What Does Insurance Cover in an Auto Accident?

Our previous blog posting discussed the types and amounts of insurance that Oregon law requires automobile owners to purchase in order to legally operate a vehicle. This article examines in greater detail what the required insurance covers in the event of an automobile accident.

Damage to Your Automobile

Damage to your automobile is covered by mandatory insurance. If your car is capable of being repaired, you may have to negotiate with the insurance company over the reasonable cost of repairs. You can submit the claim either to your own insurance company or, if you believe the other driver was at fault for causing the accident, you can submit the claim to the other driver’s insurance company. If you submit the claim to your own insurance company, you will on some occasions have to pay your deductible – eventually, the at-fault party will reimburse you for the deductible. If the other driver’s insurance policy covers the loss, you will not have to pay a deductible up front.

Sometimes, the insurance company determines that the cost to repair the automobile exceeds the value of the automobile. When this happens, the insurance company declares the car to be a “total loss,” and determines the appropriate cash settlement offer to make to the owner of the automobile. If the insurance company determines the car to be a total loss, the company must notify you in writing of the decision and provide you with any valuation or appraisal reports relied upon by the insurer. We have seen many examples of insurance companies making very low initial offers in total loss cases.  It’s important to scrutinize all valuation estimates and appraisals.  We commonly work with client on these issues and regularly see insurance companies increase their offers our clients or individuals negotiating on their own.

What Does Personal Injury Protection (PIP) Cover?

Your automobile liability policy is required to contain PIP coverage and you can recover appropriate PIP payments from your own policy without regard to fault. PIP pays hospital, medical, surgical, dental, ambulance, and prosthetic services expenses, provided they are reasonable and necessary and incurred within two years after the date of the injury. The law presumes these expenses to be reasonable and necessary unless the insurer denies a service provider’s charges within 60 days of the insurer receiving notice of the claim for services from the provider.

PIP also pays 70 percent of an insured’s lost wages, not to exceed $3,000.00 per month, if the disability continues for at least 14 days. The maximum payment period is 52 weeks.

If the injured person was not engaged in an occupation, and the disability lasts 14 days, the injured person can recover reasonably incurred expenses for essential services, so long as they are performed by someone who is not related to the injured person and doesn’t live in the injured person’s household. The benefit is limited to $30.00 per day for a maximum payment period of 52 weeks.

PIP will also pay reasonable and necessary funeral expenses, not to exceed $5,000.00, incurred within one year after the injury.

Finally, if the injured person is hospitalized for at least 24 hours and has a minor child, PIP provides $25.00 per day for child care, not to exceed $750.00. The statute provides other limitations on the receipt of this benefit.

If you have questions about the applicability of PIP coverage, our experienced lawyers will be happy to discuss your circumstances with you.

If I Receive PIP Benefits, Can I Still Recover Other Damages and Losses from the At-Fault Driver?

In some states, a person injured in an automobile accident must exhaust PIP benefits before filing suit against a negligent driver. Oregon law, on the other hand, permits injured parties to recover from the at-fault party before PIP benefits are exhausted.

Liability Coverage

If you cause a car accident, an injured party will expect you (and your insurance company) to be responsible for the damages you caused. Your policy should cover the damages up to your liability limits. Additionally, if you are sued, your insurer should provide you with an attorney to defend you. It is important to notify your insurer promptly of any accident.

If another person caused the accident, you are entitled to be compensated for all of your losses caused by the other driver. In turn, the negligent driver’s insurance is required to provide coverage for amounts the negligent driver is determined to be liable, up to policy limits. These losses can include property damages, personal injuries, pain and suffering, impairment, and other economic and noneconomic losses discussed in previous articles on this blog. Unfortunately, especially when injuries are serious, our attorneys have learned that insurance companies often take every step available to them to lessen the amount they pay for an injured person’s damages. Always remember the insurance adjuster you’re talking with is paid to give you as little about of money for your injuries as possible.  We take pride in fighting on behalf of our clients to make sure fair compensation is paid.

Call for a Free Consultation

Insurance policies are complicated and insurance adjusters are well-trained and efficient in their efforts to keep the insurance company’s costs to a minimum. At Nelson MacNeil Rayfield, we fight hard to reach a fair settlement with insurance companies. However, if a jury trial is necessary, our lawyers can present your case in its best light to a jury. If you have questions about insurance coverage, or need help with a personal injury lawsuit, please reach out for a free consultation.


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