      
   4.9146 reviews

The Election That Changes Who Pays First

Request a Case Review

Kantrowitz, Goldhamer, Graifman, Perlmutter & Carballo, P.C.

10b9db026d89119e951a851045ac17eee7784f79

Written/Reviewed By:

Barry S. Kantrowitz, Esq.

Last Updated: Jul 21, 2026

Read Time: 3 mins

Most New Jersey drivers assume their auto insurance automatically covers all medical bills after a crash. A specific policy election can actually shift that responsibility onto a health plan first, and many drivers do not realize they made this choice when they set up their policy.

What Is The Health Insurance Primary Election?

Under N.J.S.A. 39:6A-4.3, a named insured under a New Jersey auto policy can elect to make their Personal Injury Protection coverage secondary, meaning their private health insurance pays medical bills from a car accident first, before PIP coverage applies.

Why Would Someone Choose This Option?

Selecting this option often reduces the auto insurance premium, since the auto insurer’s exposure decreases when a health plan handles primary coverage. Drivers with strong existing health insurance sometimes see this as a straightforward way to lower their auto insurance costs.

What Happens If The Health Plan Denies Coverage?

If the health plan does not cover a specific treatment or expense, PIP coverage generally steps in as secondary coverage to pay the remaining uncovered amount, up to the auto policy’s PIP limits. This coordination is meant to prevent a gap where neither source pays a legitimate medical expense.

Why Do Coordination Problems Happen So Often?

Confusion arises when either the health plan or a medical provider does not realize which coverage should be billed first. Kantrowitz, Goldhamer, Graifman, Perlmutter & Carballo, P.C. sorts out exactly this kind of billing confusion regularly for clients caught between two insurers. If a PIP carrier voluntarily pays a bill it was only secondarily responsible for, the healthcare provider often never learns the claim should have gone to the health insurer first, and the coordination process can break down entirely.

Does This Election Affect Passengers Or Only The Policyholder?

The election generally applies to the named insured and resident relatives covered under that policy. Passengers who are not part of the household covered by that specific policy generally have their own applicable coverage determine primacy, separate from the driver’s election.

What Documentation Helps Sort Out A Coordination Dispute?

Because these disputes often come down to which insurer should have paid first, gathering the right records matters considerably:

A copy of the auto policy showing the health insurance primary election, if made
Explanation of benefits statements from both the health plan and the PIP carrier
Complete billing records showing which entity was billed and when
Correspondence with either insurer regarding a denied or disputed claim

How Does This Apply To A Hackensack Car Accident Claim?

Because a coordination breakdown can leave medical bills unpaid or improperly denied, sorting out which coverage actually applies matters considerably after a crash. A Hackensack car accident lawyer can help identify which coverage should be primary and push back on an improper denial.

What If Medical Bills Are Being Denied By Both Insurers?

When both a health plan and a PIP carrier deny responsibility for the same medical expenses, resolving the dispute often requires directly challenging the coordination determination rather than simply resubmitting the same claim. A Hackensack car accident lawyer can help identify the correct primary payer and pursue payment accordingly.

This election can meaningfully change how a car accident claim gets processed, which is exactly why confirming which coverage applies matters early rather than after bills start piling up. If you are dealing with a coverage dispute after a car accident in Hackensack, reach out to our office to go over your policy and billing situation.

Why Trust Us?

150+ Reviews

50+ Years of Service

Full-Service Law Firm

Client Reviews

    
 
 
      Posted on Google  
   LWelsh 
 16 days ago
 
 
 Trustindex verifies that the original source of the review is Google. Clever and efficient.
  
 
     Posted on Google  
   Kenny Perlow 
 37 days ago
 
 
 Trustindex verifies that the original source of the review is Google. KGG Law, and Barry Kantrowitz in particular, set the bar high for what a thorough, practical, strategic, compassionate and smart lawyer can be. Everything about Barry's advice and representation was exemplary and the stress mitigation that resulted was invaluable. On top of that, the ultimate result Barry achieved was beyond what was reasonable to expect and we are forever grateful. Often, people say that you hire a lawyer to prevent a problem. Sometimes, unfortunately, you need an attorney to solve a problem and I could not recommend Barry and his firm any more highly in that regard.
  
 
     Posted on Google  
   Aliza Ali 
 101 days ago
 
 
 Trustindex verifies that the original source of the review is Google. My dad had a great experience with this law firm. From the very beginning, the team was professional, knowledgeable, and always willing to answer our questions. They kept us informed throughout the entire process and made what could have been a very stressful situation much easier to handle. We truly appreciated their dedication, honesty, and hard work. Thanks to their support, my dad felt confident every step of the way. We are very grateful for everything they did and would highly recommend this firm to anyone looking for reliable legal representation.
  
 
     Posted on Google  
   Jana Montero 
 104 days ago
 
 
 Trustindex verifies that the original source of the review is Google. I had a wonderful experience working with Sam Smith. He was very responsive, thorough, and easy to work with from start to finish. He walked me through everything clearly and made what started as a very stressful situation for me into something completely manageable. I would not hesitate to recommend him and the firm!
  
 
     Posted on Google  
   Mike Sakmann 
 110 days ago
 
 
 Trustindex verifies that the original source of the review is Google. I sought legal advice regarding an employment matter and had an excellent experience working with Sam Smith, Esq. at KGG Law. Sam was thorough, attentive, and took the time to listen carefully to my concerns before providing clear, thoughtful guidance. I appreciated the professionalism and care shown throughout the process, and I would confidently recommend KGG Law to anyone in need of legal assistance.
  
 
     Posted on Google  
   Liz Hecker 
 116 days ago
 
 
 Trustindex verifies that the original source of the review is Google. I can't say enough about this firm. They manage to comfort you during the whole legal process while staying professional and doing what is right. I would recommend them to anyone and also hire them again if I need legal help.
  
 
     Posted on Google  
   Brandy Miller 
 139 days ago
 
 
 Trustindex verifies that the original source of the review is Google. Kate is the best. She helped me very quickly, and was very attentive with all of my needs. So thankful for her
  
 
     Posted on Google  
   Mike Greenspan 
 152 days ago
 
 
 Trustindex verifies that the original source of the review is Google. Kate Carballo is a dedicated, passionate, and creative attorney whom I had the pleasure to lecture with at a state trial lawyer's conference. Kate's lecture demonstrated how she uses her innovative and "out-of-the-box thinking" to achieve outstanding results for her injured clients. That Kate is certified by the Supreme Court of New Jersey as a civil trial attorney is a testament to her skills, experience and commitment to excellence.
  
 
     Posted on Google  
   Jonathan Sampson 
 159 days ago
 
 
 Trustindex verifies that the original source of the review is Google. Was referred to KGG law by a friend and could not have asked for better legal representation. They walked me through every step of the process after my accident and began every call with “ how are you feeling” which was just one example of how much they care about their clients. They handled my case very efficiently, professionally and courteously. My attorney Kate Carballo was a rock star! So clearly experienced, she consistently made me feel at ease with the process. Highly recommend
  
 
     Posted on Google  
   Vinnie Kung 
 162 days ago
 
 
 Trustindex verifies that the original source of the review is Google. We had a great experience with the team at KGG Law. While it was a traumatic time for our family, they made it very easy for us and explained all of our options. They even performed due diligence to make sure that after our settlement, there would be no further issues which I think is even more important than the settlement itself. Thank you!

see all reviews