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Rejected PIP in Washington? Who Pays Your Medical Bills After a Crash

By AutoInsuranceBundle.pro · Published November 1, 2026

Short answer: If you rejected PIP in writing, your own auto policy will not pay Washington's no-fault PIP medical and wage benefits. Your health insurance usually pays first, the at-fault driver's liability coverage can reimburse you, and underinsured motorist coverage may help if that driver has too little or no insurance. You can ask your insurer in writing to add PIP back.

Personal injury protection, usually called PIP, is the part of a Washington auto policy that pays your own medical bills and some lost income after a crash, no matter who caused it. Insurers have to offer it, but you are allowed to turn it down. Many drivers do that to save a little on premium and forget about it until the day they are hurt. If that is you, the medical bills do not simply disappear. They are paid from other sources, in a different order and often more slowly.

The short video below explains the basics in about half a minute. It uses licensed stock footage of roads and paperwork, not footage of any real crash or claim. The full guide follows.

What Washington law says about rejecting PIP

Under RCW 48.22.085, insurers must offer PIP with auto liability policies. The named insured can reject it, and a written rejection binds everyone covered by the policy. Once you reject it, the insurer does not have to add PIP back when the policy renews unless you ask for it in writing.

The Washington Office of the Insurance Commissioner (OIC) adds the practical point: if you do not want PIP, you have to reject it in writing, or it is added to your policy. So if you never signed a rejection, check your declarations page before assuming you have no PIP.

What you gave up

These are the minimum PIP benefits set by RCW 48.22.095. The OIC notes that you can buy higher limits, for example medical coverage of up to $35,000.

PIP pays these benefits without waiting for anyone to decide who caused the crash. That speed is what you lose when you reject it. The OIC also notes that PIP does not cover motorcycles, mopeds and similar vehicles, so riders are in a similar position even without a rejection form.

Who pays your medical bills instead

Without PIP, the money usually comes from three places.

• Your health insurance. In most cases this is the first payer. Expect deductibles, copays and network rules. Your health plan may later seek repayment from any injury settlement you receive, depending on the plan's terms.
• The at-fault driver's liability coverage. If the other driver caused the crash, their bodily injury liability coverage can pay your medical bills, lost wages and other damages. The catch is timing: the liability insurer usually pays once, at settlement, not bill by bill. Washington uses pure comparative fault under RCW 4.22.005, so your recovery is reduced by your own share of fault.
• Your underinsured motorist coverage (UIM). Under RCW 48.22.030, UIM must be provided in amounts equal to your liability limits unless you rejected it in writing too. In Washington, UIM also covers vehicles with no insurance at all and hit-and-run or phantom vehicles. For a phantom vehicle with no physical contact, the crash generally has to be reported within 72 hours.

If you rejected both PIP and UIM, your options narrow to health insurance and whatever the at-fault driver's insurer pays. State rules vary, so these protections work differently outside Washington. Call (888) 217-5854 for free quotes that include PIP and UIM.

Step-by-step: what to do if you are hurt without PIP

1. Get treatment and use your health insurance card. Tell the provider the injury came from a car crash.
2. Report the crash to your auto insurer. Even without PIP, you may have UIM, collision or other coverage that applies.
3. Open a claim with the other driver's insurer if they caused the crash. Ask for the claim number and the adjuster's contact details.
4. Keep every bill and statement. Medical bills, explanation of benefits forms and pay stubs showing missed work.
5. Check your declarations page. Confirm whether you actually rejected PIP and UIM, and whether the rejection was in writing.
6. Ask about UIM early if the other driver has low limits, no insurance or cannot be identified.

Should you add PIP back?

That depends on your health coverage, your income and how much risk you are willing to carry. PIP pays quickly and covers costs that health insurance may not, such as lost wages and help with daily tasks. Because Washington insurers do not have to add PIP back at renewal, you need to request it in writing. Ask for a quote with and without PIP so you can see the actual price difference.

FAQ

Can I still get my medical bills paid if I rejected PIP?

Yes, usually. Health insurance often pays first, and the at-fault driver's liability insurer or your UIM coverage may reimburse you later. What you lose is fast, no-fault payment from your own auto policy.

Does rejecting PIP also reject underinsured motorist coverage?

No. PIP and UIM are separate. Each one has its own written rejection under Washington law. Check your policy documents to see which ones you signed.

How do I add PIP back to my Washington policy?

Ask your insurer in writing. Under RCW 48.22.085, once you reject PIP the insurer does not have to offer it again on renewal unless you request it in writing.

Does PIP pay if the crash was my fault?

Yes. PIP is no-fault coverage, so it pays its benefits regardless of who caused the crash. That is one reason drivers choose to keep it.

Is PIP available for motorcycles in Washington?

According to the OIC, PIP does not cover motorcycles, mopeds and similar vehicles. Riders should look at medical payments, UIM and their health coverage instead.

Questions about your coverage? Call a licensed agent at (888) 217-5854 to compare free quotes.

Important: This article is general information, not legal, tax, or insurance advice, and coverage rules vary by state, insurer, and policy. AutoInsuranceBundle.pro is a free, independent insurance comparison and referral service. We are not an insurance company, we do not issue policies, and we do not provide insurance advice. Calls to the number on this site are routed to licensed insurance agents or agencies in our partner network, who may receive compensation. Calling is completely voluntary and there is no obligation to buy. Rates, discounts, and availability vary by carrier, state, and individual eligibility; not all carriers, products, or discounts are available in all states. Calls may be recorded for quality and compliance purposes.