#8 MISTAKE: Not Finding Hidden PIP Policies

QUESTION: How can I help my patients access all the PIP benefits they have available to them?​

ANSWER: If your patient depletes the PIP benefits for the car they were in during the accident, they may be able to access other PIP policies, including their own car insurance policy — or if they were living with a family member at the time of the accident, they may be able to access the PIP benefits connected to their family member’s auto policy. If your patient needs more treatment and they’ve exhausted their PIP benefit, they can investigate other PIP policies.

Not asking your patient enough questions about possible hidden PIP policies is the eighth biggest mistake that can be made in your patient’s personal injury claim.

One of the most helpful things that you can do to ensure that your patient is able to get all the medical treatment they need to have a full recovery from their injuries from their car accident is to ask questions to uncover additional PIP policies. 

When a patient tells you, “I got a letter from the PIP carrier saying that my PIP benefit is exhausted,” the assumption is that there’s no PIP coverage left. This may mean that your patient will either stop getting treatment, have to pay as they go, or you’ll have to bill their health insurance. Maybe your patient has health insurance; maybe they don’t. Maybe their health insurance doesn’t cover certain types of providers — or it covers such a limited number of visits that it doesn’t really accomplish the goal the health insurance is designed to do.

Remembering to ask a few follow-up questions about other available PIP policies can make all the difference in your patient having access to the medical care they need to make a complete recovery.

Let’s say your patient is a passenger in someone’s car, the primary PIP policy is going to be the insurance policy that covers the car they were in. However, there may be a second PIP policy that can be accessed.

According to Oregon statute,  if your patient has their own automobile insurance — once the PIP coverage for the car they were in during the accident is exhausted, they can then make a claim through their own PIP carrier, and get another $15,000 of coverage.

What if your patient has fully used the PIP insurance of the car they were in, and the second PIP policy is also exhausted? What then? Believe it or not, if they were living with a family member at the time of the collision; an aunt, an uncle, or even an adult child who has their own automobile insurance, they can make a third claim with the PIP carrier of the family member that they were living with at the time of the accident.

Recently we had a client who had exhausted their PIP coverage. We asked if, at the time of the collision, there was a family member living in their residence, who had their own auto insurance policy. Sure enough, our client’s 22-year-old son was living at home, with his own auto insurance policy. That’s how we found the second PIP policy that made it possible for our client to continue to get the treatment he needed and make a full recovery from his injuries.

What about if your patient was injured as a pedestrian? They may actually be able to tap into the at-fault driver’s PIP benefits — but only if other PIP policies and health insurance are not available.

We’re here to be a bridge of support for you and your patients.

We have developed a robust library of information for your patients who have been injured in an accident, which can be found in the INJURED? START HERE portal on our website.

There are 40 topic-focused articles, with accompanying videos, organized into the four categories that include the personal injury claim-related questions we’re asked most often, which include:

• Top 10 Personal Injury Claim Mistakes to Avoid
• What You Need to Know About Your Claim
• How Are My Medical Bills & Wage Loss Paid
• How to Prepare for Your Independent Medical Exam

Each article provides advice and guidelines to help your patients navigate each phase of the personal injury claims process. Whether we represent your patient or not, we are passionate about them knowing how to protect their rights, get the medical care they need, and avoid the mistakes that can harm their personal injury claim.

Each article provides advice and guidelines to help your patients navigate each phase of the personal injury claims process. Whether we represent your patient or not, we are passionate about them knowing how to protect their rights, get the medical care they need, and avoid the mistakes that can harm their personal injury claim.

Additionally, if it would be helpful to have the information we feature on our website available in your office to pass along to your patients, we’ve developed brochures for each of the four article series -- in both English and Spanish that we’re happy to send to your office. Please complete the form below and we’ll get them out to you promptly.