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Guide · Insurance claims · New Jersey

PIP denied, delayed or used up in New Jersey: what happens next

Updated By Spencer, editorEvery fact cites a source

Your PIP insurer has 60 days after written notice of a claim to pay, deny it in writing with reasons, or explain in writing why it needs up to 45 more days. Either side can take a PIP dispute to dispute resolution. Bills past your PIP limit can be claimed from the person at fault. Checked October 11, 2026.

Sources: N.J.S.A. 39:6A-5(g), (h); N.J.S.A. 39:6A-5.1(a), (b); N.J.S.A. 39:6A-4; N.J.S.A. 39:6A-4.3; N.J.S.A. 39:6A-5(g); N.J.S.A. 39:6A-12; N.J.S.A. 39:6A-2(k)
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What happened with your PIP claim?

Pick the closest one. It shows how New Jersey's rules treat it. It can't tell you whether your claim should be paid.

No payment and no answerThe payment may be overdue
What it is
A claim the insurer hasn't paid or answered.
Why it matters
The law sets a clock once the insurer has written notice.
The rule
A PIP payment is overdue 60 days after written notice, unless the insurer denied it or asked for more time in writing. Overdue payments carry interest.
What you can do now

Keep a copy of what you sent, and the date it arrived.

Source: N.J.S.A. 39:6A-4; N.J.S.A. 39:6A-4.3; N.J.S.A. 39:6A-5(g); N.J.S.A. 39:6A-5(g), (h); N.J.S.A. 39:6A-5.1(a), (b)
They denied itA dispute you can take further
What it is
A denied PIP claim.
Why it matters
A denial has to come in writing, with reasons.
The rule
Either side can send a PIP dispute to dispute resolution, run by an organization the state designates.
What you can do now

Get the denial in writing and keep it with the bills.

Source: N.J.S.A. 39:6A-5(g), (h); N.J.S.A. 39:6A-5.1(a), (b)
They say a treatment isn't neededA dispute about medical benefits
What it is
A disagreement over whether PIP pays for care.
Why it matters
Disputes over PIP medical benefits can go to dispute resolution.
The rule
Any dispute over PIP medical expense benefits may go to dispute resolution, at either side's request.
What you can do now

Ask your provider's office whether it has appealed the decision.

Source: N.J.S.A. 39:6A-5(g), (h); N.J.S.A. 39:6A-5.1(a), (b)
PIP ran outThe person at fault, in a claim
What it is
Medical bills above your PIP limit.
Why it matters
The PIP law doesn't limit recovering them from whoever caused the crash.
The rule
Bills above PIP limits, deductibles and copayments can be recovered from the person at fault.
What you can do now

Keep every bill past the limit, and a note of who paid it.

Source: N.J.S.A. 39:6A-12; N.J.S.A. 39:6A-2(k)

The insurer's deadlines

  1. Acknowledge the claimN.J.A.C. 11:2-17.6(b)Within 10 working days
  2. Pay, or deny in writing with reasonsN.J.S.A. 39:6A-5(g)Within 60 days of written notice
  3. More time to investigate, in writingN.J.S.A. 39:6A-5(g)Up to 45 more days
  4. Overdue paymentsN.J.S.A. 39:6A-5(h)Carry interest at the court rate
Source: N.J.A.C. 11:2-17.6(b), (e); N.J.A.C. 11:2-17.7(a), (b), (c)(2), (c)(3), (e), (f); N.J.S.A. 39:6A-4; N.J.S.A. 39:6A-4.3; N.J.S.A. 39:6A-5(g); N.J.S.A. 39:6A-5(g), (h); N.J.S.A. 39:6A-5.1(a), (b)

If PIP is denied

A denial has to come in writing, with the insurer's reasons. From there, a PIP dispute can go further.

  1. Dispute resolutionEither side can send a dispute over PIP benefits to dispute resolution. The state's insurance commissioner designates the organization that runs it.Source: N.J.S.A. 39:6A-5(g), (h); N.J.S.A. 39:6A-5.1(a), (b)
  2. A complaint to the stateComplaints about an insurance company go to the New Jersey Department of Banking and Insurance, in writing.Source: New Jersey Department of Banking and Insurance, How to Request Assistance; N.J.S.A. 17:29B-4(9)(f)
  3. Your doctor's billing officeAsk where the bill stands, and whether anyone has appealed the decision.

When PIP runs out

Every standard policy's PIP has a limit, up to $250,000 per person unless a lower amount was chosen in writing.

NJBills past the limit

They can be recovered from the person at fault, along with deductibles and copayments.

Source: N.J.S.A. 39:6A-12; N.J.S.A. 39:6A-2(k)
NJIf health insurance was made primary

Health insurance pays first. PIP then pays reasonable medical expenses it doesn't cover, up to the PIP limit.

Source: N.J.S.A. 39:6A-4.3(d); New Jersey Department of Banking and Insurance, Auto Insurance New Jersey Buyer's Guide
NJThe deadline to sue

An injury lawsuit against the person at fault generally must be filed within 2 years.

Source: N.J.S.A. 2A:14-2(a)
Source: N.J.S.A. 39:6A-4; N.J.S.A. 39:6A-4.3; N.J.S.A. 39:6A-5(g)

When it's worth asking a lawyer

  1. PIP denied care your doctor says you needA dispute over PIP medical benefits can go to dispute resolution.Source: N.J.S.A. 39:6A-5(g), (h); N.J.S.A. 39:6A-5.1(a), (b)
  2. PIP ran out and the bills keep comingBills past the limit are claimed from the person at fault, and that claim has a deadline.Source: N.J.S.A. 39:6A-12; N.J.S.A. 39:6A-2(k); N.J.S.A. 2A:14-2(a)
  3. No answer, long past the deadlineA PIP payment is overdue 60 days after written notice, unless the insurer denied it or asked for more time in writing.Source: N.J.S.A. 39:6A-4; N.J.S.A. 39:6A-4.3; N.J.S.A. 39:6A-5(g); N.J.S.A. 39:6A-5(g), (h); N.J.S.A. 39:6A-5.1(a), (b)

Sources

General information, not legal advice. We don't know the facts of your claim. A lawyer can review them, and most injury lawyers offer a free consultation.

What to do next

Questions people ask

What do I do if my PIP claim is denied in New Jersey?

Get the denial in writing; it must give the insurer's reasons. Either side can send a PIP dispute to dispute resolution, run by an organization the state designates.

How long does a New Jersey insurer have to pay a PIP claim?

A PIP payment is overdue 60 days after the insurer gets written notice of the claim and its amount, unless it denied the claim or asked for up to 45 more days in writing.

What happens when PIP runs out?

Medical bills above your PIP limit, plus deductibles and copayments, can be recovered from the person at fault.

Can I complain about my insurer?

Yes. Complaints about an insurance company go to the New Jersey Department of Banking and Insurance, in writing.

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