Personal Injury Protection Attorney: Filing Deadlines You Must Know

Personal Injury Protection, often shortened to PIP, moves fast. It pays medical bills and certain lost wages after a crash, often before fault is decided. The tradeoff for that speed is a thicket of deadlines that can quietly kill an otherwise valid claim. I have watched diligent people lose thousands because a form went in a week late or a medical bill lacked the right coding. The calendar matters as much as the facts.

This guide breaks down PIP deadlines that commonly apply in no-fault and hybrid states, how insurers use them, and where a personal injury protection attorney makes a difference. Laws vary by state and policy, so consider this a practical map, not a statute book.
What PIP Actually Covers, and Why Timing Drives Everything
PIP is designed to pay immediate needs: ambulance and hospital costs, follow-up care, some lost income, mileage to appointments, and, in some states, replacement services like child care or housekeeping if your injuries keep you from normal tasks. It does not wait for liability to be proven. That is the good part.

The hard part is the deadlines built into both state statutes and the fine print of your auto policy. Miss one deadline and the insurer may deny payment even if the treatment was obviously tied to the crash. Providers feel this sting too. I have seen clinics eat five-figure write-offs because a claim form arrived on day 46 when the policy said 45.

Deadlines fall into a few buckets: notifying the insurer, seeking initial treatment, submitting bills and proof, attending exams or interviews, contesting denials, and, if needed, filing suit before the statute of limitations expires. Each bucket can carry its own trap.
The First Timer: Notify the Insurer
Most policies require prompt notice, often described as “as soon as reasonably possible,” yet many quietly define that as a specific number of days. Thirty days is common. Some carriers accept late notice if you show no prejudice, but do not count on grace.

What counts as notice? A claim phone call followed by a claim number usually suffices. Many insurers also require a written PIP application. The application is not decoration, it triggers benefit processing. Hold off, and the clock for payment never starts for the insurer, but the cutoffs for your bills keep ticking.

I advise clients to call their own insurer within 24 to 48 hours if they are physically able. If you were a passenger or pedestrian, you may still need to notify your household policy or the vehicle’s policy depending on state priority rules. In multi-policy households, a personal injury attorney can help sort which carrier is primary.
The “14-Day Rule” and Other Treatment Windows
Several states impose a short window to seek initial medical care. In Florida, for example, you generally must obtain initial services and care within 14 days from the crash to unlock PIP benefits. Other states set 30 days as a practical threshold. Even where no statute sets a clock, many policies take a hard line on delays between accident and first treatment.

Why it matters: insurers equate delay with unrelated injury. If you felt “fine” after the crash and waited three weeks, expect an argument that your neck pain came from something else. If you cannot see a doctor immediately, urgent care or an emergency room visit documented within the first week helps preserve the line of causation, and it satisfies initial treatment requirements in many jurisdictions.
Submitting Medical Bills: The Provider’s Deadline Can Become Yours
PIP pays bills that are timely submitted. Policies often require providers to submit standardized claim forms, like CMS-1500 or UB-04, within 30 to 45 days of service, and sometimes every 30 days thereafter. In some states the statute gives providers up to 90 days, but the policy may demand earlier submissions with rolling deadlines for continuing care.

Patients assume their clinic handles this. Most do, yet back-office mistakes are common. Coding errors, missing assignments of benefits, and lack of supporting notes lead to “pending” status that quietly morphs into a denial once the window closes. When I audit denied claims, a frequent culprit is lack of proof that the bill was transmitted on time. In my files, the winning providers keep mailing receipts, fax confirmations, or portal screenshots with timestamps.

If you are treating after a crash, ask your providers to confirm they know which policy is primary and that they are sending bills under PIP, not your private health plan. Get copies of billing submissions monthly. It seems tedious, but it beats paying a $6,000 MRI out of pocket because a box was unchecked.
Proof of Loss and Medical Authorizations
Insurers often require a sworn proof of loss or a PIP application with details of injuries, lost wages, and providers. Deadlines commonly run 30 days from receipt of the form. Refusing to sign medical authorizations creates delays or denials. You can and should limit authorizations to relevant time periods and body parts, but a blanket refusal gives the insurer cover to suspend benefits.

A https://martinktrc495.fotosdefrases.com/evaluating-pain-and-suffering-insights-from-experienced-lawyers https://martinktrc495.fotosdefrases.com/evaluating-pain-and-suffering-insights-from-experienced-lawyers personal injury law firm will tailor authorizations to protect privacy while satisfying the policy. I have negotiated narrower authorizations that exclude mental health records unrelated to the crash, which kept the claim moving without opening the door to a fishing expedition.
Independent Medical Exams and Recorded Statements
Policies reserve the insurer’s right to examine you under oath, take a recorded statement, or schedule an independent medical examination. Miss these on the first scheduled date without a good reason and benefits can be suspended.

