Can Cyclists Get PIP Insurance Coverage if They Are Thrown Into a Stationary Vehicle?

Answer: Yes, an Oregon cyclist can get No-Fault PIP medical coverage if they are thrown into a Stationary Car waiting at a Stop Sign. See below for details.

Here at Ross Law, we are constantly fighting to ensure that insurance companies comply with the law and the terms of their insurance policies. This often results in interesting litigation where we get to geek out over what the language in the law and policies actually mean. (Click Here to Read about our USAA Dispute)

For example, we recently represented a cyclist who was hit by a car while lawfully riding his bike on the street. The impact of the crash threw the cyclist into a stationary vehicle waiting at a stoplight. State Farm insured the stationary vehicle.

The law allows cyclists to be eligible for up to $15,000.00 in no-fault PIP medical coverage in certain circumstances. Our cyclist client was eligible for PIP medical benefits, but State Farm denied our request for coverage because they claimed the law required that their insured’s vehicle is moving in order for the cyclist to be “struck by” the insured vehicle.

We obviously had a different take on State Farm’s reading of the law. ORS 742.520(1) and (2) were enacted to ensure that Oregon’s pedestrians had no-fault PIP coverage to pay their medical bills in the event they were “struck by” a vehicle. Cyclists are considered pedestrians under Oregon’s PIP law. As a result, it was our position that in order to fulfill the legislative intent that cyclists medical bills get paid by no-fault insurance; the court had to interpret the phrase “struck by” as the forceful collision between two objects. One could be stationary or both could be moving. The court agreed with our position and granted our Motion for Summary judgment. This means that our cyclist client will be reimbursed $15,000.00 for the medical bills that he paid out of his pocket.

State Farm also likely has to pay our cyclist client’s attorney fees. That means that the cyclist will collect the entire $15,000.00. This is important as it means that the cyclist basically received free legal representation because the insurer that took an unreasonable position should have to pay his legal fees. The court will decide that issue in the near future.

State Farm may appeal the matter. If they do then we are ready to continue to fight. This was a big win. Future cyclists should benefit from our work and won’t be denied PIP benefits simply because the insured’s vehicle was not moving at the time of the crash.

If you are injured while riding your bike and are trying to get your medical bills paid after a crash with a vehicle, call Ross Law at 503.224.1658. Jeremiah Ross is a personal injury lawyer that represents cyclists throughout Oregon and is happy to provide a free personal injury and insurance case evaluation.

Please remember that all cases are different and your facts may not entitle you to PIP coverage if you were a cyclist or pedestrian that was hit by a car. Remember there is a priority of coverage issues that mean if you have PIP insurance of Health Insurance then you may not be eligible to get PIP insurance from the vehicle that struck you. Please also remember the law is constantly changing so please contact a lawyer to obtain legal advice. This post is not intended to be legal advice and is for general education purposes.

5 Things Inured Cyclists Should Know About PIP and Getting Medical Bills Paid

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.

Reimbursement for Transportation to Crash Related Medical Appointments?

Here in Oregon we are fortunate to have Personal Injury Protection Benefits, or "PIP" benefits.  PIP benefits are no fault auto insurance benefits that allow people that are in car crashes to receive up to $15,000.00 to cover crash related medical expenses.  (Click here for a more detailed explanation of all PIP benefits and limitations).   Although the law mandates Oregon Auto Insurers to provide PIP benefits, it is not always clear exactly what are crash related medical expenses.  More specifically, does an Oregon Auto Insurance policy provide benefits to reimburse a person to travel to medical appointments?  Oregon's Supreme Court recently said no.  PIP benefits do not include transpiration costs to receive medical benefits.  

This is a blow to injured people in Oregon that rely on these benefits, and especially rural Oregonians.   This is due to the fact that folks living in urban areas have easy access to medical care.  However, people living on the Oregon Coat, in Southern Oregon, Central Oregon and Eastern Oregon may have to travel hours to see a medical specialist and even stay in a hotel.   Unfortunately, Oregon's Court did not find that argument compelling.

The Oregon Supreme Court  addressed the issue of whether or not medical transportation is reimbursable under Oregon's PIP law, ORS 742.520 (1).  In Dowell v. Oregon Mutual Ins. Co. 361 Or 62 (2017),  the court analyzed the 2007 PIP statute which notes Oregon Auto Insurance Policies must have a provision that that covers:

"All reasonable and necessary expenses of medical, hospital, dental, surgical, ambulance and prosthetic services incurred within one year after the date of the person’s injury, but not more than $15,000 in the aggregate for all such expenses of the person.” ORS 742.524(1)(a)

It is important to note, the law has since changed to allow services for two years after the date of the person's injury.   However, that did not effect the court's analysis in this case.   The court determined ORS 742.524 did not intend expenses for ordinary transportation to receive medical treatment or to obtain medication .  Again this is not good news for injured Oregonians and we can only hope for a legislative fix.   

All hope is not lost though.  You may still be able to recover transportation costs to medical care from the at-fault driver.  If you or someone you know has questions about your PIP benefits please call Jeremiah Ross at 503.224.1658. Ross Law LLC is happy to give you a free telephonic case evaluation.    

Also, remember the law is always changing.   Please rely on the text of the Court's decision and not solely on this post. Also, remember to rely on the current statute as the legislature is constantly changing the laws.   Lastly, this post is not intended to be legal advice and is for informational purposes only.   This could also be considered legal advertising.