PIP and UIM Claims

PIP: medical and wage benefits regardless of fault

Personal-injury protection is no-fault coverage on your own auto policy. Washington requires insurers to offer it under RCW 48.22.085, and a policyholder can only turn it down in writing. The minimum benefits under RCW 48.22.095 cover medical and hospital expenses, funeral expenses, part of your lost income, and loss of services, payable no matter who caused the crash. PIP gets your treatment started without waiting for a liability fight to resolve. We open the PIP claim promptly, keep the benefits flowing, and push back when the insurer cuts them off early with a paper medical review.

Uninsured and underinsured motorist (UIM) claims

Underinsured-motorist coverage is what protects you when the person who hit you had too little insurance, or none, or fled the scene. Under RCW 48.22.030, a Washington auto policy must include it unless you rejected it in writing, and the statute counts a driver with no insurance at all as underinsured. It also reaches a crash caused by a "phantom" driver who never made contact with you or your vehicle, as long as the crash was reported to police within 72 hours and the facts can be backed by evidence beyond your own testimony. Functionally, you make the claim against your own insurer, but you still have to prove the other driver's fault and your damages as if you were suing them, and your insurer steps into their shoes to defend. We treat a UIM claim like the liability case it really is, because that is how it has to be proven.

PIP reimbursement and the made-whole rule

After a liability settlement, your PIP insurer often wants its money back. Washington limits that. Under the made-whole rule from Thiringer v. American Motors Insurance Co., 91 Wn.2d 215 (1978), an insurer cannot recoup PIP until you have been fully compensated for your loss. And under Mahler v. Szucs, 135 Wn.2d 398 (1998), when it does recover, it must share in your attorney fees on a pro-rata basis. We enforce both, which often means the reimbursement demand shrinks or disappears.

Stacking, offsets, and coverage language

More than one policy can apply, and the order and limits matter. Washington lets an auto policy cap UIM at one limit per accident, however many vehicles or premiums it covers, and when you have similar coverage under more than one policy, the policies can hold your total to the highest single limit. So the policy wording decides how much is really available. Insurers also use offset and anti-duplication clauses to reduce what they pay, and Washington courts scrutinize provisions that try to cut UIM below what the statute requires. We read the coverage language closely, because getting the stacking and offset analysis right is often the difference between policy limits and a fraction of them.

When a coverage claim becomes a bad-faith claim

Because PIP and UIM are claims against your own insurer, the insurer owes you a duty of good faith. When it denies a valid UIM claim, terminates PIP without a reasonable basis, or drags the process out, that mishandling can support a separate bad-faith claim, and an unreasonable denial of coverage or benefits can also support a claim under the Insurance Fair Conduct Act, RCW 48.30.015, which allows up to triple damages and attorney fees. UIM and PIP are contract-based, and their deadlines can differ from the three-year injury deadline under RCW 4.16.080. The coverages also have notice conditions, so it is a mistake to wait.