Personal Injury Protection
PIP is the acronym for “Personal Injury Protection.” PIP is additional insurance coverage added to your basic required automobile liability insurance. Since I am licensed in both Oregon and Washington as a primary care physician, I am familiar with the insurance laws of both states.
PIP is REQUIRED coverage in Oregon. Oregon law requires a minimum coverage of $10,000.00. PIP is NOT required in Washington. Hence, there are many Washington drivers that do not have any PIP coverage in their automobile insurance policy. There are even some drivers that are not aware they do not have any PIP coverage. This is really sad. When the consumer shops around for the cheapest auto insurance policy, some companies will make an insurance quote, without the PIP coverage, to make the policy more attractive, in terms of cost alone.
Not having PIP coverage is a real big mistake. I’ve had, and still have, many patients who either purposely declined PIP coverage to keep their policy costs down, or were not aware their policy did not include this coverage, and/or they did not understand what PIP covers. Allow me to explain:
When you are involved in a MVC “Motor Vehicle Collision”, you will likely need some medical attention. A very important side note: Never, never settle with the at-fault insurance company right away. They will make you an attractive offer. They will do so quickly, for a reason. Even a five mile-per-hour rear-ended collision, “whiplash”, will result in substantial damages to your upper back, neck, and head. Just watch the impact studies performed (filmed with rapid film, then played back in slow motion), with dummies. Even when the dummies are seat belted in, with a good headrest; it is impressive, the amount that their upper body, neck, and head, are violently thrust about. The bodily damages that result from a rear-ended collision, do NOT manifest until about eight (8) weeks AFTER the MVC. (This is precisely why the at-fault insurance companies will make you a cash out offer, really fast.) Then, in about 8 weeks after your MVC, out of the blue, your upper body, neck, and head; are now hurting like you never imagined. You will also be getting some violent migraine headaches as well, from your upper body and neck muscles which insert at the base of your skull. These are called trigger points, which when pulling at the base of your skull, will give predicable headache patterns; usually that seem to go up the back of your head, over the top, to the front, then settle behind your eyes. If bad enough, then jump down to your TMJ (the joint that opens and closes with you eat food), giving very painful TMJ pains. Seek medical help ASAP after your MVC for your best chances of the fastest recover. The “standards of care” of the medical doctors is/and has been for years, Vicodin and Flexeril. These simply mask the pains. The alternative care doctors “standards of care” is massage with Chiropractic. While the Chiropractic portion is needed, this “standards of care” fails to address the damages done to your brain stem. Your brain stem, when concussed, (which occurs with a simple five mile-per-hour accident), usually will slow down brain signals from passing from your brain, through your spinal cord in your neck, down the rest of your spinal cord. It is like the constriction in an hour glass. The results will be feelings of being “discombobulated,” “can’t get it together”, etc. There could also be vestibular damages (inner ears) which results in a person losing their balance when they are standing, their eyes are closed, and a friend gives them a gentle push. The best “standards of care,” from my 20 years experience working with MVC patients, is a combination of spinal manipulation (chiropractic, osteopathic, or naturopathic, all are the same), married into FSM “Frequency Specific Microcurrent”. (Details of FSM are on this website, in the index, under “FSM”.)
PIP coverage pays for any and all medical treatment provided by a licensed physicians, regardless of who is at fault in the MVC. You simply go to the physician(s) of your choice, give them your PIP claim number, which was provided by your insurance company when you reported your MVC. No money is required from you personally. Your doctor will bill your insurance company directly. After you are fully recovered from your injuries, then your insurance company will get reimbursed for the money they paid your doctor(s), from the at-fault insurance company. The doctors and the insurance companies do the paperwork, you just concentrate on getting better.
NO PIP? Here is what is going to happen: Most doctors will not take on a patient who does not have any PIP coverage, unless that patient pays out of pocket, each and every time, at times of service. Since most patients do not have that kind of money in their savings account, they have a problem. They will need to find a doctor who is willing to work for free, taking a huge change that their medical bills will eventually be paid in full, at some later date. What normally occurs after the patient has recovered to their “pre-MVC health status”; is the at-fault insurance company will make an offer for settlement. Their usual offer will usually start at about ten (10) cents to the dollar, up to maybe 25 or 50 cents to the dollar. If for example, your total medical bills, including any ER or ambulance, is $20,000.00, their offer for settlement will start at about $2000.00, and will stop at about $8000.00. Then the patient finds they still will owe between $18,000.00 to $12,000.00 in unpaid medical bills. This does not even include the “pain and suffering” compensation to the MVC victim that is normally considered in the final offer. Then what? Now the patient has to hire an attorney, with the attorney’s additional and very high fees. Then there are discoveries, negotiations, arbitrators, possible court dates. All in all, figure at least five or more years before your MVC case has any chance of being settled. Your doctors will have to wait about five, or even more years, to maybe get paid, hopefully in full, but likely not. It is a real mess. You will owe the unpaid balance.
How much PIP? $10,000.00 coverage is NOT enough. With ambulance and ER fees, then appropriate ongoing needed medical care, this amount can get used up quickly. Get at least $35,000.00 coverage. Some companies even sell $100,000.00 coverage. (It is not expensive coverage.)
“IME exams”: IME is the acronym for “Independent Medical Exam.” If you are ever in a MVC, eventually either your insurance company, or the at-fault insurance company, may require to you go to an “IME.” (Depends on the insurance company, some are notorious.) The IME doctor is hired by the insurance company to provide an unbiased appraisal of your current health status, in relation to your MVC injuries. (Are your current pains a direct result of the MVC?) Over the last 20 years, it is interesting that in all my patient’s IME exams, the IME doctor has always ruled in favor of the insurance company. (The patient’s ongoing medical care is permanently terminated.) It is also very interesting, that one of my patients, in whom I instructed both my patient and his attorney, how an IME is conducted. (The attorney was not aware.) Hence, my patient’s attorney then hired me to attend his client’s IME exam, as a professional witness. When the IME doctor discovered another doctor was going to be present to validated the IME exam, the IME doctor quickly canceled the IME. That insurance company has demanded that my patient sign a waiver, stating he will not bring a doctor to the exam with him as a witness. (My patient is very willing to go to an IME, as long as he can bring both his attorney and a doctor to validate the IME exam.) That insurance company cannot find a single IME doctor who will perform the IME, with another doctor present. Now tie in that every IME exam on every patient of mine over the last 20 years, has somehow always ruled in favor of the insurance company. My question is this: Is there anything “independent” and about an “Independent Medical Exam.?” I predict in the future, insurance companies will begin adding language to their policy contracts, that will prevent any patient from bringing any outside doctor as a professional witness to the IME exam. I further predict, eventually, this will have to go all the way to the Supreme Court, to invalidate such policy language. Since insurance companies exibit such a huge amount of power, this will likely take years to be corrected, if this is eventually put into insurance policies. How many patients will loose their rights to a fair IME until such language would be declared illegal? Worse, how many patients will still have lingering health issues after their MVC because they were cut off pre-maturely?
Do yourself a favor and get at least $35,000.00 PIP coverage. It is not expensive. If you get into a MVC, find a doctor in your area who specializes in FSM (Frequency Specific Microcurrent), and can also perform spinal manipulations (Naturopathic, Osteopathic, or Chiropractic), and/or works closely with another qualified physician who can assist.
If you have any questions, there is so much more I could say, give me a call.