Many people get confused when insurance companies tell them after a car accident that Kansas is a no fault state. No fault does not prevent an injury victim from getting a settlement when the collision was due to a negligent driver.
No Fault Laws in Detail
No fault laws are fairly straight forward. When you are in a collision, Kansas law provides your own insurance company has to pay certain benefits upfront—these benefits are known as personal injury protection benefits (when talking with insurance companies, they call them "PIP" benefits).
These laws help an injury victim get some of their medical bills paid upfront and provide for wage loss payments upfront, prior to seeking a settlement from the person who was at fault. However, if you don't have a serious injury, you can't get a recovery from the person who was at fault for pain and suffering and other noneconomic losses. A serious injury usually is an injury resulting in at least $2000 of medical bills. Other serious injuries include a fracture to a weight-bearing bone, permanent disfigurement, or any kind of permanent disability. Once you qualify with a serious injury, you "breach the threshold" and you have a case where you can seek damages for pain and suffering, accompanying mental anguish, disability, disfigurement, inconvenience, loss of time, loss of enjoyment of life, and other terms categorized as noneconomic losses.
When you get a settlement from the insurance company for the at-fault person, under normal circumstances, you have to reimburse your insurance company from the settlement. The reason for reimbursement is simple. If you were allowed to collect medical bills, wage loss, and other PIP benefits from your own insurance company, and then later you collect those same damages from the insurance company for the negligent person, you would be getting paid twice.
However, when the negligent person has insufficient insurance, and you are not getting paid for duplicative damages, the insurance company providing PIP payments has to waive their claim to get repaid. Also if there is a determination that you have comparative fault, and you are partially negligent in causing the wreck, the insurance company providing PIP payments has to reduce the amount they get reimbursed by whatever fault is attributable to you. The insurance company getting their money back also has to pay a proportionate share of attorney fees when they get their money back (this saves the injury victim from paying attorney fees on that part of the recovery).
Types of PIP Benefits
Usually, there are four types of PIP benefits available. Kansas requires minimums on these benefits, but you can purchase higher coverages.
For medical bills related to the wreck, the minimum is your insurance company has to pay up to $4500 of medical bills, including reimbursing you for your prescription purchases related to the wreck.
For wage loss, the minimum is $900/month, up to one year. Wage loss is reimbursed at 85% of the gross wage loss and the insurance companies require documentation of two things. You have to get an off-work slip from your doctor confirming what time frame you are unable to work, but you also have to have written wage loss verification from your employer confirming your absence and rate of pay.
A less used PIP benefit is called substitution services or essential services. If your injury prevents you from doing your chores at home and you pay someone else to do those chores, you can get reimbursed up to $25/day for up to 365 days. You need documentation from your doctor that these services are necessary due to your injuries and the doctor's note needs to specify what time frame you needed this assistance. You also need documentation of your payments to others (receipts for their work).
Finally, there is a PIP benefit called occupational rehabilitation, which allows up to $4500 towards occupational therapy services (not physical therapy which is billed under medical) or psychiatric service aimed at restoring your ability to work following an injury.
For death cases, there are PIP benefits to assist with funeral expenses (only $2000), and survivors benefits to pay dependent heirs which basically pays the wage loss of the deceased ($900/month for a year) to the heirs.
These no fault benefits are available even when the collision is your fault. In those cases, you get these PIP benefits, but you don't get a settlement from the other driver for damages like pain and suffering.
This post is very general and summarized—we always offer free advice if you have questions. Call Brian and Brian at Pistotnik Law with your questions any time! Contact us today. We are friendly and willing to help!