Here is the nuance from real cases. If the exam site is 90 miles away with no public transit, courts in some states frown on denials for missing that appointment. If you offer prompt alternative dates or ask for a closer location, document it in writing. Go alone and you may misstate facts under stress. Go with a personal injury protection attorney and the tone changes. I prepare clients for what is fair game and what is not, keeping the focus on objective facts.
Wage Loss Benefits: Employer Forms and Paystubs on a Clock
PIP wage claims often require an employer verification within a specified timeframe, typically 30 days from the request. If your employer drags its feet, you may lose several weeks of checks. I tell clients to alert HR immediately and then send gentle reminders every few days. If your workplace is small, give the insurer a point of contact and hours. When HR is nonresponsive, an injury attorney can send a targeted request that gets noticed.

Self-employed claimants face an extra hurdle. Carriers want tax returns, invoices, and sometimes bank statements. Start assembling them early. Waiting until day 29 to upload a shoebox of receipts invites delay.
Statutes of Limitation: PIP Versus Bodily Injury Claims
Two tracks run in parallel: your no-fault PIP benefits and any bodily injury claim against a negligent driver. They carry different clocks.

For PIP, the statute of limitations to sue your own insurer for unpaid benefits can range from one to six years depending on the state and whether the policy language shortens the period. Some states run the clock from the date of each unpaid bill, which means rolling deadlines. I once filed a suit to save a single month of physical therapy charges that were about to expire while the rest of the bills had more time. Details like that decide whether a clinic stays whole.

For bodily injury lawsuits, states often allow two to three years from the date of the crash, though several have shortened timelines or special notice rules for government-owned vehicles. If your injuries meet a no-fault threshold, you may pursue pain and suffering beyond PIP. Do not let comfort with PIP payments lull you into missing the separate deadline to pursue the negligent driver. An accident injury attorney keeps both calendars in view.
The Threshold Dance in No-Fault States
In threshold states, your right to pursue non-economic damages depends on crossing defined criteria: significant disfigurement, permanent loss of a body function, or medical expenses over a statutory amount. The timing of diagnostic tests influences threshold arguments. Insurers regularly claim that MRI findings weeks later reflect degeneration, not trauma. Ordering advanced imaging too late can complicate that debate.

There is a balance. Not every sprain needs an MRI on day two. But if symptoms persist beyond normal recovery windows, delay helps the defense. As a bodily injury attorney, I work with treating physicians on the clinical timeline so that, if we must litigate, the record supports both medical necessity for PIP and a threshold crossing for the civil case.
Coordinated Versus Primary PIP and How It Changes Deadlines
Some policies coordinate PIP with private health insurance. If your policy states that health insurance is primary for certain services, those health-plan deadlines for pre-authorization, referral, and claim submission become part of the picture. Miss a pre-auth for physical therapy under your HMO and the PIP carrier may refuse to cover it too, arguing it was not “reasonable and necessary” considering your policy structure.

Read your declarations page. If the policy is “excess” PIP, the sequence matters. In these setups, a personal injury claim lawyer aligns providers with the correct billing order so you do not end up trapped between two carriers pointing fingers at each other while the provider threatens collections.
Coordinating Benefits When You Were Working or on the Job
If you were injured while working, workers’ compensation may be primary for medical care, with PIP stepping in for limited lost wages or other benefits depending on the state. Workers’ compensation has its own notice requirement, often immediately or within 30 days. Miss that and you could diminish both comp and PIP. An injury lawsuit attorney will coordinate the two systems and protect your right to a third-party claim against any negligent driver or contractor who caused the crash.
The Hidden Deadline: Policy Limits Exhaustion
PIP usually has a dollar cap. Many states set it at $10,000, though some policies carry higher or lower amounts. As bills accumulate, the insurer pays until the limit is met, then stops. Exhaustion is not a deadline in the calendar sense, but it functions like one. Once exhausted, late-arriving bills shift to health insurance, medical payments coverage, or, if another driver is at fault, to the bodily injury claim.

Here is the human part. People delay filing a bodily injury claim because PIP seems to cover everything. Then PIP exhausts, and you realize the statute for suing the negligent driver is only months away. I keep a running ledger projecting when PIP will run out based on average monthly treatment cost. That projection drives decisions about settlement timing and whether to accelerate negotiations with the liability carrier.
Denials and Appeals: Short Fuses
If the insurer denies a bill or reduces it based on a fee schedule, it will issue an explanation of benefits. Some states require you to demand reconsideration or submit a civil remedy notice within a set number of days before filing suit. Others allow you to move straight to litigation. Providers, especially small clinics, benefit from a system: log the denial date, the reason, and the appeal deadline, then send a concise written dispute with supporting notes or codes. A negligence injury lawyer can package this cleanly, which often prompts payment without court.

For claimants, a blanket denial can signal a required exam or a missing form. Call, get a specific answer, and follow up in writing. Phone-only conversations vanish. Emails or certified letters anchor the timeline and keep your options open.
Two Short Checklists to Stay Ahead of the Calendar Within 14 to 30 days: notify your insurer, file the PIP application, see a doctor, and give limited medical authorizations. Every 30 days: confirm providers submitted bills, send wage verification updates, and document mileage and out-of-pocket costs.
These habits keep the claim live while your body does the slow work of healing.
Common Edge Cases That Derail Good Claims
Out-of-state crashes complicate everything. If you carry PIP in a no-fault state and crash in a fault-based state, your policy may still apply, but the submission rules follow your policy and home-state law. This mismatch creates arguments about medical necessity evaluated under different fee schedules. I once resolved a cross-border denial by showing the policy’s choice-of-law clause and the insurer’s own handbook that adopted home-state rules for traveling policyholders.

