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What is Extended Medical Expense Coverage (Non-PIP)?

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When NJ drivers buy automobile insurance policies for their cars or trucks, there are different types of coverage options they can purchase. Two of the mandatory coverage options in a NJ standard auto policy are:

  • first party benefits or PIP coverage; and
  • liability coverage.

The first party benefits or PIP coverage pays for the insured driver’s medical expenses and costs as a result of a car accident. This coverage kicks in even if the driver did not cause the accident.

The default PIP coverage amount in a standard NJ auto policy is $250,000, and a driver may choose to purchase a reduced coverage limit of $15,000, $50,000, $75,000 or $150,000.

Liability coverage comes into play when the insured driver injures another driver i.e., is responsible for causing an accident. If the other injured driver files a car accident lawsuit against the insured driver, the liability coverage would pay the other driver for his damages, but up to the limit purchased.

Also see: How Your Car Insurance Policy Affects Your Legal Rights To Financial Recovery After A NJ Car Accident

Extended Medical Expense Coverage

There is another coverage in all NJ auto policies that many drivers may not know about called extended medical expense coverage or non-PIP coverage. NJ auto insurance carriers are required to provide a minimum of $1,000 of extended medical expense benefits, and the insured driver can choose to increase that coverage up to $10,000.

This coverage provides medical expense benefits or accidental death benefits up to the limit purchased (maximum of $10,000) if an insured person suffers injuries or death in an accident arising out of the ownership, maintenance, or use of either an insured automobile or a highway vehicle which is neither owned by the insured nor available to him or any family member for regular use.

The next question is when does medical extended expense coverage apply? A situation where this coverage will be applied is in a motorcycle accident; however, the motorcycle cannot be owned by the injured motorcycle rider. Consider the following: a motorcycle rider borrows his brother’s motorcycle and is injured after an SUV hits him head on. The injured rider has his own car insurance policy, but PIP coverage does not apply because he was not injured while in an automobile. When he bought his auto policy, he increased his extended medical expense benefits to $10,000.

The rider incurs $35,000 of medical expenses. Because he was not riding his own motorcycle, he will receive $10,000 of extended medical expense benefits to pay for part of his medical expenses.

If the rider was riding his OWN motorcycle, then he would not be able to receive extended medical expense benefits from his auto policy.

Extended medical expense benefits may also apply if an insured driver was injured in a public transit bus accident.

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