August 23, 2018

Oregon Guide to PIP Claims | What You Need to Know

Oregon PIP Law

When you are in an auto accident in Oregon you soon realize that figuring out which insurance company pays the medical bills or for wage loss is complicated. This guide to Personal Injury Protection (PIP) Benefits is intended to provide a bare minimum of information about the process and what pitfalls to avoid. There are many aspects to Oregon PIP Law. It in no way is meant to replace an in-person consultation with an experienced auto accident lawyer.

How does a PIP claim work?

Oregon Personal Injury Protection (PIP) Benefits

Anyone injured in a car crash in Oregon is instantly covered by their insurance companies Personal Injury Protection (PIP) benefits. PIP benefits are legally required to be in your auto insurance policy with the intended purpose of providing for immediate medical care, wage loss, and replacement service benefits. This requirement is laid out in ORS 742.520. In order to get these insurance benefits the injured person must first file a claim with their insurance company and fill out an application for benefits. Once this is completed, all reasonable, necessary, and related medical services must be covered by your auto insurance company for two years from the date of the crash.

The Five Steps to Take to Open Your PIP Claim

The Five Steps to Take to Open Your PIP Claim

  1. File Claim

    File an insurance claim with your insurance company.Your insurance card will have a hotline to call. Make sure to write down the claim number. Take a photo of it with your phone so you have it with you at all times. Many carriers also have mobile apps.

  2. Interview

    Submit to a recorded interview with your insurance company if they request it. Never submit to a recorded interview with the at-fault party’s insurance company.

  3. PIP Application

    Fill out the PIP application when it arrives. Make sure to be as comprehensive as possible when filling out what body parts were injured in the crash. Do not leave anything out.

  4. PIP Adjuster

    When you receive the first correspondence from the PIP adjuster, take a photo of their contact information.

  5. PIP Ledger

    When you receive medical treatment, give the medical provider the PIP claim number and the adjuster’s contact information. This will cause the bills to be routed to your PIP claim. Consider requesting a “pip ledger” every month or two to see what your balance is and how much your medical providers have been billing. Continue to do this until you have finished treating for your injuries.

Why Does My Insurance Company Have to Pay the Medical Bills?

Medical exam

It may seem odd that your insurance company is paying the medical bills, but there is a reason. When you’re hurt in a car crash, you should not have to wait for the at-fault party’s insurance company to reimburse you. Unfortunately, in some cases it can take years before the other insurance company is finally forced to pay these costs. Because of this, Oregon has decided that you should not have to wait to have these bills paid. This is the reason for Oregon PIP law. Your insurance company has the responsibility to take care of these costs, up to the policy limits. Your insurance company has the same contractual responsibility to pay for part of your wage loss, if the wage loss lasts for two weeks or more. At the end of your treatment, your insurance company will seek reimbursement from the at-fault driver’s insurance company for any benefits that were extended to you.

I Heard Oregon is a No-Fault State-What does that Mean? Oregon PIP Law

Despite the name, no-fault insurance has nothing to do with who was at-fault for the car crash. No-fault just means it does not matter who was at-fault for the accident when it comes to being eligible for PIP benefits from your insurance company. Everyone hurt in an auto accident in Oregon is immediately eligible for No-Fault PIP Benefits, even if they are the ones who caused the accident.

Oregon PIP Law | How Much Does My Insurance Company Have to Pay?

Your insurance company has a contractual obligation to pay up to your policy limits for your medical care and wage loss. The minimum for medical benefits in Oregon is $15,000, but you can contract for far more. Wage loss is paid at 70% of your usual wage, up to $3,000 a month. There are also other PIP benefits like those for replacement services and funeral benefits, but they are less commonly used. Regrettably, insurance companies often decide to breach their contractual obligation and not pay the full PIP benefits.

What Happens When My Insurance Company Denies Payment for a Medical Bill?

When your insurance company denies payment for reasonable and necessary medical bills, it has breached its contractual obligation to you. This is called a Wrongful Denial of PIP benefits claim, and when this happens its important to talk with an experienced car accident lawyer to understand exactly what sorts of legal rights you have. Insurance companies deny PIP benefits daily in Oregon, and they do it for a simple reason—it saves them lots of money. This is because many injured people stop seeking treatment when they are unsure if they will have to ultimately foot the medical bills themselves. This is tragic, because without the necessary medical treatment many people will not have the opportunity to get better and fully recover from their injuries. An attorney experienced with Oregon PIP Law can help. It is important to understand that there are legal remedies that are readily available. Do not let your insurance company push you around, talk with the car accident attorneys at Johnson Law today. We fight insurance companies so you have the opportunity to get better.

My Insurance Company Told Me I Have to Go to an “Independent Medical Exam”—Do I Have to Go?

Your insurance company may try to send you to an “Independent Medical Exam.” This is a ridiculous label. In reality you are being sent to an “Insurance Medical Exam” that has one purpose—to try and terminate your PIP medical benefits. Before you agree to go to the exam, there are a number of considerations that need to be evaluated. This is why it is a good time to seek out a free consultation with an experienced auto accident law firm like Johnson Law, P.C., to get some basic legal advice about whether it makes sense to attend the insurance exam. In some cases, it makes sense to go. In other cases, going to the exam may harm your claim against the at-fault party’s insurance company.

My Insurance Company Has Told Me I Need to Sign A Medical Authorization Form—Do I?

You do usually have to sign a medical authorization form so your insurance company can get the medical records that correspond to the bills it pays on your behalf. This requirement is in your auto insurance policy buried deep in the fine print. Your insurance company will keep all the records and bills it collects. This is called the PIP file, and you have a right to request all of it at any time.

Oregon PIP Law | The PIP Adjuster Calls All the Time. Do I Have to Call Them Back?

You have a contractual obligation to cooperate with your insurance company. This includes communicating with the PIP adjuster regarding their reasonable inquiries. However, the PIP adjuster cannot harass you. It is important to know that once you have an auto accident lawyer, the insurance company has to talk with them, and cannot directly contact you. This is one of the many reasons it usually makes sense to talk with a lawyer as soon as possible after you are hurt.

If I Retain an Auto Accident Lawyer How Do I Pay Them?

Auto Accident Attorneys like the ones at Johnson Law, P.C. do not accept an upfront payment for their legal services. Instead they operate on a contingency fee, where they are only paid an attorney fee if they recover something for you. This is called a contingency fee. It is important to understand that the attorneys at Johnson Law, P.C. do not take any fee out of the PIP benefits provided to you. This includes PIP wage loss benefits. We only take a fee out of the settlement with the at-fault driver’s insurance company. So if you need an attorney experienced in Oregon PIP law, call Johnson Law to schedule your free consultation.

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