Step 1 – Figure Out Which Insurance Company Needs to Pay
First of all, to get your bills successfully paid, you need to file one or more claims for personal injury protection benefits, also called PIP. PIP is what I call “health insurance for the car”. So, if you were injured:
- while driving your own car, your auto insurance company will pay PIP first.
- while a passenger in someone else’s car, their insurance company will pay PIP first.
Step 2 – Call the Insurance Agent to Set up a PIP Claim
Follow these three easy steps to get your PIP claim going:
- You will need the PIP insurance policy number to set up the claim.
- The insurance company will give you a claim number and the name and contact for the claims representative who will handle the claim.
- Give your doctors’ billing office the PIP claim number and the claims representative’s name and contact information.
Step 3 – Explore Your PIP Options
PIP will pay at least $15,000 of your medical expenses for treatment within 2 years of the accident. But – you may have additional options, like these:
- You can sometimes get PIP benefits from more than one policy. If you were a passenger in someone else’s car, then their insurance will pay first. If those benefits run out, you can then collect PIP under your own auto insurance policy.
- $15,000 is the minimum – but your insurance policy may have as much as $100,000 in PIP medical benefits, so read the policy.
Step 4 – Find Out What Your PIP Benefits Cover
PIP will pay for all your medical expenses – with limited exceptions. In Oregon, they are as follows:
- $250 deductible: PIP may not pay for the first $250 in medical expenses if the policy has a deductible.
- Are your medical expenses reasonable and necessary? PIP will only pay for reasonable medical bills necessitated by injuries you sustained in a car accident. The insurance company must have some evidence of that, in case they refuse to pay your medical expenses. It must also notify you and your provider in writing that it will not pay within 60 days of receiving the bill. If the insurance company refuses to pay your medical expenses, contact a personal injury attorney versed in insurance law.
- Note that it can happen that your doctor or medical provider refuses to accept the PIP. They can do so legally, so make sure they are going to accept the insurance before you see them. If they deny the PIP and you pay them directly, you can try to get PIP to pay you back. Just know that you might not get paid back in full.
Step 5 – Get Reimbursed for Lost Wages and Other Expenses
Note that you also have some options when it comes to getting reimbursed for lost wages and other expenses, related to your accident. PIP will pay 70% of your lost income – up to $3,000 per month – if your injuries keep you from working for at least 14 days. It will pay for up to 52 weeks of lost income.
Other expenses that you might be able to get reimbursement for:
- Help Around the House: PIP will pay $30 per day if you did not have a job when you got injured. Your injuries must have disabled you for at least 14 days. And you had to hire someone to help around the house.
- Babysitting: PIP will pay up to $25 per day (up to $750 total) for babysitting services for your minor child if you were hospitalized for more than 24 hours.
- Funeral Benefits: PIP will pay up to $5,000 for funeral benefits – if they’re incurred with one year of the accident and a family member dies in a car accident.
Step 6 – Submit Unpaid Bills to Your Health Insurance
If your PIP medical benefits run out, you sometimes have another option. You can try submitting your unpaid medical bills to your health insurer. They may not agree however to pay for the medical expenses you incurred in an accident that was someone else’s fault.
