Most people we talk to after a crash have the same three questions, in the same order. Am I hurt? Can I afford to find out? Who do I even call?
This post is about the middle one. It's general information, so your actual policy always has the final word, and none of it is legal advice.
What is PIP?
PIP stands for personal injury protection. In Oregon, every auto policy includes it, and the required minimum is at least $15,000 in medical expenses per person. It's no-fault coverage, which means it can pay for reasonable and necessary care after a crash whether or not you caused it.
That's the part people don't expect. You don't have to wait for the other driver's insurer to accept blame before you get looked at.
The time limit
PIP generally applies to medical expenses incurred within two years of the crash. That's longer than most people assume, but it doesn't mean waiting is smart. Care that starts closer to the accident tends to be easier on your body and easier to document.
What "reasonable and necessary" means in practice
That phrase matters. Insurers can review whether care is reasonable and necessary, which is one reason your records need to show what was found, what was done, and how you responded. It's also why we keep the notes we do.
What about missed work?
PIP can also help with lost wages. The basic rule is 70 percent of your income, up to $3,000 a month, if your injuries keep you off work for 14 or more consecutive days, with a cap of 52 weeks. Whether and how that applies to you depends on your policy and your situation, so ask your agent or insurer directly. Our post on getting back to driving and work after a crash covers the practical side.
Where does MedPay fit?
Some drivers also carry medical payments coverage, often called MedPay, as an add-on. If you have it, it may help with costs beyond what PIP covers. The easiest way to find out is to look at the declarations page of your policy or ask your agent how the two work together on your account.
How billing works here
At Cedar, we bill PIP and MedPay directly, so most patients don't pay out of pocket to get started (see the insurance we accept). Here's the usual order of things:
- Call your insurer and open a claim. You'll get a claim number.
- Call or text us with that number and your insurance card.
- We verify your benefits and bill the carrier. You focus on getting better.
If an attorney is involved, we can work with attorney liens and coordinate records. More on that in working with your attorney and your chiropractor.
Mix-ups we hear a lot
"PIP only applies if the other driver was at fault." It's the opposite. PIP is no-fault, so it can apply either way.
"I have to wait for the other insurer." You don't need anyone to accept blame before you get looked at. You open the claim with your own insurer.
"It's unlimited." It isn't. The required minimum is $15,000 per person and your policy may carry more, so ask how much you have and how much has been used.
"PIP and a claim against the other driver are the same thing." They aren't. PIP is your own coverage for your own medical bills. Whether there's a separate claim against someone else is a legal question for an attorney, and not something we can advise on.
Before your first visit
A short list helps: your insurance card, your claim number, your adjuster's name, and a photo ID. If you were seen at an ER or urgent care in the first few days, bring those papers too. Bills from those visits may also be something your insurer can handle under PIP, so ask them how to submit them. Your policy governs, and it's worth getting the answer in writing. The days right after a crash have their own to-do list, too; see what to do in the first 72 hours.
Questions to ask your insurer
- How much PIP do I have, and has any of it been used?
- Do I carry MedPay on top of PIP?
- Is there anything I need to do to keep my claim open?
- Who is my adjuster, and how do I reach them?
Write the answers down with the date. If you'd like to know what to keep for your own records, how documentation supports your claim goes into it. Our new patient page covers what to bring, the auto injury page explains the full process for Milwaukie, Oregon City, and Gladstone patients, and you can always reach us through the contact page.
Not sure what your policy covers?
Bring your insurance card and claim number. We'll help you sort out how billing works before you commit to anything.