What are First Party Benefits in a Pennsylvania car insurance policy?
Understanding First Party Benefits in Pennsylvania Auto Insurance
Pennsylvania operates under a no-fault automobile insurance system, which means that after an accident, your own insurance policy — not the at-fault driver’s — is the first source of coverage for your medical expenses and lost wages. This coverage is called First Party Benefits (FPB), and understanding what it covers is essential for any Pennsylvania driver.
What Do First Party Benefits Cover?
First Party Benefits in a Pennsylvania auto insurance policy provide coverage for two primary categories of loss:
1. Medical Benefits
FPB pays for reasonable and necessary medical treatment resulting from injuries sustained in a covered automobile accident — regardless of who caused the crash. This includes emergency care, hospitalization, surgery, diagnostic testing, physical therapy, and other related medical services. Pennsylvania law requires a minimum of $5,000 in medical benefits coverage, though many policies offer significantly higher limits.
2. Income Loss Benefits
If your accident-related injuries prevent you from working, FPB can pay a portion of your lost wages. The mandatory minimum is $5,000 in income loss coverage, though higher limits are available and advisable. Benefits typically begin after a short waiting period (usually five days of disability) and pay a percentage of your gross income — commonly 80% — up to the applicable policy limit.
Additional Optional First Party Benefits
Pennsylvania insurers may also offer optional FPB coverages, including:
- Funeral benefits — a fixed payment toward funeral expenses if a covered individual dies in a crash
- Accidental death benefits — a payment to beneficiaries in the event of a fatal accident
- Extraordinary medical benefits — additional medical coverage beyond standard FPB limits for catastrophic injuries
Who Is Covered by First Party Benefits?
FPB typically covers the named insured, resident family members, and passengers in the insured vehicle. Pedestrians or bicyclists hit by a covered vehicle may also be able to access FPB coverage under certain circumstances.
First Party Benefits and Third-Party Claims
Receiving FPB payments does not prevent you from also pursuing a liability claim against an at-fault driver. However, in some situations, your insurer may have a right of subrogation — meaning it can seek reimbursement from the at-fault driver’s insurer for FPB it paid on your behalf. This is something an experienced personal injury attorney will account for when evaluating and negotiating your total claim.
Review Your FPB Coverage Today
Many Pennsylvania drivers carry only the minimum required FPB — $5,000 for medical benefits and $5,000 for income loss. For most people, these limits are woefully inadequate in the event of a serious accident. Speaking with your insurance agent about increasing your FPB limits is a straightforward step that can make a significant difference in your financial security after an accident.
