How Does Personal Injury Protection (PIP) Work in Oregon?
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Personal injury protection (PIP) is a mandatory form of auto insurance coverage for all drivers in Oregon except motorcyclists. Each PIP insurance policy must provide at least $15,000 of coverage per person injured in an accident, which can be used to pay for medical expenses, lost wages and other related costs. You can also choose to purchase a policy with higher limits, often up to $100,000 per person.
How does PIP coverage work in Oregon?
All auto insurance policies in Oregon must include personal injury protection, which provides coverage if you're injured due to operating a vehicle. No matter who is at fault for an accident, personal injury protection insurance pays for your injuries. PIP insurance provides coverage for:
- Medical expenses
- Lost income
- Funeral expenses
- Other expenses stemming from your injuries
Oregon law requires at least $15,000 of PIP coverage, but you can purchase a policy with higher limits if you choose. While not all PIP policies come with a deductible, which can reduce your premiums, this option is available through some insurers. Just note that the maximum deductible allowed in Oregon is $250, so adding this to your policy isn't likely to reduce premiums significantly.
Medical expenses
Oregon PIP insurance provides coverage for all necessary and reasonable medical expenses incurred within two years of an accident, as long as they don't exceed your policy limit. Medical expenses can include a wide variety of procedures, such as X-rays, surgery and dental treatments. PIP also covers your "medical mileage" — transportation costs for necessary trips to the hospital or doctor's offices. If you use your PIP for these costs, though, you must keep very detailed records of all miles driven and transportation receipts to submit with your claims.
While PIP insurance is very broad in what it covers, Oregon insurers can require you to be assessed by a doctor of their choice. If the doctor determines any procedures aren't necessary or reasonable, or says you're healthy enough to work, the insurer can dispute your claim. In that case, you can try to make a claim against the at-fault party's insurer or contest the issue with your own insurer, which will typically require involving a lawyer.
Lost income
PIP insurance in Oregon covers 70% of any wages lost due to injury in a car accident, up to a maximum of $3,000 per month. Benefits aren't triggered until you've missed at least 14 consecutive days of work but will cover lost wages for up to 52 weeks. As with any other expenses you'd include in a claim, make sure to get documentation from your doctor confirming that the injuries caused you to miss work for over two weeks. Also, provide evidence of your income prior to being injured.
Other costs
PIP insurance provides coverage for several additional expenses that might result from a car accident, including:
- Funeral expenses: If someone dies in an accident, PIP provides up to $5,000 for funeral and burial costs.
- Household replacement services: If your injury precludes you from performing normal household tasks, such as cleaning or home maintenance, PIP covers up to $30 per day in replacement services, for up to 52 weeks following an accident.
- Child care during hospitalization: If you need to be hospitalized for more than 24 hours and have a minor child, PIP provides $25 per day for child care, until either you're able to return to work or payments have reached $750 (equivalent to 30 days).
How and when to file a PIP claim in Oregon
Filing a personal injury protection claim in Oregon will not increase your premiums, so you shouldn't be concerned about filing a claim for needed benefits. Oregon's statutes of limitation are fairly strict, so if you're injured in an accident involving a vehicle, you should file a claim as soon as possible.
To do so, contact the insurance company and request a PIP application. This document should be completed with all relevant information about your injuries, the parties treating you and any expenses incurred during treatment. Submitting this form promptly to the insurer not only improves the chances your claim will be addressed, but also shortens the time until you receive PIP benefits.
With which insurer do I file a PIP claim?
In Oregon, if you were in someone else's vehicle at the time of the incident, your primary PIP coverage would be through the policy on that vehicle. Once that coverage is exhausted, you may be able to use your own PIP insurance, if you have a policy, or your health insurance.
If you were a pedestrian or bicyclist injured in an incident with a vehicle, PIP benefits would be available to you in the following order:
- If you have an auto insurance policy, you would first go to your own insurer for PIP benefits.
- If you're not listed on an auto insurance policy but a family member in your household is, you would go to their insurer for PIP benefits.
- If no one in your household has auto insurance, you would rely on your health insurance or other governmental benefits for medical coverage.
- If none of the above situations apply to you, you would file a claim for benefits with the insurer of the vehicle involved.
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How much does PIP insurance cost in Oregon?
The cost of personal injury protection insurance in Oregon varies, depending on the amount of coverage, the deductible and your driving history. As you can see below, higher PIP coverage can increase the monthly cost of an auto insurance policy with minimum liability limits by 22%.
PIP coverage | Total monthly premium |
|---|---|
| $15,000 | $166.76 |
| $25,000 | $174.71 |
| $50,000 | $187.41 |
| $100,000 | $203.29 |
Oregon tort threshold and subrogation
Unlike many states that require PIP insurance, Oregon is not a traditional no-fault state, so there's no threshold that needs to be met before you can sue the at-fault driver in an accident. Assuming the other driver is at fault, you can sue them for costs like medical expenses and lost income, as well as pain and suffering.
If you sue for compensation from the other driver's insurer, that money may be subject to subrogation if it exceeds a certain limit. This means that your insurer may be able to recoup from you some of the money they paid you in PIP benefits, if the settlement from the other insurer is large enough. However, your insurer can't reclaim any money paid unless the amount you receive from both insurers exceeds the total of your economic and noneconomic damages.
For example, say you were badly injured in a car accident and had $25,000 in economic damages, such as medical expenses and lost income. As long as your limits are high enough, your PIP insurer would pay for these expenses. If you decide to sue the at-fault driver's insurer, and they settle for an amount equal to your noneconomic damages (typically pain and suffering) your insurer would not be able to reclaim any money from you, as the payments you receive would not exceed your total damages (Situation A, below).
On the other hand, if the other driver's insurer settles for economic and noneconomic damages (Situation B), your insurer could ask you to repay the amount you received in excess of your total damages.
Situation A | Situation B | ||
|---|---|---|---|
| Damages | |||
| Economic | $25,000 | $25,000 | |
| Noneconomic | $50,000 | $50,000 | |
| Money recovered | |||
| PIP benefits from your insurer | $25,000 | $25,000 | |
| Settlement from at-fault driver's insurer | $50,000 | $75,000 | |
| Difference (can be reclaimed by your insurer) | $0 | $25,000 |
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