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Motor Vehicle Collision

What are Your Rights?

Most Oregonians are not aware of their rights in regards to being involved in a Motor Vehicle Collision (MVC).  By law, you are allowed to seek treatment for your injuries with any practitioner you choose.  This means you can see a Chiropractor, Massage Therapist, Naturopath, Acupuncturist, Physical Therapist, General Practitioner, or whoever is licensed to dispense care within their scope of practice.  No referral or preauthorization is required.  Do not let a claim representative lead you to believe otherwise!  It is just not true!  
(ORS 742.524)

Oregon is considered a “No Fault State” in regards to a MVC.  What does that mean to an individual that has been involved in a Collision?  In Oregon, your auto insurance company is required to pay medical bills and certain other living expenses such as ongoing lost wages, medication, and in home assistance care while you are recovering from a MVC regardless of who is at fault.  This "No- Fault" coverage is known as Personal Injury Protection (PIP).  Money paid for "reasonable and necessary" medical treatment under your "PIP" coverage is usually reimbursed to your insurer by the insurer of the driver at fault. 

If you are driving or riding in your own vehicle, then usually your own auto insurance company pays your PIP benefits.  If you are riding or driving in someone else’s vehicle, then usually their auto insurance company will pay your PIP benefits.  Sometimes PIP benefits are available even if you are not in a vehicle.  For example, if you are a pedestrian or bicyclist, you may still have PIP benefits under your own or the other party’s auto insurance.  Unfortunately, the law does not require motorcycle policies to carry PIP coverage, and most motorcycle policies do not include this coverage.

PIP benefits are available to you whether or not the collision was your fault.  You will not be penalized for making a PIP claim under your own policy.  However, your auto insurance company is entitled to be reimbursed by the at fault person’s auto insurance company.

If you have been involved in a MVC, you will need to fill out a PIP claim form from your insurer.  You must request this from your auto insurance company to open a claim.  You will also need to report the MVC to the DMV by completing the following form: http://www.odot.state.or.us/forms/dmv/32.pdf.

If the person that caused the collision is not insured, you can file an Uninsured Motorist claim with your own auto insurance company.  In this claim, your own insurance company will function as the company of the at-fault driver and you would be entitled to payment for your medical expenses, lost wages, pain and suffering, and, if your policy allows it, payment for property damage.  Make sure to get witnesses to support your claim.

Only Reasonable and Necessary Medical Bills Paid

Your Oregon No Fault PIP insurance carrier is required to pay all of your medical expenses which are reasonable and related to the collision up to your policy limit (usually $15,000) or within the first year whichever comes first.  Most insurance policies will have the Oregon state minimum limit of $15,000, although, you can increase your PIP insurance coverage limit up to either $25,000 or $50,000 at a nominal cost.  However, an insurer will deny medical bills that are excessive and not related to the collision.  To get the evidence it needs to deny a medical service, an insurer will send you to an insurance company doctor for a so-called "Independent Medical Examination" (IME).  Sadly, insurance company doctors are rarely impartial or independent.  Most insurance doctors will say that your treatment is not necessary-- that explains why insurers use its own doctors rather than yours.

Do I Have to go to the Emergency Room?

If your injuries are serious, by all means go the ER and let them assess you for any life threatening injuries.  This type of Triage care is essential for those types of injuries, but Doctors in the ER are not concerned about sprain/strain or moderate whiplash type of injuries.  The ER is too busy to provide care for the non-life threatening injuries.  Chiropractors are trained to diagnose and treat non-life threatening physical injuries such as sprain/strain and whiplash. 

Wage Loss

If your Doctor instructs you to remain off work for at least 14 days, you are entitled to receive a least 70% of your regular wage rate up to a maximum of $3,000.00 per month.  Your Oregon "PIP" no fault insurance carrier will pay up to 52 weeks of wage loss assuming medical and wage loss verification has met satisfaction of the minimum off-work threshold.

When PIP Refuses to Pay Medical Bills

If the collision was not your fault, you may pursue the at fault driver’s insurance company for your medical expenses as well as your pain and suffering.  If you were at fault, suing your auto insurance company or requesting arbitration is your only option.
 
What If My Medical Bills Exceed My PIP Coverage

If you have health insurance, it usually pays additional amounts.  If you do not have health insurance, you are responsible for amounts exceeding your PIP coverage.

What if I Can’t Take Care of My Children or Myself?

Your PIP insurance coverage also includes Loss of Services expenses. This benefit will pay for expenses reasonably incurred during a period of disability for essential services performed by a person not related to you, the insured, or residing in your, the insured’s, household.  For example, after the collision, if you are unable to cook meals, clean your house, or do your laundry this benefit will pay for these services to be performed.

Child care expenses include those expenses incurred for child care beginning 24 hours after the hospitalization of you, the insured, and continuing until you, the insured, are able to either:

a. Return to work; or
b. Perform essential services

PIP insurance coverage will provide reasonable and necessary expenses for funeral services incurred within one year after the date of the accident.  This benefit usually pays up to $5000.00.

Auto Insurance Companies?

All Oregon auto insurance companies can be difficult to deal with and treat their customers poorly. The Oregon auto insurance companies that I have found to treat their customers the worst are Allstate, American Family, Farmers, Progressive, and Safeco insurance.  I personally would not buy insurance from any of these companies.  Some of the Companies that have been favorable to work with are California Casualty, State Farm, and Hartford.

Insurance companies are businesses whose job it is to pay as little as possible for each claim.  While an insurer has a right to investigate losses, claims examiners are trained to ask threshold questions that will limit or bar your claim without you even realizing it.  Do not give a recorded statement or sign binding documents to the other insurance company without first seeking legal advise from a qualified attorney.

Insurance Companies know that claims generally get more expensive with time, so they offer small dollars right away to limit their exposure. Hence, that is why you see the Farmers and Progressive cars with representatives who respond to the collision scene to offer a settlement.  Your claim is not a race.  Wait until you know the extent of your injuries and that those injuries are resolved as completely as possible before discussing a settlement.  Otherwise, you risk settling short and have to pay for treatment on your own after the claim has closed.

Some people are not aware of the extent of their injuries until much later when symptoms such as headaches, pain, stiffness, burning, or reduced range of motion appear and do not go away.  If you have children involved in the collision, make sure that they receive a complete examination.  Most of the time, children cannot give an assessment of their injury.  Get treatment before making statements about the nature and extent of injuries.  Provide your auto policy number or claim number to all medical providers to help prevent delay in payment.

Do I need an Attorney?

Most MVC are settled without the assistance of an Attorney while others are in need of legal assistance.  My suggestion is that if you feel that you cannot handle the pressure of dealing with an aggressive claim representative, or if you have been denied benefits, you should consult with an Attorney.  I have had the privileged of working with several Attorneys.  My suggestion is to find one that specializes in Personal Injury.  They will have the expertise to complete your claim in a judicious manner.

DISCLAIMER: This site and any information contained herein are intended for informational purposes only and should not be construed as legal advice. Seek competent legal counsel for advice on any legal matter.

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