Personal Injury Protection
You’ve been in a motor vehicle accident. Now what? The process may be confusing, but we are here to help and this guide is the place to start. Here you will get to know the basics of PIP and its benefits, learn to choose a doctor after your accident and see how your bills will be paid.
If you are injured in a motor vehicle accident, you have the right to receive medical care, and also to receive time loss or other benefits if you can’t work or manage your household tasks. These benefits are paid by your auto insurance company under a provision of your policy called “personal injury protection” and commonly referred to as “PIP.” If the accident was the fault of someone else, your auto insurance company may be reimbursed by the insurance company of the person who caused the accident.
Can I see the doctor of my choice?
Yes. You have the right to be treated by the doctor of your choice. You may see a chiropractor, naturopath, osteopath, medical doctor, or any other licensed medical provider. The insurance company cannot tell you what doctor to see. Don’t let anyone tell you otherwise.
Can the insurance company make me see one of their doctors?
The insurance company can demand that you be examined by their doctors for a second opinion. If you do not attend the examination, the insurance company will stop paying your PIP benefits.
You will want to talk with an experienced personal injury attorney before attending an insurance medical examination.
How will my medical bills be paid?
Basically, all automobile insurance policies provide personal injury protection (PIP) benefits. PIP pays all of your medical bills from the motor vehicle collision. You are entitled to PIP benefits regardless of who was at fault in the accident.
The insurance company will pay for the medical care necessary to treat your injuries. Most PIP policies limit your medical benefits to a year after your injury and a total of $15,000. So all of your medical bills up to $15,000 and within one year after the collision are covered.
If you were in a car that did not have insurance don’t lose hope. There may be other car insurance that will pay your medical bills.
My doctor says I should not work. How will I pay my bills?
PIP benefits include compensation for income you lose if your injuries prevent you from working. This applies whether you are an employee or self-employed.
The minimum PIP benefit for lost income is 70 percent of your gross wages or $3,000 per month, whichever is less, for up to one year.
You must be off work for at least 14 days before you are entitled to PIP wage loss benefits, but your benefits will then be effective from day one. The insurance company will want your employer to verify your lost income.
What are the basic PIP benefits?
These are the minimum benefits allowed under Oregon law. You can purchase PIP coverage with greater benefits. Ask your insurance agent about the extent of your coverage.
- All medical expenses incurred for one year after the date of injury, up to a maximum of $15,000. The medical bills must be reasonable in amount and related to your injury from the accident.
- Wage loss benefits of $3,000 a month or 70% of the average monthly income, whichever is less. You must be “usually engaged in remunerative occupation.” If you are out of work temporarily, wage loss benefits may still be obtainable. You must be off work for at least 14 consecutive days. Insurance companies will often argue that each period of disability must continue for 14 continuous days in order for you to qualify for time loss benefits. We think there just needs to be an initial 14 days of continuous disability, after which any disability is compensable. Wage loss benefits are available for an aggregate of 52 weeks. So you can be entitled to wage loss benefits even after one year from the date of your injury.
- If you do not “usually” work, you can receive up to $30 per day for “essential services.” This benefit applies if you are unable to take care of things like household cleaning or child care and you need to hire someone to do those tasks. This, like wage loss benefits, can continue for an aggregate of 52 weeks. As with wage loss, the disability must be for at least 14 days. Typically the insurance company will want proof of payment and the name, address, phone number and social security number of the person doing the work.
- If you are a parent of a minor and you are hospitalized for at least 24 hours, child care benefits can be claimed up to $15 a day, with a maximum of $450.
- Reasonable and necessary funeral expenses incurred as a result of the accident, within one year of the accident. The minimum coverage required by law is $2500.