All Oregon non-commercial auto insurance policies have no-fault Personal Injury Protection (PIP) healthcare and wage loss coverage.
What this means is that if you are injured in an auto, bicycle, or pedestrian accident, your auto insurance provides a minimum of one year and $15,000 in no-fault medical coverage. Oregon Senate Bill 411 made a slight but important modification that extends PIP coverage for medical bills following an accident from one year to two years (the new law went into effect on January 1, 2016, effective on policies issued or renewed on or after that date). In addition to medical coverage, your personal injury protection insurance provides wage loss coverage.
This coverage is mandatory for all Oregon auto insurance, but not motorcycle insurance.
What if I am on my bicycle or a pedestrian?
Even if you are on a bicycle or a pedestrian, your auto insurance personal injury protection should pay your medical expenses if you are struck by a motor vehicle. If you do not have auto insurance and do not have health insurance, than the other driver’s insurance should pay your medical bills. If your Oregon personal injury protection coverage limits are reached, the other driver’s personal injury protection may also cover you if you do not have healthcare insurance.
How much wage loss will my personal injury protection insurance pay?
You PIP insurance will pay up to 52 weeks of wage loss up to the maximum monthly amount of $3,000.
Will my insurance company pay all of my medical bills?
Your insurance company is required to pay all of your medical expenses within the first two years that are reasonable and related to the accident, up to your policy limit ($15,000 for most people).
This does not mean that they will pay these bills. Insurance companies do not pay bills if they don’t have to. They can deny payment and send you to an insurance company doctor. The vast majority of the time these doctors say that your treatment is not necessary, that is why the insurance companies use these doctors rather than talking to your treating doctor.
What can I do if they refuse to pay my medical bills?
If the accident was not your fault, the best course of action is to pursue the at fault driver’s auto insurance company for your medical expenses as well as your pain and suffering.
You can also sue your own insurance company. Due to recent changes in the law, they are forced to pay for your lawyer if you sue and win. This makes it very expensive for your auto insurance company, so they are much more likely to pay your bills if you sue them.
Do I have to pay my insurance company back for my personal injury protection benefits?
Whether or not you have to pay your personal injury protection benefits back out of any settlement or award depends largely on what your attorney does early on in your case. Most of the time I can force the insurance companies to elect to pay me a fee to recover personal injury protection benefits or waive recovery out of my client’s settlement or award. Insurance companies do not want to pay me a fee, so the vast majority of the time the insurance companies do not require any repayment by my clients.
What happens if my medical expenses exceed my personal injury protection coverage?
If you have healthcare insurance, your healthcare insurance will usually pay any additional amounts. If you do not have healthcare insurance, you will be billed personally for any amounts in excess of your PIP coverage. Oftentimes I can work with providers to get them to wait for payment until the case is resolved.
If more than one person in my household has Oregon personal injury protection insurance can more than one policy apply?
In certain circumstances Oregon personal injury protection benefits “stack” for household members. What this means is that you could have double the personal injury protection coverage.
How much personal injury protection insurance should I buy?
That depends on whether or not you have healthcare insurance. If you have good healthcare insurance with low co-pays, than buying more than the minimum personal injury protection coverage is not as important. If you do not have healthcare insurance, than you should buy more than the minimum personal injury protection coverage.