How Does Massachusetts’ No-Fault Law Limit Your Right to Sue?

Massachusetts is one of 12 U.S. states that operate under a no-fault auto insurance system, which significantly impacts how accident victims can seek compensation for injuries and losses. This system is designed to streamline the process of handling auto accident claims, ensuring that victims receive timely payment for medical expenses and lost wages without the need to establish fault. However, it also places certain restrictions on the right to sue for additional damages, such as pain and suffering. 

With surprisingly little change, no-fault has been our state’s law since 1971. It is Massachusetts General Laws c. 231, s. 6D and Massachusetts General Law c. 90, s. 34M. Under this system, if you are involved in an auto accident, you must initially turn to your own insurance carrier to cover medical bills and other out-of-pocket expenses up to the limit of your personal injury protection (PIP) coverage. This coverage is mandatory and provides benefits for medical expenses, a portion of lost wages and other reasonable expenses related to the injury. 

However, it is important to note that PIP will only reimburse medical expenses up to a certain limit unless certain conditions are met that allow for additional coverage. The system works as follows:

• Initial Coverage — PIP typically covers the first $2,000 of medical expenses directly.
• Coordination with Health Insurance — If you have private health insurance, PIP will cover medical expenses beyond what your health insurance pays, up to the $8,000 limit. This includes co-pays, deductibles, or treatments not covered by your health plan.
• No Health Insurance — If you don’t have health insurance, PIP will cover medical expenses up to the full $8,000 limit.

PIP can also cover lost wages (up to 75 percent of your income) and certain replacement services, but only up to the $8,000 cap. The cap can be less if the insured opted for a deductible in their policy.

One of the major aspects of the no-fault system is the ” injury” threshold that must be met for an accident victim to sue another driver for greater losses than PIP will cover, such as pain and suffering. The injuries sustained must meet certain criteria defined under state law. These include instances where medical expenses exceed $2,000, or the injuries result in significant and permanent loss of an important bodily function, permanent disfigurement or death. Only reasonable and necessary expenses will be considered in determining whether an accident victim has incurred $2,000 worth of medical care. 

A qualified auto accident attorney is essential for victims to deal with the complexities of the no-fault system and the serious injury threshold. An attorney can assist in quantifying the injuries and losses you’ve sustained. This includes placing a value on pain and suffering, which is subjective and can require special proof, such as testimony from medical and financial experts. 

The law firm of Feinberg & Alban is dedicated to ensuring that auto accident victims receive the full compensation they are entitled to. With offices in Boston, Brookline, and Worcester, we represent clients throughout eastern Massachusetts. Call us at 617-232-5950 or contact us online to set up your free initial consultation.