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Texas is an at fault state, so nobody pays your bills automatically while you are still treating. The at-fault driver’s insurer settles once, at the end. That gap between the crash and the settlement is exactly what the other coverages are built to fill, and choosing the wrong one costs people money.
Which insurance actually pays, and in what order?
Start with coverage that pays now and does not need fault decided. Leave the at-fault driver’s insurer for last.
| Payment route | Pays while you treat | Fault has to be decided | Comes back out of your settlement |
| Personal injury protection (PIP) | Yes | No | No, in most cases |
| Medical payments (MedPay) | Yes | No | Often yes, depends on the policy |
| Your health insurance | Yes | No | Often yes, through a plan lien |
| At-fault driver’s liability | No, pays at settlement | Yes | Not applicable, it is the settlement |
| Letter of protection | No, provider waits | No | Yes, paid from the settlement |
The order matters more than most people expect. Using the wrong route first can mean paying back money you did not have to. If you are unsure which coverages you have, bring your declarations page to your first visit and our front desk will read it with you before you commit to anything. You can book at either of our Dallas and Lewisville clinics.
Do you already have PIP without knowing it?
Probably. Most Texas drivers have PIP and have never used it.
Under Section 1952.152(a) of the Texas Insurance Code, Chapter 1952, an insurer may not issue an auto liability policy in Texas unless it provides personal injury protection. You can remove it, but only by signing a written rejection. A verbal no, or an agent’s note, does not count.
The practical result is that if you never signed a rejection form, the coverage is on your policy. Section 1952.153 sets the minimum at $2,500 per person, and many drivers carry $5,000 or $10,000 without realizing it.
Check your declarations page for a line reading PIP or personal injury protection. If you cannot find it, call your agent and ask whether a signed rejection exists in your file.
Does using PIP reduce what you get from the at-fault driver?
In most cases, no. This is the part almost nobody explains, and it is the most valuable thing on this page.
In many states, if your insurer pays your medical bills and you later settle with the at-fault driver, your insurer takes that money back out of your settlement. That is called subrogation.
Texas restricts it. Section 1952.155(b) of the Texas Insurance Code says an insurer paying PIP benefits does not have a right of subrogation or a claim against another person or insurer to recover those benefits by reason of the other person’s fault. In a normal two insured driver collision, PIP money stays with you.
There is one exception. Section 1952.155(c) restores the right of subrogation when the other driver had not established financial responsibility for the vehicle at the time of the crash, which in plain terms usually means an uninsured driver.
So using your own PIP first is normally free money toward treatment, not an advance against your settlement.
How is MedPay different from PIP?
They look identical on the surface. The difference shows up at settlement.
| PIP | MedPay | |
| Pays regardless of fault | Yes | Yes |
| Covers medical expenses | Yes | Yes |
| Covers lost income | Yes | No |
| Covers household services you can no longer do | Yes | No |
| Insurer can seek the money back from your settlement | Restricted by statute | Commonly allowed by policy terms |
If you carry both, PIP is usually the one to use first. Read your own policy language on MedPay reimbursement before you rely on it, because it varies by carrier.
Can PIP and health insurance both pay on the same injury?
Yes. Texas law specifically allows it.
Section 1952.155(a)(2) states that PIP benefits are payable without regard to any collateral source of medical, hospital, or wage continuation benefits. Health insurance is a collateral source. One does not cancel the other.
In practice, PIP often pays first because there is no deductible and no network restriction, and health insurance picks up treatment after PIP limits run out. Health plans usually do assert a lien on your settlement, which is the opposite of how PIP behaves. Either way, treatment such as back pain care and pain management does not have to stop while the money is sorted out.
What if the other driver was clearly at fault?
Their insurer still will not pay your clinic visit by visit.
Liability coverage pays once, in a lump sum, when the claim resolves. That can take months. Until then your bills are yours unless PIP, MedPay, health insurance, or a letter of protection is carrying them.
This is why treating first and settling later is the normal sequence, not the risky one. It is the same reason we document auto accident injuries in detail from the first visit rather than waiting to see how the claim goes.
What if you have no coverage and no money up front?
A letter of protection is the usual answer, and it requires an attorney.
A letter of protection is a written agreement in which the provider treats now and is paid from your settlement later. The agreement runs through your attorney, so you need representation before one can be signed.
Understand what it is. This is deferred payment, not free care. If the case does not recover, the balance is still yours under most agreements. Read the document before you sign it.
What does PIP actually cover beyond the bills?
More than most people use it for.
- Reasonable and necessary medical and dental expenses from the crash
- Loss of income benefits under Section 1952.154, commonly paid at 80 percent of lost wages
- Reasonable expenses for household services you can no longer perform, which covers people who were not earning a wage
- You, your passengers, and in many cases you as a pedestrian or cyclist
If you are a stay at home parent or retired, the household services benefit is the one that gets left on the table most often. Keep receipts.
Do you need a referral for insurance to pay?
Not to be seen. Possibly for your plan to pay.
A referral from a medical doctor is not required to book a chiropractic appointment in Texas. The Texas Board of Chiropractic Examiners sets what a chiropractic license does and does not cover, and a license does not extend to surgery or prescribing prescription drugs.
Health insurance is separate. Some plans require prior authorization or a referral before they will pay, and many cap annual visits. PIP has no such requirement. If you want to know what treatment involves before you call your carrier, start with what a chiropractic adjustment in Dallas actually does.
FAQs
Does PIP cover chiropractic care in Texas?
Yes. PIP pays reasonable and necessary medical expenses from the crash, and chiropractic treatment qualifies. There is no fault determination, no deductible in most policies, and no network restriction, which is why it is usually the fastest route to starting care.
Will my insurance rates go up if I use my own PIP?
PIP is no fault coverage, so using it is not the same as being found at fault. Rating practices still vary by carrier, so ask your agent directly. What the statute does settle is that PIP payments generally are not recovered from your settlement under Section 1952.155(b) of the Texas Insurance Code.
What if I was a passenger and not the driver?
You often have more options than the driver does. Coverage may exist under the driver’s PIP, under your own auto policy, and under the at-fault driver’s liability insurance. Check all three before assuming you have nothing.
How long do I have to use my PIP benefits?
Report the claim promptly and follow the notice terms in your own policy, which are shorter than the deadline for filing suit. Do not treat the two year filing deadline as your PIP deadline. They are separate clocks.
Do you handle the insurance paperwork or do I?
Our front desk verifies coverage and bills PIP, MedPay, and most health plans directly. Bring your declarations page, your claim number, and the other driver’s information to your first visit at either our Dallas or Lewisville clinic.
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