Multiple vehicles and family members introduce priority disputes. Imagine a college student hurt while riding in a friend’s car, but still a dependent in a household with its own PIP policy. Which policy pays first? Most states set a priority ladder: the policy on the vehicle, then the injured person’s household policy, then the Assigned Claims Plan if no coverage exists. Get this wrong and bills ping-pong unpaid. An injury settlement attorney will send simultaneous notices to both possible carriers and demand a written determination of priority.

Preexisting conditions spark predictable fights. The insurer will suggest your back pain predates the crash. The solution is not argument, it is records. Ask your treating doctor to compare pre-accident and post-accident symptoms and imaging, and to explain why the crash aggravated a prior condition. Put it in the chart before a defense examiner does it for you.

Government vehicles change your timeline. If the at-fault driver was a city or state employee, notice-of-claim statutes can require formal notice within 60 to 180 days, far shorter than the general statute of limitations. You still pursue PIP, but you must also meet the special notice requirement to keep your civil injury lawyer options open for the negligence claim.
When to Bring in a Lawyer, and What They Actually Do
People often search “injury lawyer near me” once a bill is denied or an exam is scheduled at an inconvenient time. An earlier call helps. A personal injury attorney audits deadlines, narrows authorizations, prepares you for exams, and polices the insurer’s own clocks. Insurers have deadlines too. In many states, they must pay or deny within 30 days of receiving a properly executed claim. If they stall without good reason, interest and attorney’s fees may attach. A civil injury lawyer uses those statutes to leverage prompt payment.

A premises liability attorney’s experience is relevant when the crash involves a fall or collision on private property with overlapping medical payments coverage. The rules differ, but the instincts transfer: early notice, preserved footage, and timely provider submissions. A serious injury lawyer brings a different lens to high-value cases, prioritizing diagnostic proof, functional capacity evaluations, and life care planning while keeping PIP flowing so treatment is not interrupted.

Many firms offer a free consultation personal injury lawyer session. Use it to map your deadlines, confirm which insurer is primary, and decide whether your case just needs light guidance or full representation. If your injuries are minor and the insurer pays promptly, you may not need ongoing personal injury legal representation. If denials persist or your symptoms worsen, an injury claim lawyer can prevent small missteps from compounding.
Practical Documentation That Wins Deadline Fights
Insurers dispute facts. Good records cut the argument short. Keep a small folder or a cloud drive with:
Claim number, adjuster name, and all correspondence dates. Treatment dates, provider names, and billing submissions or portal screenshots.
Those two lists are enough to anchor most disputes. With that timeline, a personal injury claim lawyer can show that you notified the carrier on day three, saw a doctor on day one, and that your provider sent bills every 30 days. When an adjuster asserts late submission, timestamps end the debate.
PIP and Settlement Timing: Avoiding the Cliff
Liability carriers prefer to wait until treatment stabilizes. You prefer to settle before financial pressure forces decisions. PIP helps bridge that gap, but only if it keeps paying. When PIP nears exhaustion, the ground shifts. Your negotiating leverage often improves once you can show total medicals, residual deficits, and any temporary or permanent wage loss.

A best injury attorney sequences these pieces. They may advise pausing certain elective treatments until pre-authorization is in place, or moving a key diagnostic earlier to solidify threshold status. They may also recommend med-pay coverage as a supplement if your policy allows it. The goal is not to inflate bills but to create a clean, medically necessary record that supports both compensation for personal injury and a timely, defensible settlement.
What Happens If You Miss a Deadline
All is not always lost. Some deadlines are “soft,” meaning the insurer must show prejudice from the delay. Others are hard cutoffs baked into statutes. I have reopened claims by demonstrating that notice was reasonable under the circumstances, such as when a client was hospitalized and sedated for days. For provider deadlines, resubmitting with corrected codes and a letter explaining the initial transmission error sometimes revives payment, especially if done within a short grace period.

When the door truly closes, the strategy changes. Health insurance becomes the payor, and the bodily injury claim grows more important. A personal injury legal help consultation at this point focuses on preserving the remaining statute, gathering evidence of fault, and identifying all available coverages, including underinsured motorist benefits. The tone shifts from administrative to adversarial, and the calendar resets around the court system’s clocks.
Final Thoughts From the Trenches
Deadlines decide dollars in PIP claims. Most are short, some are hidden, and nearly all are manageable if you start early, document consistently, and communicate in writing. The insurer’s job is to apply the policy as written. Your job is to meet the policy on its own terms while protecting your broader rights.

If you are reading this after a crash, act now. Notify the carrier. See a clinician. Gather your pay records. Ask your providers how and when they submit PIP bills. If anything feels uncertain, a personal injury protection attorney can walk you through the dates, the forms, and the practical steps that keep benefits flowing. The law rewards people who move promptly. Your recovery, physical and financial, depends on it.