By Dr. Mike Kam, DC. Updated July 2026.
Oregon’s Personal Injury Protection (PIP) benefit covers a minimum of $15,000 in medical expenses per person, for treatment within two years of the crash (ORS 742.524) — and once either limit is hit, PIP stops paying. What comes next is usually your health insurance, then UM/UIM if you carry it, and sometimes a settlement from the at-fault driver’s insurer. None of that kicks in automatically. It helps to know the order before you’re the one staring at a bill.
How much PIP coverage do you actually have?
Every Oregon policy covering a private passenger motor vehicle is required to include PIP (ORS 742.520(1)(a)), and the statutory minimum is $15,000 in medical, hospital, dental, surgical, ambulance, and prosthetic expenses per person, for costs incurred within two years of the injury (ORS 742.524). That $15,000 is a floor, not a ceiling — some policies carry higher PIP medical limits. Check your own declarations page under “Personal Injury Protection” or “PIP Medical” for your actual number; don’t assume it’s exactly $15,000. Two carve-outs worth knowing: PIP doesn’t cover injuries from operating or riding a motorcycle or moped (ORS 742.520(2)), and insurers can exclude PIP while you’re driving for a rideshare company like Uber or Lyft (ORS 742.520(1)(e)) — that gap is usually filled by the rideshare company’s own policy instead.
PIP also covers wage loss — 70% of lost income, once disability lasts at least 14 days, capped at $3,000 a month for up to 52 weeks (ORS 742.524(1)(b)) — and funeral expenses (up to $5,000), separate limits from the medical benefit. This post is about the medical side, since that’s where most of our patients feel it first.
What actually makes PIP “run out”?
Two different things can end your PIP medical coverage, and either one alone is enough to do it:
- The dollar limit is reached — billed expenses add up to your policy’s PIP medical maximum (at least $15,000).
- The two-year window closes — expenses incurred more than two years after the crash aren’t covered, even if dollars remain.
Most patients hit the dollar limit first, especially with imaging, a specialist referral, or a longer recovery. But if care is spread out — a flare-up eighteen months later, say — the calendar can close the door before the money does.
Will your insurer actually tell you PIP is running out?
There’s no Oregon statute that requires a dedicated “your PIP is about to run out” letter on a fixed timeline — that’s a common assumption worth correcting. What the law does require: if an insurer is going to deny a charge, including one that pushes past the PIP limit, it has to notify you, the injured person, in writing within 60 days of receiving the claim from your provider — stating the reason and how to contest it — with a copy going to the provider (ORS 742.528). Until that denial notice goes out, your charges are presumed reasonable and necessary (ORS 742.524(1)(a)). Separately, Oregon requires insurers to reply to written claim correspondence within 30 days (OAR 836-080-0225), which backs up the advice that follows. The reliable way to track your own balance is your own paperwork — ask your insurer in writing for a running total of what’s been paid against your limit, and ask your clinic’s billing desk to do the same on their end.
What pays next, once PIP is gone?
| Payer | When it applies | What to know |
|---|---|---|
| Your health insurance | Almost always the next payer | Normal copays and deductibles apply. It is treated like any other injury, not a special auto-accident carve-out. If you later recover money from the at-fault driver, your health plan may claim a right to be reimbursed. Oregon limits that sharply: under ORS 742.544 an insurer cannot take reimbursement or subrogation for health benefits out of your recovery until you have first been fully compensated, and any plan language to the contrary is void (ORS 742.544(7)). The real exceptions are Medicare, Medicaid, and a self-funded employer plan under ERISA, which follow federal law instead. |
| UM/UIM | If the at-fault driver had too little insurance, or none | Every Oregon auto policy includes uninsured/underinsured motorist coverage (ORS 742.502) unless you signed to lower it. This is a fault-based claim, not automatic like PIP. |
| A liability claim or settlement | If someone else caused the crash | Oregon is an at-fault state — PIP pays regardless of fault, but everything beyond it is determined by who caused the crash. This is where people often bring in an attorney. |
One thing worth being precise about: PIP itself is a no-fault benefit — it pays regardless of who caused the crash. That doesn’t make Oregon a no-fault state. Oregon is an at-fault (tort) state; PIP is simply a mandatory slice of coverage that pays first, before fault gets sorted out.
