The recent news of Tom Brady’s early morning car crash suggested a review of Massachusetts No-Fault law. Fortunately, Brady was uninjured and so would have no need to apply for No-Fault or Personal Injury Protection (PIP) benefits. Had he not been so lucky, he would have been subjected to the arcane workings of Massachusetts automobile insurance law.
No-fault coverage would have been provided by the insurer of the car that he was driving at the time of the collision. News reports indicate that his Audi was registered in New Jersey raising an interesting question of whether New Jersey or Massachusetts no-fault insurance would apply. Assuming that Massachusetts insurance applied, Brady would be entitled to collect benefits for his medical expenses and loss of wages up to a limit of $8,000. For medical expenses, the first $2,000 of expenses would be paid by his automobile insurer with his health insurer picking up expenses beyond this amount. The automobile insurer would have to reimburse him for his co-pays and unreimbursed medical expenses (up to the $8,000 limit) after paying the first $2,000 in expenses. One exception would occur if Brady’s health plan required his care be provided by a specific network of providers. In that case, if Brady went outside the network for care, neither his health insurance nor the automobile no-fault would pay for the care. This might occur if, for example, he went for chiropractic care, physical therapy, or acupuncture outside of his health insurer’s network. He would have bear this expense on his own.
If Brady’s injuries caused him to miss practice, a game or other work, the automobile no-fault coverage could provide wage-loss replacement (up to the combined $8,000 limit for medical and wage loss). The fact that he signed a new contract later on the day of his accident would not let him collect at his pay rate in that contract. He would be limited to the rate that his old contract provided based on the average for the 52 weeks before the accident. However, if the Patriots paid Brady during the time that he missed because of his accident injuries, he could not collect no-fault wage loss payments for that same period of time. If he used up all his sick time because of the accident injuries and later from an unrelated cause had to miss work without pay, he could collect no-fault wage loss benefits to compensate for the sick time he used.
The hypothetical injury to Tom Brady in his recent accident illustrates the workings of Massachusetts nofault insurance. It’s clear in the case of Brady that the no-fault scheme provides no real replacement for any injury he might have suffered. Although the hypothetical Brady injury is the extreme case, in practice, no-fault insurance provides no meaningful benefit for the majority of automobile accident victims. The obvious question is what about a claim against the at-fault driver who caused Brady’s accident. Brady would only be able to make this claim if his accident-related medical expenses exceeded $2,000, or he suffered a fracture, loss of limb, sight or hearing, serious disfigurement or was killed in the crash. When an accident causes injuries of this severity, both the no-fault claim and the claim against the at-fault driver should be made by a qualified personal injury attorney.
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