Most people think of a car accident claim as a claim against the driver who caused the collision and that driver’s insurance company. Often, that is where the claim begins.
But it is not always where it ends.
In my practice, I sometimes see people surprised to learn that their own automobile insurance company may become part of their injury claim. That can happen because they have Personal Injury Protection, commonly called PIP, because the responsible driver has no insurance or not enough insurance, or because the collision involved a hit-and-run or unidentified vehicle.
A claim against my own insurance after a car accident in Washington does not necessarily mean your insurer has done something wrong. In many situations, you are simply asking the company to provide benefits you purchased under your policy.
What changes is the relationship. Your insurer is no longer handling only vehicle repairs or administrative issues. It may now need to evaluate medical treatment, coverage, liability, causation, damages, or the amount of benefits available under the contract.
That is where I start paying much closer attention to the policy itself.
When Can I Make a Claim Against My Own Insurance After a Car Accident in Washington?
Your own automobile policy may become involved when a coverage you purchased applies to the accident.
Two of the most important first-party coverages in Washington injury claims are:
- Personal Injury Protection (PIP), which can provide certain benefits after an automobile accident without first requiring you to prove that another driver was at fault.
- Uninsured/Underinsured Motorist coverage (UM/UIM), which may provide protection when the person responsible for the accident has no applicable insurance or does not have enough insurance to cover the damages you are legally entitled to recover.
Washington law requires insurers issuing automobile liability policies to offer PIP coverage, although a named insured may reject that coverage in writing.
Washington also generally requires automobile policies to include underinsured motorist protection unless the named insured or spouse rejects all or part of that coverage in writing. The statute expressly addresses uninsured or underinsured motorists, hit-and-run vehicles, and certain phantom-vehicle accidents.
The important point is that the words “my insurance company” do not tell me what coverage actually exists. One of the first things I look at is the complete policy, declarations page, endorsements, applicable limits, and any coverage rejection documents that may matter.
PIP and UM/UIM Are Both First-Party Coverage, but They Do Different Jobs
One issue I frequently explain is that PIP and UM/UIM should not be treated as interchangeable coverages.
PIP Can Help With Certain Losses While the Injury Claim Develops
PIP is designed to provide specific benefits following an automobile accident.
Under Washington’s minimum PIP framework, insurers must offer coverage that includes up to $10,000 in medical and hospital benefits, a $2,000 funeral expense benefit, up to $10,000 in income-continuation benefits subject to a weekly limit, and loss-of-services benefits subject to statutory limits. Washington law also provides for higher PIP limits when requested by the named insured.
For someone injured in a collision, the medical-benefit portion may be especially important because medical treatment can begin long before the liability claim against the other driver is resolved.
Washington defines PIP medical and hospital benefits to include reasonable and necessary accident-related health-care expenses, with medical expenses generally needing to be incurred within three years of the automobile accident.
From an attorney’s perspective, I want to know more than whether the declarations page simply says “PIP.”
I look at:
- the applicable PIP limit;
- what benefits have already been paid;
- whether medical bills are being processed;
- whether the insurer is questioning whether treatment is related to the accident;
- whether benefits have been limited or terminated;
- what written explanation the insurer provided; and
- how PIP interacts with the rest of the injury claim.
Washington has specific claims-handling rules governing circumstances in which an insurer relies on medical opinions to deny, limit, or terminate PIP medical benefits. Those rules require disclosures regarding the insurer’s basis for its decision and identify issues such as whether treatment is reasonable, necessary, accident-related, and timely.
That does not mean every disagreement over PIP is improper. It does mean I want to understand why benefits are being questioned rather than assuming that a denial or termination letter tells the entire story.
UM/UIM Coverage Creates a Different Relationship With Your Insurer
UM/UIM coverage becomes relevant for a different reason.
Washington defines an underinsured motor vehicle, in general terms, as one for which no applicable liability insurance exists or the available liability insurance is less than the damages the covered person is legally entitled to recover.
