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What is PIP insurance, and what does no-fault mean?
PIP is coverage in your own policy that pays certain injury costs no matter who caused the crash. 'No-fault' usually means PIP plus limits on suing. Which system your state uses decides who pays first and when you can sue. General information, not legal advice.
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The words
PIP, no-fault, add-on, at-fault: four terms people mix up
- A Your own insurer pays first-party benefits (PIP/MedPay) regardless of fault
- B A claim against the at-fault driver’s insurer
- Lawsuit threshold in some states
Personal injury protection (PIP) is first-party coverage: your own insurer pays certain costs, such as medical bills and sometimes lost income, after a crash, whoever caused it. MedPay (medical payments) is a smaller, similar coverage. Triple-I notes that the extent of PIP varies: in the most comprehensive states, "a policyholder receives compensation for medical fees, lost wages, funeral costs and other out-of-pocket expenses." [1]
States then differ on whether you can still sue the other driver:
| System | PIP or similar benefits | Right to sue the other driver |
|---|---|---|
| No‑fault | Required | Limited by a threshold (a dollar amount of medical bills, or a described "serious injury") |
| Choice no‑fault | Required | You choose a limited or an unlimited right to sue (Kentucky, New Jersey, Pennsylvania) |
| Add‑on | First-party benefits (PIP or medical payments) are written into the policy, though some states let you reject or waive them in writing | No restriction on lawsuits. Triple-I: first-party coverage "may not be mandatory." [1] |
| At‑fault (tort) | Not required in the policy | No threshold. The at-fault driver can be sued for pain and suffering as well as expenses. |
The at-fault row is Triple-I's description of a "traditional tort liability" state, where "there are no restrictions on lawsuits." [1] For the state-by-state picture, see the state-by-state no-fault versus at-fault table.
Thresholds
What a lawsuit threshold looks like
A threshold is the line you must cross before you can sue for pain and suffering. Two forms are in use, and both appear in the statutes we read:
- A dollar threshold. Utah's statute says a person "may not maintain a cause of action for general damages arising out of personal injuries alleged to have been caused by an automobile accident" unless a listed condition applies, including "medical expenses to a person in excess of $3,000." [3]
- A described "serious injury." New York: "there shall be no right of recovery for non-economic loss, except in the case of a serious injury, or for basic economic loss." [4]
Pennsylvania sits in between: drivers choose. The "limited tort" election precludes a noneconomic-loss suit unless the injury is "serious." [6]
Add-on example
An add-on example: Maryland
Maryland shows the third type. Its Insurance Article says each insurer that issues a motor vehicle liability policy "shall provide coverage for the medical, hospital, and disability benefits described in this section," and the benefits "shall include up to $2,500." [5] The section we read does not limit the right to sue; we checked only the sections cited here. Washington is the optional version: PIP must be offered, and a named insured "may reject, in writing, personal injury protection coverage." [7]
Our four states
Tennessee, Alabama, Oklahoma and South Carolina
| State | What we verified | What we did not |
|---|---|---|
| South Carolina | The statute says: "There is no personal injury protection (PIP) coverage mandated under the automobile insurance laws of this State." [2] If an insurer sells such coverage, it "shall not be assigned or subrogated and is not subject to a setoff." | Whether any particular policy includes medical payments. |
| Alabama | The Alabama sections we read set the liability minimums and require uninsured motorist coverage unless the named insured rejects it; see uninsured motorist coverage. We found no PIP requirement in them. | We could not read an official Alabama source that states the system, so we do not classify Alabama and it is left out of the state-by-state table. |
| Oklahoma | The Oklahoma sections we read require liability insurance and require uninsured motorist coverage that the insured may reject in writing; see uninsured motorist coverage. We found no PIP requirement in those sections. | We did not verify Oklahoma's classification against an official statement, so it is left out of the state-by-state table. |
| Tennessee | Nothing in the Tennessee sections we read on uninsured motorist coverage or on fault establishes whether PIP is required. | We could not read an official Tennessee source that states the system, so we do not classify Tennessee here. The who pays medical bills page covers what the site has verified for Tennessee. |
If you were hurt in a state you do not live in, the rules of the state where the policy was written and the state of the crash can both matter; that is a question for the insurer or an attorney.
Want to talk it through? A person usually calls you back in about 15 minutes (8am to 8pm Central). You never pay CrashFirst. CrashFirst is not a law firm, does not evaluate your coverage and does not give legal advice. General information as of November 9, 2026.
CrashFirst is not a law firm and does not give legal advice. This checklist is general information. Every situation is different.
Keep reading
- Reference
No-fault vs at-fault states: what does 'no-fault state' mean?
Which states are no-fault, choice no-fault, add-on or at-fault, with required PIP amounts and lawsuit thresholds, each from the state's statute or insurance department. 46 of 50 states, Nov 2026.
Open - State reference
Who pays medical bills after a car crash in Tennessee?
Health insurance, the at-fault driver's insurer, your own coverage and hospital liens: how each works in Tennessee, with statute citations. Nov 2026.
