Ross Law often fields calls from cyclists that were injured by a negligent driver (aka the “bad driver.) Many times the injured bike rider is struggling to figure out the insurance issues and how they can, 1) recover for their lost wages, and 2) get their medical bills paid. Whether or not a person can recover for lost wages (Wage Benefits) or get their medical bills (Medical Benefits) paid largely depends on whether or not they have PIP (Personal Injury Protection) insurance available to them. If you have questions about what PIP insurance is or how much you can receive in PIP, please CLICK HERE to Ross Law’s previous article on Oregon PIP benefits. The big thing to remember about PIP is that it is “no-fault” so it applies regardless of who is at fault.
The following should hopefully assist injured Oregon cyclists to navigate the insurance issues if they were injured in a crash with a bad driver.:
1) Does an Injured Cyclist Have PIP Insurance Coverage? Maybe. Insurance policies issued in Oregon are legally required to provide personal injury protection (PIP) coverage in certain scenarios. Generally, PIP will provide coverage for a cyclist that is injured in a crash with a bad driver. However, it is not that simple. It also becomes a matter of priority of insurance policies. That will be discussed below.
2) If a cyclist was injured in a crash with a bad driver, does the injured cyclist’s PIP Pay for lost wages and medical bills? Probably. Under Oregon law the injured cyclist’s own PIP insurance from the cyclists’s auto policy will pay first. If the injured cyclist does not have their own Oregon Auto Insurance Policy then the injured cyclist’s health insurance should typically pay. Lastly, if the injured cyclist does not have an Oregon Auto Insurance Policy or health insurance then PIP coverage can be obtained through the bad driver’s Oregon Auto Insurance Policy.
3) Can an injured cyclist get PIP benefits if they do not have their own Oregon Auto Insurance Policy? Maybe. It is very common for an injured cyclist to not have their own auto insurance policy. As a result, they may think that they do not have access to PIP benefits. An injured cyclist may be able to get PIP insurance coverage through a resident relative or through a ride-sharing program. If the injured cyclist has no PIP coverage of their own, then the injured cyclist can have access to the bad driver’s PIP to pay medical bills if 1) the injured cyclist does not have any health insurance coverage or 2) the injured cyclist’s health insurer does not pay the full amount of the medical bills (think co-pay expenses or out of network expenses). The bad driver’s PIP may also be responsible for paying PIP wage loss benefits if the injured cyclist cannot obtain PIP coverage of their own.
4) Why Would The Bad Driver’s Insurance Company Refuse to Pay PIP Medical Benefits to an Injured Cyclist? Usually, when the bad driver’s insurer is refusing to provide PIP coverage to an injured cyclist it is because the bad driver’s insurer is not convinced that: 1) the injured cyclist does not have PIP coverage under an Oregon Automobile Insurance Policy, or 2) the injured cyclist does not have health insurance. The bad driver’s insurer will often send out a document titled “Declaration of No Coverage” or something similar for the injured cyclist to sign. If you receive one of these documents you should immediately call a Personal Injury Lawyer to discuss it. Additionally, the bad driver’s insurer may claim that they are only paying reasonable and necessary medical expenses. They may deny payment of a bill because they claim it was not reasonable or necessary. Should that occur, please contact a Personal Injury Lawyer to discuss it.
5) How Does PIP Work if Your Health Insurance Is Paying Some Medical Expenses But Not All? Remember that if the injured cyclist does not have their own PIP insurance but they have health insurance then the health insurance becomes primary coverage over the bad driver’s PIP. As a result, the bad driver’s PIP will only pay medical expenses that are not paid by your insurance company. This can be frustrating as a practical matter because people often have to pay co-pays at the time they seek treatment. If this occurs, then the bad driver’s PIP insurer should reimburse the injured cyclist for the paid co-pay once the bad driver’s PIP insurer receives proof that it was paid. The bad driver’s PIP will usually send a check directly to the injured cyclist a couple of weeks it receives proof of payment (aka proof of loss.)
If you or someone you know were a cyclist injured in a crash with a bad driver, please call Oregon Personal Injury Lawyer Jeremiah Ross at 503.224.1658. Jeremiah Ross has represented injured cyclists for years and is happy to provide a free case evaluation. Jeremiah Ross has also successfully sued numerous insurance companies for failing to provide Personal Injury Protection benefits to injured Oregonians. Pleae remember the law is constantly changing and this blog article is for information only. Please contact a personal injury lawyer if you have questions, comments, or concerns. Do not rely solely on this post.