Utah’s no-fault Personal Injury Protection (PIP) minimum is $3,000 per person, per accident. In real life, a single emergency room visit with diagnostic imaging can hit or exceed that amount, pushing bills onto you unless other coverage applies. When reasonable medical expenses surpass $3,000 or another qualifying condition is present, you cross Utah’s “serious injury threshold” under Utah Code § 31A-22-309, opening the door to a third-party claim against the at-fault driver for additional damages. If the at-fault driver lacks sufficient coverage, uninsured/underinsured motorist (UM/UIM) benefits on your own policy may help cover the shortfall, subject to policy terms, set-offs, and consent-to-settle provisions.
For guidance tailored to your situation, call (801) 851-1202 or schedule a free consultation.
Key Takeaways About Utah PIP Coverage
- Utah requires only $3,000 minimum PIP coverage, which is often insufficient for modern ER and follow-up costs.
- If your medical expenses exceed $3,000, or in the case of death, dismemberment, permanent disability, or permanent disfigurement, you meet Utah’s serious injury threshold under Utah Code § 31A-22-309, allowing you to sue the at-fault driver for your remaining damages.
- Third-party liability claims may seek past and future medical expenses, wage loss, and non-economic damages, subject to proof, coverage, and policy limits.
- Don’t stop treatment because PIP is exhausted; attorneys can often arrange letters of protection so medical providers may agree to treat you on a lien that will be paid from an eventual settlement, though provider acceptance varies.
Utah’s $3,000 PIP Minimum: A System That Has Not Kept Pace
Personal Injury Protection coverage, commonly called PIP, is Utah’s no-fault insurance. Under PIP, your own insurance company pays your medical expenses and a portion of lost wages regardless of who caused the accident under Utah Code § 31A-22-306. Utah requires minimum PIP coverage of $3,000 per person per accident.
The problem? The $3,000 minimum has not kept pace with medical costs.
The Healthcare Cost Reality
Modern medical treatment costs have far outpaced Utah’s PIP minimum. Typical post-crash costs can include emergency room facility and physician fees, ambulance transport, CT scans and MRIs, six to twelve physical therapy visits, specialist consultations, and outpatient surgery. A single ER visit with diagnostic testing can consume most or all of the $3,000 PIP coverage before any actual treatment begins.
Surgical procedures often cost tens of thousands of dollars. Physical therapy typically requires multiple sessions over weeks or months. Specialist consultations add up quickly. Many accident victims find their $3,000 PIP exhausted within days or weeks while their ongoing treatment needs continue for months.
Utah’s Serious Injury Threshold: Your Path to Additional Compensation
Utah’s no-fault system includes an important exception. When your injuries meet the “serious injury threshold” defined in Utah Code § 31A-22-309, you may pursue additional compensation from the at-fault driver beyond the $3,000 PIP coverage.
You meet the serious injury threshold through any of these conditions:
- Death
- Dismemberment (loss of body part)
- Permanent disability or impairment
- Permanent disfigurement
- Medical expenses exceeding PIP coverage ($3,000+)
The most common way accident victims meet this threshold is through medical expenses exceeding $3,000—which typically happens when accidents require emergency treatment, diagnostic imaging, specialist care, or ongoing therapy.
What Meeting the Threshold Allows
Once you meet Utah’s serious injury threshold, you may file a claim against the at-fault driver’s liability insurance to recover all of your remaining damages. This includes all past and future medical bills, all lost wages, lost earning capacity, pain and suffering, emotional distress, loss of quality of life, and permanent impairment compensation.
The serious injury threshold provides a path to pursue additional compensation beyond your no-fault benefits when the criteria are met. Many injury scenarios exceed $3,000 quickly, especially when ER diagnostics or ongoing care are involved.
Third-Party Liability Claims: Getting Full Compensation
When you meet the serious injury threshold, you may file a third-party liability claim against the at-fault driver’s insurance. This claim operates separately from your PIP coverage and allows the recovery of damages that PIP doesn’t cover, particularly pain and suffering damages.
In a typical example of a third-party liability claim, PIP pays initial medical bills up to $3,000. You file a claim with the at-fault driver’s liability insurance, proving their negligence. You document all damages, including medical records, bills, lost wage statements, and evidence of pain and suffering.
Settlement or judgment proceeds typically follow an allocation order: PIP carrier reimbursement if subrogation applies under policy and Utah law, payment of medical provider liens, compensation for lost wages, and finally payment to you for non-economic damages like pain and suffering. Understanding this allocation helps you assess whether settlement offers adequately address all your damages.
When the At-Fault Driver Has No Insurance
Many Utah drivers operate vehicles without insurance or carry only minimum liability limits of $25,000 per person, which is often inadequate for serious injuries. When the at-fault driver is uninsured, your uninsured/underinsured motorist (UM/UIM) coverage under Utah Code § 31A-22-305 becomes critical.
UM coverage is purchased on your own policy but pays when at-fault drivers lack insurance. It functions like the at-fault driver’s liability insurance would have, covering all damages beyond PIP, including medical expenses, lost wages, and pain and suffering.
Under Utah Code § 31A-22-305.3, underinsured motorist coverage is subject to statutory set-off provisions and policy clauses requiring your insurer’s consent before accepting the at-fault driver’s settlement. If their $25,000 policy pays out but your damages total $60,000, your UIM coverage may pay the difference up to your policy limits, subject to these consent-to-settle provisions and set-offs.
Continuing Treatment When PIP Is Exhausted
One critical mistake accident victims make is stopping medical treatment when PIP coverage runs out. This damages both health outcomes and legal claims. Insurance companies might argue that gaps in treatment prove injuries weren’t serious.
