Disclaimer
Every claim is different. This is a general overview of the typical process.
Understanding the lifecycle of an insurance claim helps reduce anxiety. Here is the typical flow of an auto injury claim in Oregon.
Phase 1: The First 72 Hours (Triage)
- Report the Crash: You call your insurance to open a claim. You get a Claim Number and an Adjuster.
- PIP Opens: Your adjuster confirms your Personal Injury Protection (PIP) coverage.
- Vehicle Inspection: If your car is damaged, they will arrange for an estimate or tow.
Phase 2: Treatment & Recovery (Months 1-6+)
- Medical Care: You see doctors, chiropractors, or physical therapists.
- Billing: Providers bill your auto insurance (PIP) directly. You should not be paying out of pocket (up to $15,000).
- IME (Independent Medical Exam): Occasionally, if treatment goes on for a long time, the insurance company may ask you to see their doctor to confirm you still need treatment.
Phase 3: Property Damage Settlement (Weeks 1-4)
- Repairs: Your car is fixed.
- Total Loss: If the car is totaled, they pay you the "Fair Market Value" of the vehicle. This is usually handled separately from your injury claim.
Phase 4: Demand & Settlement (After Treatment Ends)
Once you are "medically stationary" (fully recovered or as good as you're going to get):
- Demand Package: You (or your lawyer) send a letter to the at-fault driver's insurance demanding payment for:
- Medical bills (repaying PIP)
- Lost wages
- Pain and suffering
- Negotiation: The adjuster makes an offer. You counter-offer. This back-and-forth can take weeks.
- Settlement: You agree on a number, sign a release, and get a check.
Phase 5: Litigation (If Settlement Fails)
If you cannot agree on a fair amount, your lawyer may file a lawsuit. Most cases settle before trial, but filing a suit shows you are serious.