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Insurance guide

Pennsylvania car accident insurance: a patient's guide

If you have Pennsylvania auto insurance, your own policy usually pays your medical bills first, whoever caused the crash, through its first party benefits (often called PIP): the benefits your own policy pays to you and the people it covers. State law requires a medical benefit of $5,000 and lists chiropractic among the treatments it can pay for. This guide is general information, not legal advice, and coverage depends on your policy; for treatment itself, see car accident and whiplash care.

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Whose policy pays my medical bills after a crash in Pennsylvania?

Usually your own: Pennsylvania law sets an order of priority for first party benefits, starting with the policy on which you are the named insured.

Pennsylvania law (75 Pa.C.S. § 1713) says an injured person recovers first party benefits in this order:

  1. If you are a named insured on an auto policy: that policy.
  2. If you are covered as an insured under a policy because you live in the named insured’s household (a spouse or other relative, or a minor in their custody): the policy covering you.
  3. If you were riding in an insured vehicle and neither of the above applies: the policy on that vehicle.
  4. If you were not in a vehicle, for example walking or cycling: the policy on any vehicle involved in the accident.

Except for workers’ compensation, these auto benefits come first: the law treats health plan benefits as paying in excess of them, not in duplication (75 Pa.C.S. § 1719). The Pennsylvania Insurance Department’s Auto Insurance Guide describes the medical benefit as paying medical bills for you and others covered by your policy, regardless of fault.

What is the minimum first-party medical benefit in Pennsylvania?

$5,000: Pennsylvania law requires auto insurers to include a medical benefit of $5,000 in the policies they issue, and higher amounts are available to buy.

The requirement (75 Pa.C.S. § 1711) applies to policies on vehicles registered and operated in Pennsylvania; it does not apply to motorcycles or recreational vehicles not intended for highway use. The law describes the medical benefit as coverage for reasonable and necessary medical treatment and rehabilitative services, and lists chiropractic among them (75 Pa.C.S. § 1712).

The law also limits what a provider may charge for treating an injury covered by these benefits. Providers must bill the insurer, not you, and may not bill you for the difference between their full charge and the amount the insurer pays (75 Pa.C.S. § 1797).

What do limited tort and full tort mean for me?

They decide whether you can sue an at-fault driver for pain and suffering: with full tort you can; with limited tort you cannot, unless the injury is a serious injury or another exception in the law applies.

Full tort and limited tort in Pennsylvania (75 Pa.C.S. §§ 1702 and 1705)
QuestionFull tortLimited tort
Can you seek medical and other out-of-pocket costs from an at-fault driver?YesYes
Can you seek compensation for pain and suffering?YesOnly for a serious injury, or when another exception in the law applies
What if you never chose an option?Full tort is the defaultApplies only if you chose it

The law defines a serious injury as “a personal injury resulting in death, serious impairment of body function or permanent serious disfigurement” (75 Pa.C.S. § 1702).

Even with limited tort, the law keeps your full tort rights against an at-fault driver who, for example, is convicted of driving under the influence in that accident (or accepts Accelerated Rehabilitative Disposition for it), was driving a vehicle registered in another state, intended to injure someone, or did not carry the insurance the law requires (75 Pa.C.S. § 1705(d)). Your insurer or agent can tell you which option your policy has.

How does LeGault Chiropractic bill after a car accident?

We bill your auto insurance directly, and when we do, you pay nothing up front.

  1. Call or book online

    Call 412-364-4100 or book online to see Dr. Steven K. LeGault, DC.

  2. We bill your auto insurance

    We send the bill to your auto insurance directly.

  3. Nothing up front

    When we bill your auto insurance, you pay nothing up front. Coverage depends on your policy.

When should I talk to a lawyer?

Consider it if you were seriously injured, if fault or coverage is disputed, or if a deadline may be near; only a lawyer can advise you on your own case.

Pennsylvania law sets time limits for going to court:

  • A lawsuit for injuries caused by another person’s negligence must be started within two years (42 Pa.C.S. § 5524).
  • A lawsuit for unpaid first party benefits must be started within four years of the accident, or within four years of the last payment if benefits have been paid; a different rule applies to minors (75 Pa.C.S. § 1721).

Is this legal advice?

No: this page is general information about Pennsylvania law, not legal advice, and coverage depends on your policy.

Laws change and policies differ. Your insurer or agent can explain your own policy, the Pennsylvania Insurance Department auto insurance guidance (opens another site) covers the basics, and the statutes themselves are published as 75 Pa.C.S. sections 1705, 1711 and 1797 (official text) (opens another site) on the General Assembly’s website. The statute wording on this page was checked against that official text on October 14, 2026.

Just had a car accident?

Get emergency care first for any serious injury, then see car accident and whiplash care for what to do next.

Before you come in, read about your first visit, or see other insurance we accept, including Medicare and workers’ compensation.

Book an appointmentCall 412-364-4100

Questions, answered

If I chose limited tort, can I still recover my medical bills?

Yes. Limited tort restricts only claims for pain and suffering and other nonmonetary losses; under either option you may still seek recovery of medical and other out-of-pocket expenses from an at-fault driver (75 Pa.C.S. § 1705).

What happens when my auto medical benefit runs out?

Your health insurance may then pay, depending on your plan: Pennsylvania law treats health plan benefits as paying in excess of auto first party benefits (75 Pa.C.S. § 1719). Your insurer can tell you how your own coverage works.

Sources

  1. 75 Pa.C.S. § 1711, Required benefits (official text). (opens another site)

    Policies must include a medical benefit of $5,000 (motorcycles and recreational vehicles not intended for highway use excepted).

  2. 75 Pa.C.S. § 1712, Availability of benefits (official text). (opens another site)

    The medical benefit covers reasonable and necessary medical treatment and rehabilitative services, including chiropractic; higher benefits are available for purchase.

  3. 75 Pa.C.S. § 1713, Source of benefits (official text, Pennsylvania General Assembly). (opens another site)

    The order in which first party benefits are recovered: named insured’s policy, the policy covering an insured, the occupied vehicle’s policy, then any vehicle involved.

  4. 75 Pa.C.S. § 1719, Coordination of benefits (official text). (opens another site)

    Except for workers’ compensation, auto first party benefits are primary; health plan benefits are in excess of them.

  5. 75 Pa.C.S. § 1797, Customary charges for treatment (official text). (opens another site)

    Charges are limited; providers must bill the insurer, not the insured, and may not bill the insured for the difference.

  6. 75 Pa.C.S. § 1702, Definitions (official text). (opens another site)

    “Serious injury”, “noneconomic loss” and “insured” as the law defines them.

  7. 75 Pa.C.S. § 1705, Election of tort options (official text). (opens another site)

    Full tort and limited tort; full tort if no choice is made; exceptions that keep full tort rights.

  8. 75 Pa.C.S. § 1721, Statute of limitations (official text). (opens another site)

    Actions for first party benefits: four years from the accident, or from the last payment; a separate rule for minors.

  9. 42 Pa.C.S. § 5524, Two year limitation (official text). (opens another site)

    Actions for injuries caused by another’s negligence must be started within two years.

  10. Pennsylvania Insurance Department. Auto Insurance Guide (rev. October 2016). (opens another site)

    Medical benefits pay medical bills for you and others covered by your policy, regardless of fault; minimum limit $5,000; full tort is the default if limited tort is not elected.