[FOR MEDICAL PROVIDERS] #8 Finding Hidden PIP Policies

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

ANSWER: One of the most important things you can do to help your patient have a full recovery from their injuries from a car accident is to not assume there are no other PIP benefits available to cover their medical treatment. All you need to do is ask your patient a few simple questions to determine if there are hidden PIP benefits your patient may not be aware of.

Your patient not asking 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 is to ask more in-depth questions about possible other PIP policies they may have.

When a patient tells you, “I got a letter from the PIP carrier saying that my PIP is exhausted,” the assumption is that there’s no PIP left. This may mean they will either stop getting treatment, have to pay as they go, or bill 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, right?

It’s important to know that by asking your patient a couple of really simple questions, you can find out if there are hidden PIP policies that can be used.

Let’s say your patient is a passenger in someone’s car, the primary PIP 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 fifteen thousand dollars worth of coverage.

What if your patient has fully used the PIP insurance of the car they were in, and the second PIP policy is exhausted?  What now? 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 collision!

What is important is not to assume there’s no other PIP coverage available; there can be in fact hidden PIP policies — the key is asking your patient these additional simple and straightforward questions.



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