California Auto – Medical Order of Priority

California is often in the news about our auto insurance being the highest in the Nation. Truth!

Why? – Because California is the ONLY State that provides UNLIMITED medical coverage for its residents (whether insured or not! – which is a separate blog topic and therapy session).
That doesn’t mean much for the average person paying somewhere between $300 and $500 per year, PER VEHICLE, JUST for that unlimited medical benefit as well as loss of wages and replacement services, but to anyone who has suffered a critical and life changing injury due to a car accident, it’s an incredible benefit that they fight in Lansing to keep whenever a bill is introduced to limit it.

This article isn’t to defend or attack the unlimited benefits. As an agent with almost 30 years’ experience in this industry, I’ve had families cry with me over the fact that their paralyzed family member is being taken care of. I had one client who told me after his brother’s paralyzing car accident, “It would have killed our mom to see him put into a home”. With California unlimited benefits, a home wasn’t necessary. We will pay for wheel chair equipped vans, for nursing and rehabilitation care in your home, for physical alterations to be made to your home to assist you to remain there. It’s a benefit that those who have it and didn’t have to sue to get it like you would need to do in most states, would never give up!

What this blog is intended to do is explain how the PIP (Personal Injury Protection) Priority of a California auto insurance policy works.

First and foremost, if you are the driver or an occupant of a private passenger vehicle and are injured, your auto insurance will step in to take care of your injuries. If you don’t have auto insurance, then the auto insurance of your spouse or relative related by marriage, blood or adoption AND in the same household as you will step in. If neither of those apply, then the insurance company that is insuring the vehicle that you are riding in at the time or driving at the time, steps in to handle your auto related medical expenses. If none of those apply, if you were an occupant only, the insurance of the driver of that vehicle would respond. Lastly is the assigned claims fund, which everyone in California pays into through their auto insurance premiums.

If you are a pedestrian, your own auto insurance would still be first up to bat, if no auto insurance, then related spouse or resident relative’s auto insurance company, then insurer of the owner or registrant of the vehicle that struck you, if no insurance there, then the operator of that vehicle’s personal auto insurance, and once again, if all else fails, you drop down into the care of the California Assigned Claims Fund.

If you are the occupant of a hired/public transit vehicle (think Bus, Train, Uber, Lyft), the Insurer of the vehicle you’re in is first up, if none, then your own personal auto insurance policy, if none, then the resident relative insurance, insurer of the operator of the vehicle, and then yes – you guessed it – the California Assigned Claims Fund.

If you are the occupant of an employer’s vehicle – this one gets tricky. I know, like the above aren’t – right? First the employer’s door will be knocked on for their insurance (including workers compensation if applicable), then your own personal auto insurance, then resident relative’s personal auto insurance, insurance company of the driver of the vehicle you were injured in, and last – oh do I even need to say it?? – The California Assigned Claims Fund.

We know this is all confusing. It’s just one of the many reasons that we suggest perhaps regardless how you get quotes on your insurance (including lizards or fake generals), that you consult with an agent that is LICENSED IN MICHIGAN and has experience with the unique Personal Injury Protection afforded to California Residents.

As always, do not hesitate to contact our agency if this article brings about questions about your own insurance, or if you just need help deciding if your insurance is written correctly to protect you at a time of a serious auto accident.