Open - Guide
How are car accident settlements calculated? The factors, not a formula
The factors courts and statutes name when a car accident claim is valued: damages types, fault share and caps in TN, AL, OK and SC. No formula, no dollar estimates. Sourced.
Open - Guide
What is uninsured motorist coverage, and how does it work?
What uninsured and underinsured motorist (UM/UIM) coverage is, and how Tennessee, Alabama, Oklahoma and South Carolina rules read on offer, rejection and limits. Sourced.
Open - Tool
Minimum car insurance by state: look up your limits
Pick a state to see its minimum required car insurance limits, with the statute or insurance department page behind each number. All 50 states, checked Nov 2026.
Open
Sources
- Triple-I (Insurance Information Institute), Background on: No-fault auto insurance (checked November 9, 2026)Official source“a policyholder receives compensation for medical fees, lost wages, funeral costs and other out-of-pocket expenses”“In add-on states, first-party coverage may not be mandatory”“In traditional tort liability states, there are no restrictions on lawsuits”“Each insurance company compensates its own policyholders (the first party) for the cost of minor injuries, regardless of who was at fault in the accident”“the term no-fault applies only to states where insurance companies pay first-party benefits and where there are restrictions on the right to sue”
- S.C. Code § 38-77-144, PIP not mandated, South Carolina Legislature (official) (checked November 9, 2026)Official source“There is no personal injury protection (PIP) coverage mandated under the automobile insurance laws of this State”
- Utah Code § 31A-22-309, tort threshold, Utah Legislature (official) (checked November 9, 2026)Official source“may not maintain a cause of action for general damages arising out of personal injuries alleged to have been caused by an automobile accident”“medical expenses to a person in excess of $3,000”
- N.Y. Insurance Law § 5104, New York State Senate (official) (checked November 9, 2026)Official source“there shall be no right of recovery for non-economic loss, except in the case of a serious injury, or for basic economic loss”“there shall be no right of recovery for non-economic loss, except in the case of a serious injury”
- Md. Code, Insurance § 19-505, Maryland General Assembly (official) (checked November 9, 2026)Official source“shall include up to $2,500 for:”“shall provide coverage for the medical, hospital, and disability benefits described in this section”
- 75 Pa.C.S. § 1705, election of tort options, Pennsylvania General Assembly (official) (checked November 9, 2026)Official source“Unless the injury sustained is a serious injury, each person who is bound by the limited tort election shall be precluded from maintaining an action for any noneconomic loss”“Each person who is bound by the full tort election remains eligible to seek compensation”
- RCW 48.22.085, personal injury protection coverage, Washington Legislature (official) (checked November 9, 2026)Official source“A named insured may reject, in writing, personal injury protection coverage”
- 75 Pa.C.S. § 1711, required benefits, Pennsylvania General Assembly (official) (checked November 9, 2026)Official source“shall include coverage providing a medical benefit in the amount of $5,000.”
Page last updated November 9, 2026. Attorney review pending. General information, not legal advice. Fees, hours and rules change; confirm on the official page. How we source.
Questions
What is PIP insurance?
PIP stands for personal injury protection. Triple-I describes the first-party benefits as coverage where "each insurance company compensates its own policyholders (the first party) for the cost of minor injuries, regardless of who was at fault in the accident." [1] The benefits and limits vary by state.
What is no-fault insurance?
In its strict form, "the term no-fault applies only to states where insurance companies pay first-party benefits and where there are restrictions on the right to sue." [1] Many people use the word more loosely for any system where your own insurer pays some losses regardless of fault.
How does personal injury protection work?
It depends on the state. Maryland, for example, requires insurers to "provide coverage for the medical, hospital, and disability benefits" described in its section, and the section shows up to $2,500 [5]. Pennsylvania's policies "shall include coverage providing a medical benefit in the amount of $5,000." [8]
What states require PIP?
Twelve states and Puerto Rico are the "true" no-fault states in Triple-I's description, and others require PIP or medical payments without limiting lawsuits. Our state-by-state table lists every state we could verify with its own statute or insurance department. See the no-fault versus at-fault table.
Is PIP insurance worth it?
We do not tell you whether to buy any coverage. Where it is required, you have it whether or not it is worth it to you. Where it is only offered, Washington's statute shows it is optional: "A named insured may reject, in writing, personal injury protection coverage." [7]
What is a no-fault state for car accidents?
It is a state where PIP is mandatory and the right to sue for pain and suffering is limited by a threshold. Utah, for example, bars a general-damages claim unless medical expenses exceed $3,000 or another listed injury applies [3]. New York allows recovery for non-economic loss only "in the case of a serious injury." [4]
What is full tort versus limited tort?
In Pennsylvania a driver elects one. A person bound by the limited tort election is precluded from suing for noneconomic loss "Unless the injury sustained is a serious injury." [6] A person under the full tort election "remains eligible to seek compensation" without that limit [6].
Is a no-fault state the same as no-fault divorce?
No. This page is about auto insurance only. No-fault divorce is a different body of law that we do not cover.