How to use your Personal Injury Protection (PIP)
When you bought your insurance policy, if you are like most people in Oregon, you were thinking you were getting liability coverage, so if you caused a crash and injured someone, your insurance would take care of them. But your insurance also contains “personal injury protection.” known as PIP.
The idea behind PIP is that if you get injured from “the use, occupancy or maintenance, of any motor vehicle” (ORS 742.520 (2) (a)), then your own insurance will pay up to $15,000 for your medical treatment. If you have paid extra premiums for higher limits, then you may have more than $15,000 in coverage. They will only pay for medical treatment received within one year after the accident, no matter how much or how little of the $15,000 you have spent.
If you are hit by a car as a pedestrian or a bicyclist, and do not have car insurance, you may still have PIP, because there are circumstances in which the PIP for the driver who hit you has to pay your bills.
What PIP Pays
PIP is the first place to go to get your medical bills paid after any injury involving a car. In fact, when your health insurer finds out you were involved in a car crash, they usually will not pay your bills, because they expect PIP to pay them, up to $15,000.
PIP can make a huge difference in your life, particularly if you have no health insurance. But even if you do have health insurance, PIP has no deductibles or copayments, and, within reason, you can go to any medical provider you want. Some PIP policies have a deductible, but Oregon law does not allow the deducible to be more than $250.
If you have been hurt in a car crash and you have auto insurance, use that PIP to get all the medical care you need.
PIP will also pay some of your wage loss, but not all of it. PIP will pay 70% of your normal wages up to a maximum of $3,000 per month. One of the reasons they only pay 70% of your income is that, generally speaking, you do not have to pay taxes on the money you receive from PIP.
But there is a catch. PIP will only pay your wage loss if you miss at least 14 consecutive days of work. To collect wage loss reimbursement from PIP, you need a note from a doctor saying you cannot work for 14 days or more. And you have to miss at least 14 days of work in a row.
People often want to know, “If I use my vacation days or my sicks days so that I am not actually losing wages, can I still get PIP to pay my wage loss?” The answer is, “Sort of.”
You can get PIP to pay your wage loss, but if you have used vacation pay or sick days, then the money PIP pays for wages lost is probably going to go to your employer, not you. Then you would need to negotiate with your employer to get the sick days or the vacation days put back into your account in exchange for the PIP money you have given back to your employer.
If you do not generally work for pay –for example if you are a stay-at-home mom or dad–there is a PIP “wage loss” for you too. If, because of your vehicle-related injuries, you are unable to perform normal household functions (cooking, cleaning, childcare) for 14 days or more, PIP will pay up to $30 per day for you to hire someone to do these things for you. True, $30 doesn’t usually cover the help you need, but it is better than nothing.
How to Get PIP to Pay
To get PIP benefits, you have to cooperate with your insurance company. This means you will need to sign a medical release, which allows them to get your medical records and speak with your doctors to find out if you are really injured. You will probably have to answer some additional questions for them as well. Some insurance companies will require you to give a recorded statement. This can be dangerous territory. If you are thinking of getting a lawyer, you should do that before you give anyone a recorded statement.