Jarred Marks Medical expenses
At least $3,000 per person for necessary medical, surgical, X-ray, dental, rehabilitation, ambulance, hospital and nursing services.
Utah Injury Claims · No-Fault & PIP
Utah pays your first medical bills through your own policy, then limits when you may claim pain and suffering from the driver who hit you. A fracture, a permanent injury documented on objective findings, or medical expenses above $3,000 will cross it.
The short answer
Utah requires every auto policy to carry personal injury protection, and PIP pays your early medical bills without regard to fault. That is what no-fault means here. It does not end the at-fault driver's responsibility; it decides who pays first.
The consequence people do not expect is the second one. Until your claim crosses a statutory threshold, you cannot recover general damages from the driver who hit you.
What PIP pays
The statutory floor is set by U.C.A. § 31A-22-307(1). A policy may offer more, and many do.
At least $3,000 per person for necessary medical, surgical, X-ray, dental, rehabilitation, ambulance, hospital and nursing services.
The lesser of $250 per week or 85% of lost gross income and lost earning capacity, for up to 52 consecutive weeks.
Up to $20 per day, for a maximum of 365 days, for work you would have done at home but cannot.
Up to $1,500 in funeral, burial or cremation benefits, and a death benefit payable to the heirs of a person who dies.
The income and household-services benefits are not paid for the first three days unless the disability lasts more than two consecutive weeks. PIP benefits are paid monthly as expenses are incurred, and they are overdue if the insurer does not pay within 30 days of receiving reasonable proof. Overdue benefits carry interest at 1.5% per month, and an insurer that has to be sued for them also pays your attorney fee. That is U.C.A. § 31A-22-309(5).
The threshold
General damages are the human part of a claim: pain, suffering, loss of enjoyment. Utah gates them. A person covered by PIP cannot maintain a claim for general damages arising from an auto accident unless one of six things is true.
U.C.A. § 31A-22-309(1)(a)
A person covered by personal injury protection may not maintain a cause of action for general damages arising out of an automobile accident, except where the person sustains one or more of the following:
Two of those prongs get overlooked. A bone fracture qualifies on its own, whatever the bills come to, so a broken wrist crosses the threshold on the day it is diagnosed. Permanent impairment has to rest on objective findings, which means an examining physician has to document it rather than record what you reported.
Note the words in excess of on the last prong, and note that the measure is the reasonable value of the care rather than whatever a provider happened to bill.
The exception
If the driver who hit you had no insurance and you are claiming against your own uninsured motorist coverage, the threshold does not apply to you at all.
U.C.A. § 31A-22-309(1)(b)
Subsection (1)(a) does not apply to a person making an uninsured motorist claim.
Your economic losses are also outside the gate. The threshold restricts general damages. Medical bills and lost income remain recoverable from the at-fault driver whether or not you cross it, subject to the offsets that apply when PIP has already paid part of them.
What it means for you
For a serious injury the threshold is a formality, crossed in the first week of treatment. It matters in the middle cases, where a soft-tissue injury is treated conservatively, the bills stall just short of the line, and the insurer has an obvious interest in keeping them there.
It also explains an adjuster's behaviour that otherwise looks strange. An early, friendly offer made before treatment finishes can be an offer made while your claim is still below the line. Accepting it closes the claim at that value.
Related
A straight answer on when a Utah car accident claim needs a lawyer and when it does not, including the fault rule that bars recovery at an even split.
What actually determines the value of a Utah car accident claim: medical expenses, lost income, general damages, insurance limits, comparative fault and liens.
Utah deadlines for injury, property damage and wrongful death claims, including the one-year notice of claim required when a governmental entity is involved.
A case review costs nothing and takes about 15 minutes. If the claim does not need a lawyer, we will say so.