1. What Are First Party Benefits?
When the Pennsylvania Motor Vehicle Financial Responsibility Law (PMVFRL) first became the law in Pennsylvania, everyone was required to carry $10,000.00 in first party medical benefits and $5,000.00 of first party wage loss benefits. This changed some time ago and now you are only required by law to carry $5,000.00 of medical benefits under your auto insurance policy. There is no requirement to carry wage loss benefits under your auto policy. You can still carry more than the required minimum in medical benefits and this is probably a good idea if you don’t have good health insurance otherwise, because if you have a claim for injuries against another driver, his insurance company will likely not pay your medical bills as you treat, like your auto or health insurance. Likewise, if you don’t carry wage loss benefits under your policy, your wage loss will likely not get paid as you lose wages, either. First party benefits are benefits you carry under your own auto policy to pay for losses you are sustaining, as you are suffering the loss. This is different from the money you may collect from another responsible party by settlement or verdict, because this normally occurs later, at one time, well after the loss is sustained. Even if you don’t own a car and therefore do not have your own auto policy, first party benefits can be available to you through the vehicle you were occupying at the time of the injury.
2. When Are You Eligible For Wage Loss Benefits?
Sections 1711 and 1722 of the PMVFRL provide that to be eligible for first party benefits, your injury must “arise out of the use or maintenance of a motor vehicle”. A motor vehicle is also defined in that law and through cases, and does not include ATV’s or some other motorized vehicles. Your personal car or truck is certainly within the definition. If you have first party benefits they are also available for injuries in cars and trucks you may be operating for your employer. There must also be a reasonable connection between the use or maintenance of the motor vehicle and your injury. Sometimes the connection is obvious, such as when you driving or occupying a car or truck and are struck by another car or truck. Sometimes, it is obvious that there is no connection, such as when you get injured in a fight with another driver because he cut you off on the highway. However, there are other situations in the gray area where it may not be so clear. What about getting bitten by a dog as a passenger in a car, stepping into a hole while getting out of your car, stacking packages inside your work van, or falling on the loading dock while carrying packages from your work truck? In some of these examples, first party benefits are payable and in some, they are not. Can you tell which are which? The law looks to how much the actual use or maintenance of the motor vehicle caused the injury, as opposed to some other force, not connected with the use or maintenance.
3. Can you get First Party Wage Loss While Collecting Comp For a Work Injury?
The answer is yes, so long as you carry first party wage loss benefits under your policy, or they are otherwise available if you don’t own a motor vehicle. You can collect first party wage loss benefits, even if you are already collecting workers’ comp wage loss benefits for the same injury. The formula for how they are paid is somewhat different than if comp was not available. If there are no comp benefits, first party wage benefits cover 80% of the actual wage loss up to the limits available under the policy. If comp is payable, first party wage loss benefits cover 80% of the difference between the actual wage loss and what you are receiving in comp, also up to the policy limits. This is because comp is “primary” or the first source of benefits when both may be payable. These auto benefits are traditionally referred to as “wrap around” benefits and they can be used to supplement the comp and better compensate you for the wage loss. Could you be eligible for first party wage benefits? Call us to find out.in a timely fashion.