Oregon Personal Injury Protection Insurance —(PIP)
Information provided by the Law Offices of Michael A. Colbach
Oregon Personal Injury Protection
What is Oregon Personal Injury Protection Insurance?
Personal injury protection insurance is medical and wage loss insurance that is required for every Oregon non-commercial auto policy.
Why do I have to make a claim through my insurance company for personal injury protection benefits?
Oregon law provides that your insurance company provide personal injury protection insurance regardless of whose fault the accident is. They pay your bills up front and then bill the other driver’s insurance company when the claim is done. This is easier for you, as you do not have to deal with the hassle of getting your medical bills paid by the other driver’s insurance company.
Who does personal injury protection insurance cover?
It covers all of the occupants of the car. It also covers you if you are a pedestrian or a cyclist. If you do not have personal injury protection but are a pedestrian or cyclist hit by a car, the driver’s personal injury protection covers you.
What does Oregon law require personal injury protection insurance to cover?
Medical expenses: Personal injury protection is required to pay reasonable medical expenses for up to one year and $15,000 ($15,000 is the minimum, a few people have higher limits).
Wage loss: Personal injury protection is required to pay wage loss after you are out of work for 14 consecutive days as a result of your injuries. This amount is up to 70% of your lost wages with a maximum of $3,000 per month. This wage loss continues up to 52 weeks, so it may extend past the one year medical coverage.
Loss of Services: Expenses incurred for essential household services that you would normally have done yourself but cannot do because of your injuries. This only applies to people who would not otherwise have been working. This is limited to $30 per day.
Funeral expenses: Personal injury protection insurance will pay funeral expenses of up to $5,000.
Does my personal injury protection always pay my medical bills?
No. The law requires that they pay reasonable and necessary medical bills. Insurance companies do not like to pay out claims and do whatever they cannot to pay. There is a recent trend to question your medical treatment early on and send you to an “independent medical exam”. These exams are anything but independent. They are usually done by doctors who no longer treat patients and often have problems with the medical board. These doctors are not independent. They are loyal to the insurance companies who pay them thousands of dollars to do a ½ hour exam. I had one doctor testify that he had made approximately 20 million dollars doing these exams. Another doctor testified that he “almost always finds for the side that hired me.” If the insurance companies really wanted a fair opinion, they would just ask your treating doctor.
What do I do if they refuse to pay my medical bills?
If your personal injury protection carrier refuses to pay your medical bills, you can use your healthcare insurance, pay for your own care (not too realistic) or you can force your insurance company to pay by suing them. If you sue your personal injury insurance carrier and win, they are required to pay your court costs and attorney fees. This can get very expensive for them, so they often settle these lawsuits quickly.
What happens when my Oregon personal injury protection runs out?
Once you hit the one year mark, your personal injury protection medical coverage expires no matter what. If you are still within the one year and you are a pedestrian or a cyclist, you may be able to get benefits under the other drivers personal injury protection. After the one year mark you must either pay your own bills or your healthcare insurance must pay them.
Will I have to pay my Oregon personal injury protection benefits back when I settle?
This depends on what your lawyer does early on in your case. If your lawyer knows what they are doing, they can make it so 90% of the time you do not have to pay a penny of the money that your personal injury protection paid. This is especially important when you have a case where the other driver does not have enough insurance and you settle for their $25,000 policy limits. If your lawyer did their job, you usually do not have to pay back any of the $25,000 to your insurance company. If they did not do their job, then you may get stuck paying back most of the $25,000.
I have Kaiser insurance. Do I have to use Kaiser for my treatment under my personal injury protection?
No. Your Oregon personal injury protection allows you to choose to treat with whatever doctor you want, as long as it is reasonable and necessary.
Is there anything I can do to help avoid my personal injury protection denying my bills?
Yes. In my experience, bills are much more likely to be denied if they see a pattern of very frequent chiropractic treatment, massage therapy, or alternative medicines. If you are seeing a chiropractor five times a week, be prepared to have your insurance look into your treatment. I have found that if your are treating with a medical doctor (MD or DO), your much, much less likely to have your bills questioned. My advice would be to have your family doctor be in charge of your treatment and refer you out to physical therapy and specialists as needed.
Who can I call if I have a question regarding my Oregon personal injury protection?
Call the Law Office of Mike Colbach at (503) 243-1900. I can probably answer your question in a few minutes over the phone. I do not charge you for answering questions.
MIKE COLBACH - COLBACH LAW
434 NW 19th Ave,
Portland, OR 97209