This can arise when:
- the at-fault driver has no insurance;
- the at-fault driver’s liability limits are insufficient compared with the damages;
- the responsible driver leaves the scene and cannot be identified; or
- certain unidentified or “phantom” vehicles cause the collision.
What many people do not realize is that making a UM/UIM claim against your own insurer does not necessarily mean the company simply writes a check because you paid premiums.
The insurer still needs to evaluate the claim.
In a UM/UIM case, that evaluation may include questions about:
- who caused the collision;
- whether the other vehicle qualifies as uninsured or underinsured;
- whether you are an insured under the relevant policy;
- whether exclusions or other policy provisions apply;
- whether the accident caused the claimed injuries;
- the nature and extent of those injuries;
- past and future medical expenses;
- lost income and other economic losses;
- noneconomic damages; and
- the amount of other insurance available.
This is where the relationship can feel strange.
You are dealing with your own insurance company, but on certain issues your interests and the insurer’s evaluation of the claim may not be identical. The company has contractual obligations under the policy, but it may still disagree about liability, medical causation, damages, or the value of the UM/UIM claim.
That is not automatically bad faith. A legitimate disagreement can exist.
But it does mean I approach a UM/UIM claim as an actual injury claim that needs to be developed carefully, rather than treating it as a routine request for policy benefits.
An Underinsured Driver Can Turn One Accident Into Two Insurance Claims
Consider a driver traveling on I-5 between Everett and Arlington who is seriously injured when another driver causes a collision.
The other driver has liability insurance, so at first the claim appears relatively straightforward.
Later, however, it becomes clear that the available liability limits may not be enough to address the losses associated with the injuries.
At that point, the injured person’s own UM/UIM coverage may become relevant.
When I review a situation like this, I do not look only at the limits shown on one declarations page. I want to understand the entire coverage picture.
That can include:
- the at-fault driver’s available liability insurance;
- the injured person’s own UM/UIM limits;
- potentially applicable policies in the household;
- relevant policy definitions and exclusions;
- PIP benefits;
- settlement communications; and
- the evidence supporting the full value of the underlying injury claim.
The timing and procedure of an underinsured motorist claim can depend on the policy language and the circumstances. That is why I do not like assumptions such as, “The other driver only had $25,000, so my insurance automatically owes me the rest.”
The analysis is more careful than that.
First, I need to understand what damages can actually be supported. Then I look at what insurance potentially applies and how the different coverages fit together.
Hit-and-Run and Phantom-Vehicle Claims Require Special Attention
Washington’s UM/UIM statute expressly includes protection relating to hit-and-run and phantom vehicles, subject to the applicable policy and statutory requirements.
A phantom vehicle is particularly important to understand because Washington law uses that term for certain accidents in which another vehicle causes the injury or damage without physically contacting the insured person or vehicle.
For a phantom-vehicle claim under RCW 48.22.030, Washington requires competent corroborating evidence other than testimony from the insured or another person making a UM/UIM claim from the accident. The accident also must be reported to the appropriate law-enforcement agency within 72 hours.
That is a very Washington-specific requirement and a good example of why I examine the facts before giving someone a general answer about whether UM/UIM applies.
Imagine that another vehicle suddenly enters a driver’s lane near Everett, forcing the driver to swerve and crash into a barrier. The vehicle that caused the emergency never makes physical contact and leaves.
That is very different from a straightforward collision where both vehicles remain at the scene.
In a case involving an unidentified vehicle, I would want to understand whether there was physical contact, whether witnesses or video exist, what was reported to law enforcement, and what the policy requires.
Those details can determine which coverage questions need to be addressed.
Your Own Insurance Company May Ask for Information Too
Another distinction people sometimes overlook is that dealing with your own insurer is not necessarily the same as dealing with the other driver’s insurer.
Your insurance policy is a contract.
Depending on the coverage and policy language, the policy may impose cooperation, documentation, or other claim-related obligations on the insured. Exactly what an insurer may request and what an insured must provide depends on the circumstances and the contract.
