Bicycle Injuries

The best insurance for payment of medical expenses in full is personal injury protection (PIP) insurance coverage.

What is PIP? PIP is optional insurance coverage that is added to an auto policy. In the event of a collision, PIP will help pay for medical expenses, wage loss, and loss of essential services -- regardless of who is at fault. The minimum amount of PIP medical expense coverage in Washington is $10,000, but policies can be purchased that provide coverage of $25,000, $35,000, or more. 

Is PIP insurance mandatory? PIP insurance coverage is not mandatory for individual car owners in Washington state. However, their insurance companies must offer the coverage. RCW 48.22.085 provides that no new liability insurance policy or renewal of an existing policy may be issued unless PIP coverage is offered as an optional coverage. The law states that a named insured may reject, in writing, PIP coverage. The insurance carrier is not required to include PIP coverage in any supplemental, renewal, or replacement policy unless a named insured subsequently requests such coverage in writing.

What else can PIP do? PIP coverage also helps in that you avoid deductibles, co-pays, and limited referral networks, and in most cases should cover medical bills in full as they are incurred.

How do healthcare providers bill PIP? When PIP coverage is available, health care providers should promptly submit records and bills to the PIP insurance carrier, be available to answer questions from the PIP adjuster, and make sure all submitted records are legible, organized, and properly coded.

Where can I get more information on PIP? If you want to learn more about PIP coverage in Washington, you can also visit the Washington State Insurance Commissioner’s website.

How does PIP apply to bicycle injuries? If you’ve been injured in a bicycle collision, you may have two layers of PIP available to you. If the driver of the automobile that hit you has PIP, you are eligible to use the PIP benefits under their automobile policy. Once that PIP benefit has been exhausted, you may also use your own PIP coverage, if you have it, from your own automobile insurance policy.

What if PIP coverage isn't enough? Oftentimes, the minimum PIP coverage of $10,000 exhausts before you reach maximum medical improvement and get released from care by your primary doctor. This is especially true where you are taken by ambulance from the collision scene to a hospital for emergency care. Other times, you may have no PIP coverage available. In either situation, the primary insurance for immediate payment of medical expenses is any available health insurance.

What does health insurance in Washington typically cover? Most Washington health plans will cover chiropractic care, massage therapy, physical therapy, and acupuncture pursuant to WAC 284-43. Billing health insurance is subject to the terms of any contract that the health care provider has with the particular health plan. This means that there may be limitations on the number of treatment visits and covered conditions. You may need to obtain referrals for care, and deductibles and co-payments will apply. 

What do I do if I am injured but don't have any insurance coverage? If you do not have PIP coverage, health insurance or worker’s compensation insurance that will cover your medical bills, you can seek medical care and ask that the health care provider “hold” their bills through use of a medical lien against any future settlement with the person that caused your injury.

In what situations can a medical lien be filed? A medical lien can be filed when there is a third party responsible for your injuries AND you have outstanding medical bills associated with those injuries because:

1. You have already exhausted your PIP coverage; or
   
   
2. There is no PIP coverage, worker’s compensation, or health insurance available.

How does a medical lien work? If you still have outstanding medical bills and you have run out of insurance options, a health care provider can hold your medical bills for payment from any settlement with the at-fault party’s liability insurance carrier. This is known as a medical lien. Medical liens are governed by RCW 60.44. 

How should I proceed once a medical lien has been filed? By asking any health care provider to file a medical lien, the provider has the right to enforce the lien against any final settlement of your claims with the insurance company for the at-fault party. You should monitor how much you owe for the treatment you are receiving so that you are not surprised by a big outstanding bill that might make settlement of your claim difficult.