Does PIP cover passengers? Whose policy pays a rider hurt in your NEMT van

Yes, in the states that have it. Personal injury protection (PIP) pays an injured passenger’s own losses without anyone proving who caused the crash. For a ride company the harder question is which policy pays first, the van’s or the rider’s own, and the answer changes from state to state. This page covers five states with no-fault or first party benefit rules and what each one’s statute says about a rider hurt in a wheelchair van or sedan. How a transportation company bills a PIP insurer for rides is a different question, answered in billing auto insurance for medical transportation. The wider claim, from the first call to the lawsuit deadline, is in the passenger injury claim guide.

Does PIP cover passengers in a no-fault state?

Yes. The statutes in the five states below extend PIP to people riding in the insured vehicle. Florida’s names “passengers in the motor vehicle” and sets limits of $10,000 for medical and disability benefits and $5,000 for death benefits. Its medical benefit pays 80 percent of reasonable expenses, and only when the injured person receives initial care within 14 days after the crash. The medical benefit stops at $2,500 unless a physician, dentist, physician assistant or advanced practice nurse determines that the person had an emergency medical condition. A rider who says they are fine at the scene still has that 14-day window, which is worth telling the family.

New York’s law covers persons, other than occupants of another motor vehicle or a motorcycle, for loss arising out of the use or operation of the insured vehicle in the state (Insurance Law 5103(a)(1)). Michigan speaks of an “operator or a passenger”, Pennsylvania’s priority section names the occupants of an insured motor vehicle, and Minnesota’s names the driver or other occupant.

PIP also exists outside these five states. In Texas, for example, the insurance department’s auto guide says every auto policy includes PIP unless the insured rejects it in writing, and describes it as covering the insured’s and passengers’ medical bills plus lost wages and other nonmedical costs. Where a policy carries medical payments coverage instead, the insurance department describes it as paying the insured’s and passengers’ medical bills. The medical payments coverage entry covers it.

Which policy pays a rider first, the van’s or the rider’s own?

It depends on the state. In Michigan, Minnesota and New York a rider in your van claims against the van’s insurer first. Pennsylvania sends a rider with a policy of their own there first. Florida pays from the van’s PIP only if the rider has no PIP of their own.

• Michigan (MCL 500.3114(2)). The van’s insurer pays when the van is operated in the business of transporting passengers. Section 3114 does not define “business of transporting passengers”, and a van that carries riders for pay reads naturally as covered. The same subsection lists passengers it does not reach, among them riders in school buses, buses run by a common carrier certified by the state transportation department, buses operating under a government sponsored transportation program, buses run by or serving a nonprofit organization, taxicabs and transportation network company vehicles. Even then the vehicle’s insurer pays when the passenger has no PIP under any other policy. The section does not define “bus” either, so whether a wheelchair van falls inside the government program and nonprofit exceptions is a coverage question for your insurer or a lawyer. For an occupant of a vehicle outside subsections (2) and (3) who has no PIP policy of their own, subsection (4) sends the claim to the assigned claims plan.
• Minnesota (Minn. Stat. 65B.47, subd. 1). The security covering the van pays first, and the rider’s own policy pays only if the van has none. Subdivision 1a exempts commuter vans, vehicles carrying children to day care or school, a bus as to a Minnesota resident who is an insured, and a taxi passenger. A wheelchair van is not on the list.
• New York (11 NYCRR 65-3.12(a)(1)). The insurer of the van the rider occupied pays first. The regulation sends bus passengers to their own insurer first, but “bus” there is the term defined in Vehicle and Traffic Law sections 104 and 142, and section 104 means a vehicle with seating for fifteen or more passengers besides the driver. A wheelchair van with fewer seats is not a bus, so the van’s insurer comes first.
• Pennsylvania (75 Pa.C.S. 1713). The statute calls the coverage first party benefits. The order is the policy on which the rider is the named insured, then a policy covering the rider as an insured, then, for occupants of an insured vehicle, the policy on that vehicle. A rider covered by a household auto policy uses it before yours. When insurers share a priority, the first one claimed against pays as if wholly responsible and recovers pro rata from the rest.
• Florida (Fla. Stat. 627.736(4)(e)). The van owner’s PIP pays a rider who has none of their own. The PIP requirement exempts school buses and limousines, and taxicabs have their own security rule. A van used mainly for business is a commercial motor vehicle under the statute’s definitions, so it falls inside the requirement. Under subsection (4)(e)4, a passenger gets PIP from the van owner’s insurer only if the passenger is not the owner of a vehicle that must carry PIP and is not entitled to PIP from the insurer of such an owner, which is why a household member’s policy can come first.

Does PIP also cover your driver or attendant?

Usually through a different door. An employee hurt on the job has a workers’ compensation claim, and PIP statutes have their own employee rules. Michigan sends an employee hurt as an occupant of an employer-owned or registered vehicle to the insurer of that vehicle (MCL 500.3114(3)). Minnesota names the security covering an employer-furnished vehicle first (Minn. Stat. 65B.47, subd. 2). How your state coordinates PIP with workers’ compensation is a question for your agent, and the workers’ comp guide covers the compensation side.

Do Medicare and Medicaid pay before PIP?

No, both pay after it. PIP is no-fault insurance, and Medicare steps back for care that no-fault coverage has already paid for or is reasonably likely to pay for (42 CFR 411.20(a)(2)). Medicare’s definitions list personal injury protection among the names for no-fault insurance (42 CFR 411.50(b)).

Medicaid pays last. If a state already knows of the coverage when a provider’s claim arrives, it sends the claim back so the provider can bill the other payer first, and it then pays only the difference its schedule allows (42 CFR 433.139(b)). If it learns of the coverage after paying, it seeks recovery. For broker trips, that means the broker or the state should hear about the PIP claim when you do. The third-party liability entry explains the payment order.

What should you do when a rider is hurt in a no-fault state?

Work through these steps the same day, whether or not the rider says they are hurt.

1. Give your own insurer notice of the accident. The page on reporting a minor van accident explains why that applies even when the damage is small.
2. Ask the rider or family whether anyone in the household owns a car or has an auto policy, and write down the insurer and policy number. In Pennsylvania and Florida that policy can come first, and in Michigan it matters for the buses on the exception list.
3. Give the rider your insurer’s name, the claim number and the adjuster’s contact, so the rider can start a PIP claim. Do not promise benefits.
4. Pass along any time limit you know of. Florida’s 14 days for first treatment is the clearest example.
5. Keep the incident report and the trip record together. The incident report template lists the fields.

The trip record a PIP claim starts from

Whoever handles the PIP claim needs to know who was aboard, when and where the ride started, and which van and driver were on it. HealthRide keeps those facts on every leg, with scheduled and actual times, GPS-recorded miles and the rider’s signature captured in the driver app, and the trip log exports to CSV or PDF. See reports.