills, lost wages, or pain and suffering then you must file a personal injury claim with the property owner’s insurance company or a personal injury lawsuit against the property owner. In that personal injury claim or lawsuit, you must establish that the property owner was at fault.

So, if you are ever hurt on someone else’s property, you should determine whether there is Med Pay available to cover some or all of your medical bills.

Injured? Get Legal Help Today

If you have any questions about insurance coverage or an accident case in Massachusetts, feel free to contact us online or call us at (508) 879-3500. We are happy to discuss these matters with you and helping secure the financial compensation you deserve. 
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