If you’ve been in a pedestrian versus vehicle accident, or in a bicycle versus vehicle accident, this article will help you understand which insurance company is supposed to pay for your medical treatment costs.
Insurance adjusters often get it wrong, and even the injured person can end up scratching their head wondering just exactly who should pay, and when. One might reasonably think, “well the at-fault party should pay, right?” The answer is yes, but no, not immediately, except in some circumstances.
OK, let’s cut through the morass. Simply put, when you are a pedestrian, or a bicyclist, and are injured in an accident involving a car, then the first insurance company in line to pay for your treatment costs is your own automobile liability policy. Now you may be saying, “Wait,… what? My car wasn’t involved. I’m not at fault” That is right, even though your car wasn’t involved, and you are not at fault, the PIP coverage offered in your automobile liability policy will be first in line to pay for your treatment costs, even before your health care insurer.
If you don’t have your own automobile liability policy, then the next insurer in line is your own health care insurance. Your health care insurance is second in line, after your automobile liability policy. In some circumstances a pedestrian or bicyclist’s injuries are so significant and catastrophic that the amount available in PIP coverage under their automobile liability policy is exhausted by the treatment costs, and their health care insurance then kicks in to begin covering medical costs. Be aware that both of these insurers have subrogation rights, meaning they have the right to be reimbursed, and can assert that right through a lien against your case settlement proceeds.
Now, what if you do not have any personal automobile liability coverage, nor any health care insurance, then the PIP coverage of the automobile liability policy of the at-fault driver is the next option. Think of this coverage as third in line, after your own personal automobile liability policy and your own health care insurance.
Adjusters for the insurance companies involved, and even lawyers can sometimes get this wrong, particularly when it comes to bicyclists, in part, because of confusion over the meaning of the phrase “self-propelled vehicle” used in the statute, and consequently the policy at issue. ORS 742.518(6). A closer examination of the law elsewhere proves that “self-propelled vehicle” does not include bikes.
What is important to realize is that if you were injured by a vehicle while walking, or when riding a bike, that you can often get your medical costs covered immediately, from a number of different sources. And yes, ultimately the at-fault driver must compensate you fully for your damages and injuries, not merely for your treatment costs.