Personal injury protection, or PIP, is a provision of your auto insurance policy that will pay for various things related to an accident and resulting injuries, such as lost wages, medical expenses, and necessary services. It is a no-fault type of insurance that is available to both the at-fault party and the injured individual(s) after an accident.
Who Carries PIP Insurance?
In Oregon, auto insurance companies are required to include PIP in your insurance policy. Washington mandates PIP unless you waive the coverage in writing, which rarely happens. If you live in Washington and inquire whether or not you have PIP insurance with your insurance company, and they say no, you should consult an attorney to find out if that is, indeed, the case.
Who Does PIP Protect?
Personal injury protection insurance covers:
- The driver and all occupants of their vehicle;
- Pedestrians or cyclists if they have an auto insurance policy with PIP coverage.
Special Circumstances For Pedestrians and Cyclists Without Auto Insurance
- If you do not carry, or can’t access the benefits of an auto insurance policy, your health insurance would be responsible for any medical bills that arise from the injuries sustained in an accident.
- If you are injured by another driver’s negligence, though, their PIP insurance policy should cover your out-of-pocket expenses for things like health insurance co-pays.
- If you do not carry auto insurance coverage or medical insurance coverage, the driver’s PIP coverage will be your primary coverage in the event that you are injured in an accident that is the driver’s fault.
What are PIP Coverage Limits in Oregon?
For costs like medical bills, loss of wages, and necessary services, the minimum coverage in Oregon is $15,000 for one year after the date of the accident (this has been updated to two years on any policy written after January 1, 2016). Some insurance providers will allow you to purchase higher limits of PIP coverage.
What Does PIP Cover?
PIP covers the most basic costs related to the accident that you were involved in, such as:
- Medical bills that are reasonable and related to the injuries you incurred in the accident;
- Lost wages, if you are able to provide a written doctor’s note stating that you are unable to work for 14 consecutive days, or if you are on restricted duty, and your employer can’t accommodate you, the lost wages benefit will be activated in the amount of 70% of your income up to $3000 per month (subject to your policy limitations).
- Essential services such as cleaning, yard work, or cooking, if your injuries are such that you are not able to perform these normal household duties. PIP will pay up to $30 per day toward household help.
- Child care, in some instances.
How Do I Access My Personal Injury Protection Benefits?
First, you’ll need to file a claim with either your insurance company or with the insurance company whose PIP coverage will be primary based on the circumstances of your accident. You will be required to fill out a PIP application, and then you will be issued a claim number. You can then give your medical providers the name of the insurance company and the claim number, and they will bill the PIP insurance company directly. If you’ve already paid out-of-pocket for some expenses, you can submit those bills for reimbursement.
It is important to note that PIP will require you to sign and send a medical release. Forward that release only to PIP, not to the at-fault driver’s insurance company. If you are utilizing the at-fault driver’s PIP coverage, you should be provided with two insurance adjuster contacts – one for the PIP coverage and one for the claim against the at-fault party.
What If My PIP Claim is Denied?
Insurance companies are in the business of paying out as little as they can on claims. If you are denied PIP coverage, you should contact our office right away for advice.
Six months after PIP denies the first payment, you can sue the PIP Carrier to recover all the medical costs you are owed, plus attorney fees.
In the interim a personal injury attorney can also help you receive the necessary medical care by setting up an arrangement with your medical providers so that you continue to receive the benefit of their care, while they wait to receive payment out of the insurance settlement or lawsuit judgment.
About the PIP Independent Medical Exam
It’s very likely that your independent medical exam (IME) will not be favorable. If the PIP insurance carrier wants to schedule an appointment for an IME, it’s important that you contact an attorney right away.
If you do not take part in the IME, your PIP benefits will be cut off. Whether or not you should participate in the IME is fact specific and you should consult an attorney.
Need Help Getting The PIP Benefits You Deserve?
Contact us for a free consultation. (503) 395-2135