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What is my Personal Injury Protection (PIP) Policy?

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What is my Personal Injury Protection (PIP) Policy?

Once you suffer an injury in an automobile accident (bicycle or being hit by vehicle counts as well), your auto-insurance policy will pay $15,000 towards medical treatment reasonably related to the curative treatment of your injuries.

You may have a higher policy, but it depends on your plan.  Very few insurance companies provide any personal injury protection benefits for motorcycles, but it is worth having an experienced personal injury lawyer read your policy.
The law recently changed that allows the personal injury protection amount to be used for up to 2 years after the injury.  You have the right to see any doctor you choose, but having a referral from your primary care physician is always the safest approach.  It is beneficial to use your personal injury protection benefits and then turn to health insurance if you have used up your full policy.

If you cannot work for at least 14 straight days and have a doctor’s order stating you cannot work due to the injury, your personal injury protection will cover 70% of your lost wages at a maximum of $3,000 each month.  This amount is not taxed!
There are also personal injury benefits available for essential needs and services.

Your insurance company may try and cut off your medical benefits by stating they are not related or needed.  The insurance company may even try and have you see one of their “independent” doctors.  Having a lawyer who can protect your interests and file a lawsuit against an unlawful denial is in your interest.

 

The Law About PIP

2015 ORS 742.524¹ 

Contents of personal injury protection benefits

 (1)Personal injury protection benefits required by ORS 742.520 (Personal injury protection benefits for motor vehicle liability policies) consist of the following payments for the injury or death of each person:

(a)All reasonable and necessary expenses of medical, hospital, dental, surgical, ambulance and prosthetic services incurred within two years after the date of the person’s injury, but not more than $15,000 in the aggregate for all such expenses of the person. Expenses of medical, hospital, dental, surgical, ambulance and prosthetic services are presumed to be reasonable and necessary unless the provider receives notice of denial of the charges not more than 60 calendar days after the insurer receives from the provider notice of the claim for the services. At any time during the first 50 calendar days after the insurer receives notice of claim, the provider shall, within 10 business days, answer in writing questions from the insurer regarding the claim. For purposes of determining when the 60-day period provided by this paragraph has elapsed, counting of days shall be suspended if the provider does not supply written answers to the insurerwithin 10 days and may not resume until the answers are supplied.

(b)If the injured person is usually engaged in a remunerative occupation and if disability continues for at least 14 days, 70 percent of the loss of income from work during the period of the injured person’s disability until the date the person is able to return to the person’s usual occupation. This benefit is subject to a maximum payment of $3,000 per month and a maximum payment period in the aggregate of 52 weeks. As used in this paragraph, “income” includes but is not limited to salary, wages, tips, commissions, professional fees and profits from an individually owned business or farm.

(c)If the injured person is not usually engaged in a remunerative occupation and if disability continues for at least 14 days, the expenses reasonably incurred by the injured person for essential services that were performed by a person who is not related to the injured person or residing in the injured person’s household in lieu of the services the injured person would have performed without income during the period of the person’s disability until the date the person is reasonably able to perform such essential services. This benefit is subject to a maximum payment of $30 per day and a maximum payment period in the aggregate of 52 weeks.

(d)All reasonable and necessary funeral expenses incurred within one year after the date of the person’s injury, but not more than $5,000.

(e)If the injured person is a parent of a minor child and is required to be hospitalized for a minimum of 24 hours, $25 per day for child care, with payments to begin after the initial 24 hours of hospitalization and to be made for as long as the person is unable to return to work if the person is engaged in a remunerative occupation or for as long as the person is unable to perform essential services that the person would have performed without income if the person is not usually engaged in a remunerative occupation, but not to exceed $750.

(2)With respect to the insured person and members of that person’s family residing in the same household, an insurer may offer forms of coverage for the benefits required by subsection (1)(a), (b) and (c) of this section with deductibles of up to $250. [Formerly 743.805; 1991 c.768 §7; 2003 c.813 §2; 2005 c.341 §1; 2009 c.66 §1; 2015 c.5 §4]

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