PIP Coverage Issues

Personal Injury Protection

Personal Injury Protection (PIP) coverage is no-fault insurance coverage for injuries and lost income arising from an automobile accident. Every policy of private car insurance is required to have PIP coverage. PIP insurance covers up to $15000 in medical, dental, hospital, surgical, ambulance and prosthetic services, and 70 per cent of your lost income, if your disability from work due to your injuries lasts at least 14 days. The maximum benefit for lost income is $3000 per month, for 52 months aggregate. It is called “no-fault” because whether or not the accident was your fault, you are still entitled to PIP benefits so long as your injuries arose from the car accident. Fault is not an issue.

If you are injured in a car crash, the insurance policy covering your vehicle, or the policy covering a vehicle of a family member in your household, will provide PIP benefits for your injury treatment and lost income. If you, or no one in your family owned a vehicle and you were injured as a pedestrian, PIP benefits are available after your primary health insurance, or government benefits have been exhausted.

If you were injured in a car crash, you should receive an application for PIP benefits from the liability insurer covering your vehicle. Be sure to fill this out, sign it and send it back to the insurance company as quickly as you can, If you have any questions about the application, feel free to call me (971-727-9226) and I would be happy to answer your questions.

Insurance companies have walled off, separate departments and adjusters who cover liability coverage claims, property loss claims and PIP claims. If you receive PIP benefits, the PIP adjuster is entitled to review all your injury treatment records and bills to ensure that your treatment is related to injuries caused by the accident and the treatment bills are reasonable. If the adjuster becomes concerned that you are over-treating, they may ask you to submit to an Independent Medical Exam (IME). You are required by law to cooperate with reasonable requests for an IME. If you refuse to cooperate without cause, your benefits may be cut off.

If you have been asked to undergo an IME, give me a call. I am happy to help.

Navigating the insurance landscape can be confusing and stressful. Your Troutdale Injury Lawyer can guide you along the way so that you get all the benefits you are entitled to.

Give me a call at 971-727-9226 to discuss your case. I serve the Fairview, Gresham, Troutdale and the Greater Portland area including Beaverton, Gresham, Hillsboro, Milwaukie, Lake Oswego, Oregon City, Fairview, Wood Village, Troutdale, Tualatin, Tigard and West Linn . I provide free consultation and I do not get paid unless you win. Most consultations are conveniently available remotely, or you may come see me at my office in Historic Troutdale. I work hard to maximize all the benefits you are entitled to.