That is one reason I like to see the actual policy rather than relying only on someone’s memory of what the insurance agent said when the policy was purchased.
When a first-party injury claim develops, I may review requests involving:
- medical records or authorizations;
- proof of loss;
- wage-loss documentation;
- accident information;
- prior medical history when relevant to a disputed medical issue;
- statements concerning the collision; and
- other documentation requested under the policy.
The fact that the request comes from your own insurance company does not mean it should be ignored. It also does not mean every request is automatically appropriate in unlimited scope.
The specific policy language and the reason for the request matter.
“Full Coverage” Does Not Tell Me What Benefits You Actually Have
In my practice, I hear the phrase “I have full coverage” fairly often.
From an attorney’s perspective, that phrase is not enough to evaluate an injury claim.
Washington’s Office of the Insurance Commissioner explains that automobile policies can contain a number of different coverages, including liability, PIP, UM/UIM bodily-injury coverage, UM/UIM property-damage coverage, collision, comprehensive, and other optional protections. The OIC recommends reviewing the declarations page to confirm what coverage was actually purchased.
When I evaluate the insurance side of a case, I want the documents.
I may want to see:
- declarations pages;
- the complete policy;
- endorsements;
- coverage-limit information;
- PIP payment records;
- UM/UIM provisions;
- correspondence from adjusters;
- reservation or coverage letters, if any;
- written coverage rejections when relevant; and
- communications concerning the underlying driver’s insurance.
That paperwork can be dry. It can also change the entire analysis.
What If My Own Insurer Disagrees With My Injury Claim?
A disagreement with your own insurance company does not automatically mean the company is acting improperly.
An insurer may legitimately investigate whether particular treatment is accident-related, whether the policy provides coverage, what damages can be established, or whether the requirements for a particular coverage have been satisfied.
At the same time, Washington law regulates how insurers handle claims.
Washington’s general claims-settlement regulations identify practices such as misrepresenting relevant policy provisions, failing to reasonably investigate a claim, and failing to provide a reasonable explanation for a denial as unfair claims-settlement practices.
Washington also has a statute addressing certain unreasonable denials of coverage or payment of benefits to first-party claimants. Whether that statute or another insurance remedy applies depends on the particular facts, and a disagreement over the value of a claim does not by itself establish improper conduct.
When I review this type of dispute, I am usually asking two different questions:
What does the insurance policy require?
And:
How did the insurance company investigate and handle the claim?
Those are related questions, but they are not the same.
What I Look for When Your Own Insurer Becomes Part of the Case
When someone comes to me with a car accident claim involving their own insurer, I generally want to build a coverage map before drawing conclusions.
That means understanding:
Who caused the collision?
This remains important, particularly in a UM/UIM claim.
What insurance does the responsible driver have?
I want to know whether that coverage is actually insufficient, unavailable, or disputed.
What coverage did my client purchase?
PIP, UM/UIM, applicable limits, endorsements, and exclusions may all matter.
What benefits have already been paid?
A declarations page tells me the limits. It does not tell me how much coverage remains.
What is the insurer disputing?
Coverage, liability, causation, treatment, damages, or claim value are very different disputes.
What evidence supports the injury claim?
Medical records, diagnostic findings, wage documentation, witness evidence, vehicle damage, collision reports, and other records can become important depending on the issue.
What has the insurer actually said in writing?
I pay close attention to coverage letters, requests for information, explanations of benefits, PIP decisions, and UM/UIM correspondence.
That is the detail-oriented part of the work that many people never see. The insurance claim is not just a number. It is a combination of facts, medical evidence, Washington law, and the language of the policies involved.
Your Insurance Company Being Involved Is Not Necessarily a Bad Sign
The fact that you have to make a claim under your own insurance policy can initially feel unfair.
After all, you may have done nothing to cause the collision.
