Hurt in a Car Accident in New Jersey: PIP, the Verbal Threshold and Your Claim

If you are hurt in a car accident in New Jersey, your own auto policy's Personal Injury Protection (PIP) coverage pays your medical bills no matter who caused the crash. Whether you can also sue the at-fault driver for pain and suffering usually depends on the lawsuit option on your own policy: most New Jersey drivers have the "limitation on lawsuit" option, often called the verbal threshold, which allows that claim only for certain serious or permanent injuries.

That trade-off surprises many people. Here is how the pieces fit together, and what to do in the first weeks after a crash.

How does PIP work in New Jersey?

New Jersey is a no-fault state for medical expenses. After a crash, you generally look first to your own policy's PIP coverage, not the other driver's insurer, to pay for treatment. If you don't own a car, PIP may come from the policy of a resident relative you live with.

A few practical points:

• PIP pays regardless of fault, up to the limit you chose when you bought the policy. Limits vary widely, so check your declarations page.
• Deductibles and co-payments apply, and insurers can require treatment to follow certain care-management rules. Keep copies of everything the PIP carrier sends.
• If you were on the job, workers' compensation generally pays first. A crash during work can also support a claim against the other driver; see our page on third-party claims after a work injury.

What is the verbal threshold, and does it apply to you?

When you bought your policy, you chose between two lawsuit options:

• "Limitation on lawsuit" (the verbal threshold, N.J.S.A. 39:6A-8(a)). This is the option most New Jersey drivers have. You can sue for pain and suffering only if your injury falls into one of these categories: death; dismemberment; significant disfigurement or significant scarring; a displaced fracture; loss of a fetus; or a permanent injury within a reasonable degree of medical probability.
• "No limitation on lawsuit." This option costs more, but it keeps your full right to sue for pain and suffering for any injury caused by another driver's negligence.

The threshold you are held to generally comes from your own policy, not the other driver's. In threshold cases, proving a permanent injury takes objective medical evidence and a physician's certification, so consistent treatment and good records matter a great deal.

The threshold limits claims for pain and suffering. It does not stop you from pursuing economic losses that PIP doesn't cover, such as wage loss beyond your PIP benefits or medical bills above your PIP limit.

Who is at fault, and what if you were partly to blame?

Fault still matters for everything outside PIP. New Jersey follows modified comparative negligence (N.J.S.A. 2A:15-5.1). You can recover as long as your share of fault is not greater than that of the drivers you are suing, and your damages are reduced by your percentage. If a jury finds you 20% at fault, your award is reduced by 20%.

Insurers sometimes argue comparative fault to reduce a claim, so evidence matters: the police report, photographs of the vehicles and the road, dashcam or business video, phone records, and the names of independent witnesses.

What if the other driver has little or no insurance?

New Jersey's minimum liability limits are low, and some drivers carry none at all. Your own policy's uninsured and underinsured motorist coverage may step in when the at-fault driver cannot pay the full value of the claim. These claims have their own rules about notice, consent to settle and, often, arbitration. Settling with the other driver's carrier without telling your own insurer can put that coverage at risk.

Crashes with commercial trucks, delivery vans and rideshare vehicles can involve additional insurers and companies, which is another reason to identify every policy early.

What should you do after a car accident in Morris or Sussex County?

• Get medical care and follow through with treatment. Gaps in care are the most common argument insurers make in threshold cases.
• Get the police report from the department that responded, whether the New Jersey State Police or a local department in a town such as Jefferson, Rockaway or Sparta.
• Photograph everything: vehicles, the scene, your injuries as they change.
• Report the claim to your own insurer promptly and open your PIP claim.
• Be careful with the other driver's insurer. You do not have to give a recorded statement, and early offers rarely reflect injuries that are still developing.
• Watch the deadline. A lawsuit generally must be filed within two years of the crash (N.J.S.A. 2A:14-2). If a public vehicle or a road defect was involved, a notice of claim is generally due within 90 days.

Our article on what damages you can recover after an injury in New Jersey explains the categories of loss in more detail. If a crash took the life of someone close to you, see our page on wrongful death claims.

Talking to a lawyer about your situation

A lawyer can review your policy's lawsuit option, your medical picture and the available insurance, and tell you honestly whether a claim for pain and suffering is likely to be available. Gray Law Group offers a free initial consultation; call 973-240-7313. If you are still deciding who to call, our guide to choosing a personal injury lawyer may help.

Our office is in Jefferson, Morris County, and we represent people hurt in crashes across Morris, Sussex, Warren and Passaic counties and throughout northern New Jersey.