Insurance Claims Guide

Disclaimer: This guide offers general information about Oregon insurance claims, is not legal advice, and does not create an attorney-client relationship. Consult a licensed Oregon attorney about your specific circumstances before taking action.

Understanding Insurance Coverage

After an accident in Oregon, several types of insurance coverage may come into play. Each serves a different purpose and understanding these coverages is essential to maximizing your recovery:

Oregon Auto Insurance Requirements

Oregon law requires all drivers to carry minimum insurance coverage of:

• Bodily Injury and Property Damage Liability: $25,000 per person, $50,000 per accident for bodily injury, and $20,000 per accident for property damage
• Personal Injury Protection (PIP): $15,000 per person
• Uninsured Motorist Coverage: $25,000 per person, $50,000 per accident

Types of Coverage Explained

1. Liability Coverage

Covers damages you cause to others in an accident where you're at fault. This includes:

• Medical expenses for injured parties
• Property damage to vehicles or other property
• Lost wages and pain and suffering (in some cases)

2. Personal Injury Protection (PIP)

Oregon is a "no-fault" state for medical expenses, meaning your own PIP coverage pays for your medical costs regardless of who caused the accident:

• Covers reasonable and necessary medical expenses incurred within two years of the crash, up to your policy limits (minimum $15,000)
• Covers 70% of lost wages (up to $3,000 per month) for up to 52 weeks
• Provides benefits for essential services you cannot perform because of your injuries
• Requires prompt notice and cooperation with your insurer, so review your policy for any additional conditions

3. Uninsured/Underinsured Motorist Coverage (UM/UIM)

Protects you when the at-fault driver has no insurance or insufficient coverage:

• Uninsured motorist coverage applies when the at-fault driver has no insurance
• Underinsured motorist coverage applies when the at-fault driver's insurance is insufficient to cover your damages
• Covers medical expenses, lost wages, and pain and suffering
• Does not cover property damage in Oregon (separate UMPD coverage is available)

4. Additional Optional Coverages

Many Oregon drivers purchase additional coverage for greater protection:

• Collision: Covers damage to your vehicle regardless of fault
• Comprehensive: Covers non-collision damage (theft, vandalism, weather)
• Medical Payments: Additional coverage for medical expenses beyond PIP
• Gap Insurance: Covers the difference between your car's value and what you owe on a loan

The Insurance Claims Process

Understanding the timeline and steps involved in the insurance claims process helps you navigate it more effectively:

1. Accident Reporting:

   Report the accident to your insurance company as soon as possible. Provide basic facts about what happened, but avoid detailed statements about fault or injuries until you've consulted with an attorney.

2. Claim Assignment:

   Your claim will be assigned to an insurance adjuster who will investigate the accident, review medical records, assess vehicle damage, and determine coverage.

3. Investigation Phase:

   The adjuster will gather evidence including police reports, witness statements, photos, medical records, and possibly statements from involved parties.

4. Coverage Determination:

   The insurance company will determine if the accident is covered under the policy and which coverages apply.

5. Damage Valuation:

   The adjuster will assess the value of your damages, including vehicle repairs, medical expenses, lost wages, and sometimes pain and suffering.

6. Settlement Offer:

   The insurance company will make a settlement offer based on their assessment of damages and policy limits.

7. Negotiation:

   You or your attorney will negotiate with the adjuster if the initial offer is insufficient. This may involve providing additional documentation to support your claim.

8. Resolution:

   The claim is resolved either through settlement agreement or, if necessary, through litigation.

Dealing with Insurance Adjusters

Insurance adjusters work for the insurance company, not for you. Their primary job is to minimize the company's payout while resolving claims. Here are some important guidelines for interacting with adjusters:

What to Remember When Dealing with Adjusters

• Be polite but cautious in all communications
• Stick to the facts when describing the accident
• Avoid speculation about what caused the accident
• Do not minimize your injuries or say "I'm fine" out of politeness
• Do not give recorded statements without consulting an attorney
• Do not accept the first settlement offer without evaluation
• Do not sign medical authorizations that give unrestricted access to your medical history
• Document all communications with the adjuster, including date, time, and content

Common Insurance Company Tactics

Be aware of these common tactics used by insurance companies to minimize payouts:

• Requesting unnecessary information to delay the claim
• Making quick, lowball settlement offers before you know the full extent of injuries
• Disputing the necessity of medical treatment or suggesting you're overtreatng
• Misrepresenting policy coverage or benefits
• Surveillance to catch you engaging in activities inconsistent with your claimed injuries
• Monitoring social media for posts that could undermine your claim
• Using your statements against you to argue you're partially at fault