Attorneys can often arrange letters of protection so providers may agree to treat on a lien, with payment from settlement proceeds. These are provider-specific agreements and are not automatically enforceable unless the provider accepts the arrangement. Under these arrangements, providers agree to treat without upfront payment, placing a lien on your case. When your claim resolves, providers get paid from settlement funds.
Letters of protection are common with chiropractors, physical therapists, pain management specialists, and some orthopedic surgeons, though acceptance varies by provider. They allow you to complete necessary treatment without destroying your finances while awaiting claim resolution. Attorneys commonly negotiate these liens at settlement; outcomes vary by provider and facts.
Health insurance may also cover treatment after PIP is exhausted, though copays and deductibles apply. Your health insurer will assert subrogation rights. Attorneys negotiate these claims to minimize what health insurers recover and increase your own net recovery amount.
Strategic Mistakes That Cost Victims Thousands
Several common mistakes dramatically reduce accident victims’ recovery or leave them with crushing medical debt:
- Assuming $3,000 PIP is all you can recover: Many victims don’t understand that the serious injury threshold allows pursuing additional compensation from at-fault drivers
- Stopping treatment when PIP runs out: Insurance companies use treatment gaps to argue injuries weren’t serious; complete prescribed treatment using letters of protection if necessary
- Accepting quick settlement offers: Insurance companies may offer to “cover your PIP,” hoping you don’t realize you’re entitled to much more; once you sign a release, you cannot seek additional compensation
- Not carrying UM/UIM coverage: You cannot purchase this coverage after an accident; given Utah’s significant uninsured driver population, UM/UIM is essential protection
- Not hiring an attorney early: An attorney can structure and document claims, negotiate liens, and pursue all available coverage; outcomes vary by facts and policy limits
These mistakes leave accident victims with tens of thousands in medical debt when they had legal rights to full compensation.
Understanding Utah’s Modified Comparative Negligence
Your ability to recover damages depends partly on your percentage of fault under Utah Code § 78B-5-818. You’re barred from recovery if you’re found 50% or more at fault; recovery is reduced in proportion to any lesser fault.
For example, if the at-fault driver is 70% responsible and you’re 30% at fault, you recover 70% of your damages. Insurance companies aggressively argue comparative fault to reduce payouts, making statements you made at the accident scene critical.
When to Hire a Car Accident Attorney
Hire an attorney when your medical bills exceed $3,000, ongoing treatment is needed, surgery is recommended, your injuries appear permanent, you’ve lost significant work time, PIP is exhausted and you cannot afford continued treatment, the at-fault driver is uninsured or underinsured, or the insurance company offers a lowball settlement.
Attorneys determine whether you meet the serious injury threshold, file third-party claims against at-fault drivers, calculate full damages including future needs, obtain letters of protection to continue treatment, negotiate medical liens to reduce amounts owed, and handle all insurance communications.
Most car accident attorneys work on contingency, meaning you pay no attorney fees unless they recover compensation. The contingency fee typically ranges from 33% to 40%.
FAQ About Utah PIP Coverage and Medical Bills
My ER Bill Was $5,000—How Does $3,000 PIP Cover That?
It doesn’t. PIP pays $3,000, and you initially owe the remaining $2,000. However, since your medical expenses exceed $3,000, you meet Utah’s serious injury threshold. You can sue the at-fault driver for the remaining $2,000 plus all other damages, including pain and suffering.
How Much of My Wages Does PIP Cover and for How Long?
PIP generally covers a portion of lost income, subject to policy and statutory limits. Many policies cover up to 85% of lost wages, though specific percentages, dollar caps, and time limits vary by policy terms. Benefits typically continue for a defined period—often up to one year—but check your policy declarations page for exact coverage. PIP wage benefits are in addition to medical expense coverage, not instead of it.
Do I Need My Insurer’s Consent to Settle the At-Fault Driver’s Claim Before Using UIM?
Usually yes. Most UIM policies contain consent-to-settle provisions requiring you to obtain your insurer’s permission before accepting settlement offers from the at-fault driver. Policy terms and Utah law also govern set-offs—how much the at-fault driver’s payment reduces your UIM claim. Violating these provisions can jeopardize your UIM coverage. An attorney helps navigate these requirements.
How Do Medical Liens and PIP Subrogation Get Resolved at Settlement?
When your case settles, multiple parties may claim portions: your PIP carrier (subrogation), health insurers, and medical providers with liens. Your attorney negotiates these claims before distributing settlement proceeds. Reductions are commonly negotiated but not guaranteed—outcomes depend on Utah law, policy terms, provider willingness, and settlement amount. This negotiation significantly affects your net recovery after medical bills and attorney fees.
Will Pursuing a Claim Affect My Own Insurance Rates?
Pursuing the at-fault driver’s insurer generally does not change your premiums, but carrier practices vary. Using UM/UIM can affect premiums depending on your policy. Using PIP should not affect rates as it’s required coverage regardless of fault. Check with your insurance agent about your specific policy.
Protect Your Rights After Exhausting PIP Coverage
Utah’s $3,000 PIP minimum has not kept pace with modern medical costs. Understanding the serious injury threshold changes everything—once medical expenses exceed $3,000, you can pursue full compensation from at-fault drivers, including all medical expenses, lost wages, pain and suffering, and future needs.
Don’t let inadequate PIP coverage trap you with catastrophic medical debt. Don’t stop necessary treatment. And don’t accept lowball offers before understanding your rights.
Parker & McConkie Injury Lawyers represents Utah car accident victims navigating PIP limitations. We determine whether you meet the serious injury threshold, file third-party liability claims, secure letters of protection so you can continue treatment, calculate full damages including future needs, and handle PIP subrogation and medical liens.
Call (801) 851-1202 or schedule a free consultation online to discuss your case. We work on a contingency fee basis—you pay no attorney fees unless we recover compensation for you. Case costs might apply.
