5) After Oregon PIP benefits end, who pays MVA medical bills?
Once PIP benefits exhaust or expire, traffic accident medical bills may be processed through health insurance. To trigger health insurance company payment, fax or email the termination letter you received from the PIP carrier to the health insurer with cover letter asking them pay remaining medical bills from the accident.
Health insurance is not designed to pay medical care caused by a third person’s fault. Most health insurance policies contain language excluding such claims.
Expect the health insurer to eventually seek reimbursement for auto accident medicals it pays. The right lawyer will attempt to negotiate medical lien reductions with the health insurers and medical providers.
TIP: Before PIP benefits expire, request your complete health insurance policy. Review policy terms regarding the health insurers’ reimbursement rights.
TIP: Your health insurers may ask you to sign a “reimbursement agreement” before agreeing to pay medical providers who treat accident injuries. Consult a lawyer before signing any such agreement. Health insurance rights and duties should already be set out in the health insurance policy. However, a health insurer may refuse to process medical bills without a signed agreement to reimburse them.
TIP: Many health insurance policies are subject to deductibles and co-pay. Keep receipts and other evidence of out of pocket expenses. You will need for your claim with the “at- fault” insurance company.