If you were just in a crash in Oregon, the first insurance money you see usually comes from your own auto policy, not the other driver's. That coverage is personal injury protection, or PIP, and Oregon requires it on nearly every private passenger auto policy in the state.1
Our national hub covers what PIP and med-pay are in general. This page stays in Oregon: the exact benefit amounts, the billing caps, and the rules that decide how much of that money you actually keep.
What PIP has to cover in Oregon
Every motor vehicle liability policy issued in Oregon for a private passenger vehicle has to include PIP benefits.1 The coverage follows people, not just the car. It applies to you as the named insured, to family members living in your household, to passengers riding in your car, and to you and your household family if you are hit while walking.1 Motorcycles and mopeds are carved out, so PIP does not pay for injuries you suffer riding one that isn't on the policy.1
The statutory floor is the same at every insurer. Under ORS 742.524, PIP has to pay:
- Up to $15,000 for reasonable and necessary medical, hospital, dental, surgical, ambulance, and prosthetic care, but only for treatment you incur within two years of the crash.2
- 70 percent of your lost income if your injuries disable you for at least 14 days, capped at $3,000 a month for up to 52 weeks. Once you pass the 14-day mark, the benefit reaches back over the whole disability period, not just the days after day 14.2
- Up to $30 a day in essential-services benefits if you don't work for pay (a stay-at-home parent or a retiree, say) and your disability lasts at least 14 days, again for up to 52 weeks.2
- $25 a day for child care, up to $750 total, if a hospital keeps the injured parent for at least 24 hours.2
- Up to $5,000 for reasonable funeral expenses incurred within one year of the injury.2
One catch worth checking on your own policy: an insurer is allowed to sell a version of PIP with a deductible of up to $250 that applies to you and your resident family, so the first dollar isn't always covered.2
PIP pays no matter who caused the crash
Oregon is an at-fault, or tort, state, not a true no-fault state. PIP sits on top of that system as a required add-on. Because it is first-party coverage, it pays your medical bills and wage loss even if the wreck was your fault, and using it does not cut into your right to bring a claim against the driver who hit you.
Which policy pays first is set by statute. If you or a household family member are hurt while riding in your insured car, your own policy is primary, and the same is true for passengers in your car and for you or your family hurt as pedestrians.3 When you are injured in a car that isn't yours, or you are a pedestrian struck by someone else's insured vehicle, the priority shifts and other coverage can come first.3
Where med-pay fits in Oregon
In many states, med-pay is the optional medical coverage you buy alongside a policy. Oregon runs on a different setup. The medical protection that other states sell as med-pay is already baked into mandatory PIP, so there is no separate statutory med-pay requirement here. Some Oregon insurers still offer extra medical-payments coverage as excess protection that starts after the $15,000 PIP medical limit runs out, but that is an optional upgrade rather than something the law forces them to include. If you carry it, it stacks on top of PIP.
How much a provider can bill, and the 60-day rule
Oregon limits what your medical providers can charge PIP. For most services, a provider can bill no more than the lesser of what it charges the general public or the amount allowed under the workers' compensation medical fee schedule published under ORS 656.248.45 Hospitals run on a separate cost-to-charge formula.4
There is a deadline that runs against the insurer, not you. If a PIP insurer wants to contest or deny a provider's bill, it has to send written notice of that denial within 60 days of receiving the claim.6 That 60-day clock is one reason clean PIP bills in Oregon tend to get paid without a fight.
When your insurer has to pay, and your fee protection
PIP is supposed to be prompt, and Oregon backs that up with a fee-shifting rule. If your own insurer wrongly refuses to pay and you have to sue to collect, you can recover your attorney fees on top of the benefits.7 The insurer can only avoid that fee exposure by doing two specific things in writing within six months of your proof of loss: accepting coverage so the only dispute is the amount, and agreeing to binding arbitration.7 Courts have held the offer to arbitrate has to be unconditional, and an insurer that agrees to arbitrate but then refuses to honor the award loses the protection.7 The point of the rule is to put real pressure on a slow adjuster.
What happens to PIP when you settle
PIP is not free money. When you recover from the at-fault driver, your PIP insurer generally has a right to be paid back for what it advanced, through inter-insurer reimbursement, a lien, or subrogation.89 Oregon protects you first, though. Under the made-whole rule in ORS 742.544, a PIP insurer cannot take reimbursement out of your recovery unless you have already been fully compensated for your injuries, and it can only reach the part of the recovery that goes beyond full compensation.9 Put simply, if your settlement doesn't make you whole, your insurer doesn't get to take its money off the top ahead of you.
Deadlines that actually matter
Two clocks run at the same time, and they are not identical. PIP medical benefits only reach expenses you incur within two years of the crash, so putting off treatment can push real injuries outside coverage.2 Your lawsuit against the at-fault driver for a crash injury is a separate deadline, and it has to be filed within two years under ORS 12.110.10 Keep in mind that Oregon's minimum liability limits on the other driver are only 25/50/20 ($25,000 per person, $50,000 per crash, $20,000 for property), which often falls short in a serious injury, so your own PIP and underinsured coverage can be what carries you.11
If you are still pulling records together, your police crash report is handled separately (see our Oregon crash report guide), and if your vehicle itself lost resale value in the wreck, that is its own claim, covered on our Oregon diminished value page. When the bills or the lost wages get complicated, it is worth talking to a lawyer, and you can start with our legal directory.
This is general information about Oregon law, not legal advice.
Sources
-
ORS 742.520, Personal injury protection benefits for motor vehicle liability policies; applicability. Oregon Revised Statutes. https://www.oregonlegislature.gov/bills_laws/ors/ors742.html
-
ORS 742.524, Contents of personal injury protection benefits; deductibles. Oregon Revised Statutes. https://www.oregonlegislature.gov/bills_laws/ors/ors742.html
-
ORS 742.526, Primary nature of personal injury protection benefits. Oregon Revised Statutes. https://www.oregonlegislature.gov/bills_laws/ors/ors742.html
-
ORS 742.525, Charges for services covered by personal injury protection benefits. Oregon Revised Statutes. https://www.oregonlegislature.gov/bills_laws/ors/ors742.html
-
ORS 656.248, Medical services fee schedules (workers' compensation). Oregon Revised Statutes. https://www.oregonlegislature.gov/bills_laws/ors/ors656.html
-
ORS 742.528, Contesting a personal injury protection claim; written notice of denial required within 60 days. Oregon Revised Statutes. https://www.oregonlegislature.gov/bills_laws/ors/ors742.html
-
ORS 742.061, Recovery of attorney fees in action on insurance policy; personal injury protection safe harbor. Oregon Revised Statutes. https://www.oregonlegislature.gov/bills_laws/ors/ors742.html
-
ORS 742.534, Reimbursement of personal injury protection benefits between insurers. Oregon Revised Statutes. https://www.oregonlegislature.gov/bills_laws/ors/ors742.html
-
ORS 742.544, Reimbursement for personal injury protection benefits paid; made-whole requirement. Oregon Revised Statutes. https://www.oregonlegislature.gov/bills_laws/ors/ors742.html
-
ORS 12.110(1), Limitation on actions for personal injury; two years. Oregon Revised Statutes. https://www.oregonlegislature.gov/bills_laws/ors/ors012.html
-
ORS 806.070(2), Minimum amounts of financial responsibility. Oregon Revised Statutes. https://www.oregonlegislature.gov/bills_laws/ors/ors806.html