What about the bills that show up in between?
In our office, this is usually the point where patients start double-checking their mail — not because anything went wrong, but because the payer changed. Here’s the part worth getting exactly right: while PIP applies, Oregon law caps what a provider can charge you (or your insurer) at the lesser of its general-public rate or the workers’-comp fee schedule (ORS 742.525) — and that cap covers the whole bill, including the part PIP doesn’t pay. What it doesn’t do is erase the bill once PIP runs out. Exhaustion changes who’s responsible for what’s left; it doesn’t cancel it. If a bill looks off, or a provider is charging more than that fee-schedule rate, that’s a fair question to bring to your insurer or an attorney before you pay it. This is general information, not legal advice — for a specific billing dispute, talk to an attorney.
Is this when you need a lawyer?
Not automatically. Plenty of straightforward claims — clear fault, insurance that pays as expected, a recovery that wraps up on schedule — never need one. But PIP running out is a natural point to ask the question, especially if the at-fault driver’s insurer is denying or dragging things out, your recovery is going to outlast what’s left in coverage, or the math between what you’re owed and what’s been paid stops adding up. Sorting out fault, liability limits, and how the different payers interact is an attorney’s job, not something your clinic can advise on.
Frequently asked questions
Does Oregon PIP pay regardless of who caused the accident?
Yes — PIP is a no-fault benefit, paid by your own insurer regardless of fault. That’s different from Oregon being a “no-fault state,” which it isn’t; Oregon is an at-fault (tort) state for everything beyond PIP.
What’s the minimum PIP medical coverage in Oregon?
$15,000 per person for expenses incurred within two years of the injury (ORS 742.524). Some policies carry more — check your declarations page.
Does health insurance cover accident injuries before PIP runs out?
Usually not. Health insurance typically becomes the primary payer only after PIP is exhausted or unavailable.
Do I automatically have UM/UIM coverage in Oregon?
Yes, unless you signed to lower or reject it — Oregon requires uninsured/underinsured motorist coverage on every auto policy (ORS 742.502).
Track it before it becomes a surprise
The best time to think about what happens when PIP runs out is before it does, not after a bill shows up with your name on it. If you’re mid-treatment and unsure where your claim stands against the $15,000, our Oregon PIP coverage guide walks through the full benefit, and our page on Oregon’s PIP claim deadline covers the filing-side timeline. If you’re wondering whether your treatment plan fits inside your coverage, see how many visits most patients actually need, and if a liability claim is in the picture, the difference between PIP and BIL coverage explains what’s next. Book an appointment with Crash Care Clinics if you need care in the meantime — we bill PIP directly and can tell you where your claim stands.
Sources
- ORS 742.520 — Personal injury protection benefits for motor vehicle liability policies; applicability, including the private-passenger-vehicle requirement and the motorcycle/moped and rideshare (TNC) carve-outs.
- ORS 742.524 — Contents of personal injury protection benefits; deductibles ($15,000 medical minimum, two-year window, 14-day wage-loss threshold, funeral benefit limit, presumption of reasonable/necessary charges).
- ORS 742.525 — Provider charges; caps what a provider may charge a PIP patient or that patient’s insurer at the lesser of its general-public rate or the ORS 656.248 fee schedule.
- ORS 742.528 — Notice of denial of payment of benefits (60-day written notice to the insured, with a copy to the provider).
- ORS 742.502 — Uninsured motorist coverage; underinsurance coverage.
- OAR 836-080-0225 — Required claim communication practices (30-day reply requirement for written claim correspondence).
About the author
Dr. Mike Kam, DC is the founder of Crash Care Clinics, a Portland, Oregon auto-injury chiropractic practice. He and his team see auto-accident patients daily, bill Oregon PIP directly, and help patients understand where their claim stands as treatment progresses.
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