But coverages such as PIP and UM/UIM exist specifically because the consequences of an accident cannot always be handled entirely through the other driver’s insurance.
The important question is not simply, “Why am I dealing with my own insurance company?”
The better questions are:
What coverage applies, what benefits does the policy provide, and what does the evidence support?
If a collision in Everett, Arlington, Snohomish County, or elsewhere in Washington has developed into a PIP, uninsured-motorist, underinsured-motorist, or other first-party insurance issue, Spencer Injury Law can review the circumstances and help explain what options may be available under Washington law. Clients work directly with attorney Cassidy Spencer, whose practice focuses on personal injury matters and who has more than 10 years of legal experience.
This article provides general educational information. Insurance coverage and injury claims depend on the facts and the language of the applicable policy.
Frequently Asked Questions
Is PIP required in Washington?
Insurers must offer PIP with Washington automobile liability policies, but a named insured may reject PIP coverage in writing. That means two Washington drivers with otherwise similar automobile policies may have very different benefits available after a collision.
Does Washington require uninsured or underinsured motorist coverage?
Washington generally requires UM/UIM protection to be provided with applicable automobile liability policies unless the named insured or spouse rejects all or part of the coverage in writing. The exact coverage available should be confirmed by reviewing the policy and relevant coverage documents.
Can I use PIP if the other driver caused the accident?
Potentially, if applicable PIP coverage exists. PIP is first-party coverage and can provide specified accident-related benefits without first requiring the insured to establish the other driver’s liability. Coverage limits, exclusions, the nature of the expense, and other policy and statutory requirements still matter.
What happens if the driver who hit me does not have enough insurance?
If the at-fault driver’s available liability insurance is insufficient compared with the damages you are legally entitled to recover, your own underinsured motorist coverage may become relevant if you have applicable coverage. Determining how much may be available requires reviewing both the damages and the relevant insurance policies.
Does making a UM/UIM claim mean my insurance company is acting against me?
Not necessarily. UM/UIM is coverage purchased under your own policy, but your insurer still evaluates whether coverage applies and what damages are supported. A disagreement can arise without automatically amounting to bad faith. The policy language, investigation, evidence, and claims handling all matter.
Sources / Fact-Checking References
Washington State Legislature — RCW 48.22.030
Used to verify Washington’s UM/UIM framework, written rejection provisions, definition of an underinsured motor vehicle, and treatment of hit-and-run and phantom vehicles.
Washington State Legislature — RCW 48.22.085
Used to verify that PIP must be offered and that a named insured may reject the coverage in writing.
Washington State Legislature — RCW 48.22.005
Used for Washington’s definitions of PIP benefits, including qualifying medical expenses and the applicable time period.
Washington State Legislature — RCW 48.22.095 and RCW 48.22.100
Used to verify Washington’s minimum and higher PIP benefit limits.
Washington Administrative Code — WAC 284-30-395
Used to verify Washington-specific standards concerning an insurer’s limitation, termination, or denial of PIP medical benefits when relying on health-care professional opinions.
Washington Administrative Code — WAC 284-30-330
Used to verify general Washington claims-settlement standards, including reasonable investigations and explanations of claim decisions.
Washington State Legislature — RCW 48.30.015
Used for the limited discussion of Washington remedies involving certain unreasonable first-party denials of coverage or payment of benefits.
Washington Office of the Insurance Commissioner — Consumer’s Guide to Auto Insurance
Used to verify the distinctions among liability, PIP, UM/UIM, collision, comprehensive, and other automobile coverages.
Spencer Injury Law — Understanding Uninsured and Underinsured Motorist Coverage
Reviewed to preserve Cassidy Spencer’s existing discussion of UM/UIM, PIP, first-party insurance issues, and the importance of examining actual coverage.
Spencer Injury Law — Attorney Cassidy Spencer
Used to verify Cassidy’s personal-injury focus, more than 10 years of legal experience, direct-client approach, limited caseload, insurance knowledge, and litigation-focused case preparation.
