PIP in Massachusetts: what personal injury protection actually pays.

What PIP is and how Massachusetts no-fault works

Personal Injury Protection is one of the four compulsory coverages on every Massachusetts auto policy. It pays medical expenses, up to 75% of lost wages, and replacement services, up to a combined limit of $8,000 per person. The word that matters is no-fault. Massachusetts has been a no-fault state since the law took effect January 1, 1971, and under M.G.L. c.90 §34A, PIP pays these expenses “without regard to negligence or gross negligence or fault of any kind.”

So if you are in a crash, your own policy’s PIP pays your bills first, no matter who caused the accident. There is no waiting to prove the other driver was at fault. Fault still matters for your premium, though; an at-fault accident is a surchargeable incident under the Massachusetts SDIP and merit rating system. The statute frames PIP benefits as being “in lieu of damages otherwise recoverable” in a tort claim for accidents inside the commonwealth. That is the trade at the heart of no-fault: fast, fault-free payment of your immediate costs, in exchange for a limit on when you can sue.

If you want the broader picture of how the four coverages fit together, our page on Massachusetts auto insurance sets the stage. This piece is about PIP specifically.

Who PIP covers

Statutory PIP reaches further than most drivers assume. Under §34A it covers the named insured, members of the insured’s household, any authorized operator or passenger of the insured’s vehicle including a guest occupant, and any pedestrian struck by the insured’s vehicle.

“Pedestrian” is defined broadly. It includes people operating bicycles, tricycles, and similar vehicles, and people on horseback or in horse-drawn vehicles. If your car strikes a cyclist, your PIP responds for that cyclist’s covered expenses.

There are two important limits on scope. Anyone entitled to workers’ compensation benefits for the injury is excluded from PIP, because that person’s medical and wage losses run through the comp system instead. And PIP also steps in for you and your household members when you are injured in, or struck as a pedestrian by, a vehicle that carries no PIP coverage, unless you recover those costs in a tort action. People with no applicable policy at all can claim through the assigned claims plan established under §34N.

What PIP pays and the $8,000 limit

PIP pays in three buckets, all sharing one $8,000 per-person cap.

Medical is the first. PIP covers all reasonable expenses incurred within two years of the accident for necessary medical, surgical, x-ray, and dental services, including prosthetic devices and necessary ambulance, hospital, professional nursing, and funeral services.

Lost wages are the second. For someone employed or self-employed at the time of the crash, PIP pays wages actually lost, capped at 75% of the average weekly wage for the year before the accident, and coordinated with any sick-pay or wage-continuation program. For someone not employed at the time, PIP pays for loss of earning power under the same 75% cap.

Replacement services are the third. PIP reimburses payments actually made to people outside your household for ordinary and necessary services you would have performed for yourself or your household, so long as those services were not for income.

The cap is “at least eight thousand dollars” on account of injury to or death of any one person, and those three buckets together cannot exceed it. When the state raised other compulsory limits in 2025, the Division of Insurance confirmed that “Personal Injury Protection (PIP) remains at $8,000 per person.”

The $2,000 health-insurance coordination rule

This is the part that generates the most confused phone calls. By statute, PIP will not pay more than $2,000 of medical expenses to the extent those expenses are or will be compensated by a health, sickness, or disability policy or a health-care plan.

Here is how it works in practice. PIP pays the first $2,000 of your medical bills. Your health insurer then pays the balance beyond that. Anything your health plan does not cover, including its deductibles and copayments, can be submitted back to the PIP insurer for up to an additional $6,000, keeping everything inside the $8,000 limit.

Under 211 CMR 38.05, PIP is primary for the first $2,000 of accident-related medical claims. After that, the health plan is primary and PIP becomes secondary. A provider cannot use coordination of benefits to bill the auto policy for the gap between its negotiated health-plan payment and its full charge. Your health insurer also cannot deny accident-related expenses just because PIP exists, and no health payer can subrogate against you for more than $2,000 of PIP benefits.

The coordination rules have exceptions. They do not apply to self-funded employer-sponsored health plans, and the regulation’s definition of “Plan” excludes Medicaid state plans and Medicare supplement policies, among others. If your only health coverage falls outside that definition, the $2,000 coordination ceiling may not squeeze your PIP the same way.

Deductibles, exclusions, and the tort threshold

You can elect a PIP deductible to lower premium. The choices under §34M are $100, $250, $500, $1,000, $2,000, $4,000, or $8,000, applied per person either to you alone or to you and your household members. Be deliberate here. If you take a deductible, you cannot recover the deducted amount from an at-fault driver who is exempt from tort liability under no-fault.

PIP has hard exclusions too. An insurer may exclude a person whose conduct contributed to the injury while operating a vehicle under the influence of alcohol or a narcotic drug, while committing a felony or fleeing lawful arrest, or with specific intent to cause injury.

The tort threshold is the other half of the no-fault bargain. In a Massachusetts motor vehicle tort action, you can recover for pain and suffering only if your reasonable and necessary medical expenses exceed $2,000, under M.G.L. c.231 §6D. That threshold falls away when the injury causes death, involves loss of a body member, causes permanent and serious disfigurement, results in loss of sight or hearing as described in the comp statute, or consists of a fracture. In those situations the dollar threshold does not stand in your way.

How a PIP claim actually works

Deadlines first. You must present a PIP claim as soon as practicable and in every case within two years of the accident. The claim needs a written description of your injuries, the treatment received and contemplated, and enough information to determine the amount due. For lost wages, you authorize the insurer to obtain your wage details from any employer for the year before the crash.

The payment clock is specific. Benefits are due as loss accrues on reasonable proof. Once a licensed physician notifies the insurer of disability, the insurer has ten days to start medical payments or give written notice, with reasons, that it does not intend to pay. The model jury instruction, citing Brito v. Liberty Mutual, requires a PIP insurer to pay all reasonable medical expenses for necessary services within 30 days of receiving the bills and supporting treatment records.

That 30-day rule has teeth. If benefits stay unpaid past thirty days, any unpaid party, including a medical provider, is treated as a party to the contract and can sue. The court advances the case for speedy trial, and if the unpaid party wins, the court must assess costs and reasonable attorney’s fees against the insurer. An insurer also cannot refuse a bill based on medical review unless it sent the bill to a practitioner licensed under the same section of c.112 as the one who submitted it.

You have duties too. You must submit to insurer-selected physical exams as often as reasonably required, help the insurer get medical reports, and, if the request is reasonable, submit to an examination under oath. A willful, unexcused refusal is a material breach that can discharge the insurer’s liability. When a PIP fight becomes a coverage dispute, having a broker with a dedicated claims team in your corner helps; that is part of what our claims advocacy work is for.

Where PIP sits among the compulsory coverages after July 2025

The four compulsory coverages now read: Bodily Injury to Others at $25,000 per person and $50,000 per accident, Personal Injury Protection at $8,000 per person, Bodily Injury Caused by an Uninsured Auto at $25,000 per person and $50,000 per accident, and Damage to Someone Else’s Property at $30,000 per accident. Drivers shorthand it as 25/50/30. Our guide to how car insurance works in Massachusetts walks the full system those coverages sit inside.

Those numbers come from Chapter 275 of the Acts of 2024, which amended §§34A and 34O and applies to policies issued or renewed on or after July 1, 2025. The old 20/40/5 minimums are obsolete for anything renewed after that date. PIP was not touched and stays at $8,000.

Because the compulsory minimums are floors, not ceilings, PIP is worth reviewing alongside your bodily injury and uninsured limits at renewal. If you are pricing a new policy, start with our auto quote and we will shop it across carriers.