D.C. Optional PIP, $50,000 Medical, $12,000 Work Loss & $4,000 Funeral Benefits

Buying PIP and electing benefits are different decisions

Start with the actual policy and the election question. Personal injury protection, or PIP, is optional coverage. An insured may buy any one or any combination of medical and rehabilitation, work-loss, and funeral coverages. A policy that includes one category does not necessarily include all three. When covered, the statutory benefits are paid without regard to fault. Source: D.C. Code § 31-2404(a)(1)-(2), (b).

After an accident, a separate election to receive PIP can restrict a civil action against another responsible person. Before electing, accepting benefits, or signing an election form, read the 60-day election and tort-restrictions guide. This guide does not recommend the same choice for every claimant. Source: D.C. Code § 31-2405(a)-(g).

Confirm the covered person, vehicle and benefit categories

Section 31-2404 describes injuries arising from the insured’s operation or use of a motor vehicle, or use of the insured vehicle, within or outside D.C. PIP benefits apply only to a victim who is an insured, an occupant of the insured’s vehicle, or an occupant of a vehicle the insured is driving. Read the policy’s definitions and endorsements; the statutory description is not a finding that every person involved in the crash is covered. Source: D.C. Code § 31-2404(a)(1).

A self-insurer must state on its application whether it provides PIP. Taxicab insurers and self-insurers have separate statutory offer qualifications. Do not assume every taxi, commercial arrangement or self-insured vehicle has the ordinary optional PIP package. Source: D.C. Code § 31-2404(a)(3). Source: D.C. Code § 31-2406(a)(1)(D).

Medical and rehabilitation benefits: $50,000 and $100,000 options

The statute requires medical and rehabilitation package options of $50,000 and $100,000 per victim, with the maximum benefit for this category not less than $50,000. These are coverage amounts, not automatic lump-sum payments. Covered expenses must involve reasonable charges for reasonably necessary care, recovery or rehabilitation. Source: D.C. Code § 31-2404(c)(1), (5).

Providers must be licensed or approved and comply with applicable law. Hospital-room payments generally are limited to the reasonable and necessary semiprivate-room charge unless special or intensive care is required. The statute also permits qualifying nonmedical religious healing treatment. Keep itemized bills and records connecting each service to the accident-related injury. Source: D.C. Code § 31-2404(c)(2)-(4).

Work loss includes qualifying income loss and replacement services

The statutory work-loss options are at least $12,000 and $24,000. Income loss concerns work the victim would have performed but for the injury. The calculation excludes expected income-tax savings, presumed to be 20% unless the victim shows a different tax effect. This is not a blanket promise to replace all gross wages. Source: D.C. Code § 31-2404(d)(1)(A), (2).

The category also includes reasonable expenses for ordinary and necessary replacement services the victim would have provided for personal or family benefit, rather than income, during the first three years after the accident. Work loss incurred after the victim’s death is excluded. Preserve earnings records, proof of inability to work, and receipts identifying replacement services and dates. Source: D.C. Code § 31-2404(d)(1)(B), (3).

Funeral benefits pay actual costs up to $4,000

For the funeral category, the statute provides actual funeral and funeral-related costs up to $4,000 for one victim, payable to the survivors. It is not a $4,000 award without supporting costs and is not a substitute for analysis of a wrongful-death claim. Confirm that the relevant category was obtained under the policy and retain the invoices. Source: D.C. Code § 31-2404(a)(2), (e).

Check deductibles and other available benefits

An insurer may offer an authorized reduced-premium PIP deductible. It cannot apply that deductible to emergency medical, paramedical, ambulance or hospital services furnished during the 72 hours immediately following the accident. This protects specified emergency services from the deductible; it is not a general 72-hour deadline for obtaining all treatment. Source: D.C. Code § 31-2410(a).

Workers’ compensation and government-required temporary nonoccupational disability benefits generally must be subtracted, less reasonable collection costs, unless the law providing those benefits makes them secondary or duplicative. Separately, section 31-2406(g) restricts a PIP claim for loss eligible for compensation from another insurer or coverage, except for a deductible, unless those benefits have been exhausted. Do not assume PIP is always the first payer or collect the same loss twice without analyzing the coordination rules. Source: D.C. Code § 31-2410(b). Source: D.C. Code § 31-2406(g).

The payment clock follows reasonable proof of the loss

PIP benefits are payable as loss accrues, subject to the insurer receiving reasonable proof of the fact and amount of loss. Payment is overdue if not made within 30 days after receipt of that proof. Keep a submission log identifying each bill, wage-loss item and supporting record, when the insurer received it, and any response. The clock is not simply 30 days after the crash or after an unsupported demand. Source: D.C. Code § 31-2410(c)(1).

An overdue payment bears the statutory prime-rate interest. The statute also provides for a reasonable claimant’s attorney fee in an action for overdue PIP when a court makes the required finding that the insurer did not promptly pay the amount due. These provisions are distinct from the pre-litigation policy-limits disclosure statute. Source: D.C. Code § 31-2410(c)(2), (e)(1).

Important qualification: section 31-2411(c)(2) allows a court application over specified payee, apportionment, medical-necessity or charge disputes. If the insurer applies before the benefit becomes overdue, the interest and fee provisions identified there do not apply to the amount at issue. A disputed bill therefore requires review of the actual submissions and court proceedings, not an automatic penalty calculation. Source: D.C. Code § 31-2411(c)(2).

Records, examinations and reports are part of claim administration

Reasonable policy provisions may require a physical or mental examination when the condition is material to a PIP claim. The statute also addresses provider identification and authorization to inspect and copy relevant records. Obtain the actual request and determine its relevance; do not assume every request for unrelated lifetime records is authorized. A person examined may request copies of the examination reports without charge and may continue treatment with their own physician. Source: D.C. Code § 31-2411(b)(1)-(4).

Section 31-2410(d) makes an agreement assigning a right to future PIP benefits void. Review any proposed assignment or payment-direction document before treating it as valid under this statute. Source: D.C. Code § 31-2410(d).

Keep the election, payment and lawsuit clocks separate

The 60-day election period, the 30-day reasonable-proof payment period and the time for filing a PIP lawsuit serve different purposes. Section 31-2411(a) begins with a three-year period after injury and provides alternative timing based on a qualifying reasonably prompt written notice or the most recent PIP payment. Preserve every notice and payment record; do not calculate a final filing deadline from a brief summary alone. Source: D.C. Code § 31-2405(a), (d)-(g). Source: D.C. Code § 31-2410(c). Source: D.C. Code § 31-2411(a).

This is a review of the cited statutory text on October 22, 2026. The Firecrawl source captures identify the publisher’s code as current through October 14, 2026. Current regulations, later decisions, the law governing an older accident, disputed elections and policy-specific coverage still require separate analysis.