The Oregon legislature recently passed legislation regarding auto insurance that will be helpful for Oregonians seriously injured in a car crash, as well as the Oregon doctors and hospitals who treat them. Senate Bill 411 does a number of things regarding Personal Injury Protection insurance, as well as Uninsured Motorist and Underinsured Motorist insurance coverage.
First, in regard to Personal Injury Protection, this is the type of coverage that a passenger gets from the car they are in, which covers medical expenses up to one year (or a maximum of $15,000 in most cases) or whenever the insurance company decides to terminate their care with an insurance doctor’s examination. In addition, “PIP” insurance can cover up to 70% of a person’s monthly wage loss (or a maximum of $3,000 / month) for one year if a doctor confirms the person is unable to work after a car wreck. Oregon has historically had a limitation of only one PIP policy’s coverage. With many of our seriously injured clients, the $15,000 in medical coverage is used by an ambulance ride and an ER visit on the first day of the crash. The client is then left with no ability to receive any additional medical care for their injuries. Any payments made by the auto insurer (or their health insurer), and any doctors who will see them on a lien, all have to be paid back out of the settlement or verdict. When all of the PIP is used early due to the severity of injury, this can leave Oregon doctors waiting for years to receive payment if they decide to provide care to a patient who doesn’t have additional insurance.
The new legislation improves PIP slightly for those seriously injured. In the event a passenger is in someone else’s car with Oregon auto insurance, but they have their own separate Oregon auto insurance policy, the new legislation allows injured people to “stack” those two PIP coverages together so that the person can get the benefit of the insurance they paid for, in addition to the coverage available in a car owned by someone else. (This stacking will not apply if someone is injured in their own car, as it is only one policy that covers both the car and the person.) Stacking will allow some individuals to get a bit more insurance coverage for medical care to cover part of their staggering medical bills caused by someone else’s negligence. The legislation also requires PIP policies to extend payments out to two years, which is more in line with what medical literature says is the period at which doctors can determine whether a serious injury is permanent or not.
All this said, insurers can and do regularly terminate care for injured people before the PIP insurance is intended to stop. Under Oregon’s PIP laws, which remain in effect, insurers can terminate care anytime the insurance doctors terminate an injured person’s healthcare coverage. This is a shadow industry known to very few people who have not been injured, in which doctors can make a career out of terminating injured people’s care, rather than treating patients to help them. More than any other cause, our clients hire a lawyer because their own insurer attempts to terminate their ability to receive medical care with an “Insurance Medical Exam” or “IME.”
Senate Bill 411 also addresses a long standing problem regarding “Uninsured Motorist” (sometimes called “UM” insurance) or “Uninsured Motorist” (often called “UIM” insurance) coverage. This is the type of insurance coverage that is required in Oregon to cover instances where an Oregonian is injured either by someone with no insurance, or by someone who has too little insurance for the injuries they cause. Approximately 1 in 7 motor vehicle crashes in Oregon involve at-fault drivers who are not insured and many more drivers don’t have enough insurance for the damage they cause. This is particularly true in cases where there are serious and permanent injuries where the personal and financial losses will be high for the injured person.
Historically, Oregon’s Uninsured Motorist, and Underinsured Motorist laws have been subtractive. If the at-fault driver had $25,000 in insurance coverage, and the injured person had $25,000 in Underinsured Motorist coverage, the injured person could only get $25,000 total no matter how big their medical bills were, how much money they were going to lose by not working in the future, or how severely they were injured. Oregon law allowed insurers to subtract the amount of the at-fault driver’s insurance from the injured person’s own Underinsured Motorist insurance, sometimes leaving the person with no insurance benefit despite paying money for underinsured motorist insurance coverage. Senate Bill 411 changed the law to allow UM/UIM policies to “stack” on top of the coverage available from the insurance of the at fault driver. This means now, if the driver who caused the crash has $25,000 in liability coverage, and the injured person has a $25,000 Underinsured Motorist policy, the injured person could conceivably have access to $50,000 in coverage rather than $25,000. This will be of some benefit to our clients, although we will still face cases where there are medical bills and personal losses that are many times greater than all insurance policies added together. Part of our job in such cases is to get as much of the insurance policy we are able to obtain, and then negotiate with ambulance companies, hospitals and medical clinics to minimize the lifelong debt that our client will have due to someone else injuring them.
Overall, this is a step in the right direction for Oregonians, although Oregon’s ongoing lack of bad faith insurance laws allow insurers to continue abusing injured people and business policyholders by failing to pay the claims and forcing people into litigation for serious, life altering losses by making settlement offers that are a fraction of their actual value. This is why seriously injured people, and businesses with large insurance losses are forced to hire trial lawyers to take the insurers to trial.
Our firm deals with a large percentage of Uninsured and Underinsured Motorist cases because we handle serious injury claims where the person who is at fault either didn’t have insurance, or didn’t have enough to cover our clients losses.
It is important that before you settle a case on your own, that you consult with a lawyer to determine if you will destroy your own Underinsured Motorist claim, as certain steps must be taken before settling a claim with the at-fault driver.